A date.

The results of the biopsy on my right breast did not show a malignancy. It did show hyperplasia and some atypical cells in both the duct and lobe. These findings are consistent with a precancerous condition and with some studies reporting up to 50% of these becoming malignant over time (Love, 2005). Dr. Stoller said we could do an open biopsy to find out for sure prior to my surgery if I wanted. That didn't seem to make sense to me. If there is a chance of these things becoming cancerous in my life, why wouldn't I just get rid of them now? So...I am scheduled for a bilateral (that's both sides) mastectomy with sentinal node biopsy for tomorrow, February 15 at 3:00 pm at the Piper Center at Abbott Northwestern Hospital. She is going to treat the right breast as if it is malignant as well. Anybody wear a 36A bra...I've recently purchased some very nice ones!

Some information on lymph nodes. You've got them all over your body. They drain lymph which is a clear fluid that travels through your body's arteries and circulates through your tissues to cleanse them and keep them firm, and then drains away through the lymphatic system. Lymph nodes are the filters along the lymphatic system. Their job is to filter out and trap bacteria, viruses, cancer cells, and other unwanted substances, and to make sure they are safely eliminated from the body. Cancer cells that invade the tissues can enter the lymphatic system where they can then travel all over the body. That is what makes cancer spread from one place to another. That is the big unknown worry with cancer care. Have those nasty little cells jumped into the lymph system and taken a ride.

To try to answer this question, Dr. Stoller will sample my lymph nodes to see if there are cancer cells lurking there. But you have alot of lymph nodes in your chest and breast so to sample the right ones, she will do a procedure called a sentinel node biopsy. I thought the process was interesting. 3 hours prior to my surgery, the radiologist injects radioactive dye into my breasts. When I get to surgery, Dr. Stoller will use a geiger counter to identify which lymph nodes drained the radioactive dye from the breast. These are the nodes that are most likely to hide the cancer cells. These are the lymph nodes that she will remove for pathological examination. While I am still asleep, the pathologist will examine then to see if there are cancer cells in them. If there are not, Dr. Stoller will quit there. If there are, she will take more lymph nodes out. She is going to do this procedure on both sides. After surgery, we will find out if my lymph nodes have cancer in them. If they do, that means there is a chance that the cancer has spread to other parts of my body. If they don't, the chance of spread is less likely. Future care (like chemotherapy or radiation) is determined partly by the examination of the lymph nodes.

So... how am I doing?

Everyone asks that. My quick response is ok. It's also the socially acceptable response. The fact is, this is a tough question to answer. In one moment I feel stong, confident and resilient. In the next, not so much. For example, yesterday I hugged Mary and it popped into my head that these moments might be numbered. What if this hug is one of a finite number that I have left? Then I cry and it passes. Later, the confidence returns and I list all of the reasons why this is going to all be fine: I found it early, it's small, I trust my surgeon, etc. And so the cycle continues. Don't ask me how I am unless you really want to know.

So tomorrow I have a date with my future. I haven't been so anxious for a date since I was on my way to meet Mary Mohn for the first time nearly 11 years ago. Please think of me tomorrow. I have to be there at 1:00 pm to begin the sentinel node mapping.

Reference
Love, S. M. (2005). Dr. Susan Love's Breast Book, 4th Ed. Cambridge, MA: Da Capo Publishing.