Wednesday, October 17, 2012

Post Op

     If you are just stopping in, this is the seventeenth post in my 31 Day Series:  I Wear Pink.  I was diagnosed with breast cancer on February 18, 2009.   This series is about my journey with breast cancer.  You can find the previous posts here.

Day 17:  Post Op

       One week after the surgery to remove the cancer in my left breast I went for my post op check up.  I saw the doctor and Sara.  There was a lot to go over and discuss.  I was healing well.  I had good use of my left arm.  The swelling had subsided somewhat. There were a few areas of blue stain remaining from the dye that had been injected and some bruising.  The surgical report was in.  Sara told me that I had a "busy breast."  First I was lumpy, now I was busy.  I preferred busy to lumpy. 
       During the surgery two sentinel lymph nodes had been removed.  They were both clear of cancer.  This was important because it was more likely that the cancer had not spread beyond the breast.  Had they been positive for cancer, a lymph node dissection (removal of the lymph nodes in the breast and underarm) would have been done as well and a drain would have been put in place.  The surgical pathology report confirmed that both sentinel lymph nodes were negative for tumor cells.
     The breast mass had been removed with clear margins.  The surgeons goal is to remove all of the breast cancer along with a rim of normal tissue around it.  This is to be sure that they get all of the cancer.  When the margins are clear no further surgery is needed.  This was also good news.
     In addition to the cancerous mass, the doctor had removed two other areas.  The first was a benign, non cancerous tumor.   The other was a precancerous type of tumor.  
     The surgical report also showed that the cancer was fueled by estrogen.  This meant that the estrogen in my body promoted the growth of the type of cancer that I had.   Hormone therapy would be prescribed for me by an oncologist to keep the cancer from returning.  Standard treatment for breast cancer is surgery, chemotherapy, and then radiation.  Now my busy breast was offered the possibility of a game changer.
      I was invited to participate in the Tailor x study.  This stands for: Trial Assigning Individualized Options for treatment Rx.  My tumor met the requirements for participation in the study. This study was for women with early stage breast cancers to determine if hormone therapy alone was as effective as hormone therapy with chemotherapy.  The tumor would be tested, the test is called an oncotype, to determine if the cancer was one that would be likely to reoccur.  The tumor is looked at the molecular level.  It would be rated.  Higher scores on the oncotype were more likely to reoccur.  A score of 10 or less would receive only hormone therapy.  Scores of 11-25 would be randomly assigned to hormone therapy alone or hormone therapy with chemotherapy.  Scores of 26+ would have hormone therapy and chemotherapy.  Agreeing to participate in the study meant that my tumor would be further examined to determine if cancer was likely to return.  That was information that I wanted to have.  There was also the possibility that I would have a low number and not require chemotherapy.  I agreed to sign up for the study.  I would find out the results of the oncotype at my first visit to the oncologist. 
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