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Pathology Report

Short Version: The Pathology report from the Lumpectomy came back negative for further cancer. Good News!

Long Version: Preston, Ben and I went to my follow-up visit with the surgeon. Dr. James gave us the Pathology report.
This is what it said:
Microscopic Diagnosis:
1. Sentinel Node #1: Negative for tumor
2. Sentinel Node #2: Negative for tumor
3. Biopsy Cavity, Excision:
Extensive lobular carcinoma in situ with severel FOCI less than 1mm from the inked surgical margin
Extensive atypical lobular hyperplasia with several FOCI less than 1 mm from the inked surgical margin
Sclerosing adenosis with microcalcifications
Extensive biopsy site changes
Negative for residual invasive carcinoma.

What that means (as I understand it) is they found precancerous cells, but none that are cancerous in any of the tissue they removed.

This also probably means Chemo and Radiaion therapy is advised. I now have appointments with the Oncology Dept at St Mary's in Walla Walla. I will meet with both the Chemo Doctor (Quackenbush) and the Radiation Doctor (Nigrin) on August 13th. At that time we will learn about what is in store for the months ahead.

Dr. James check the incision sites and was very pleased with how they looked. I must say they are much better looking than the first surgery!

I am going to enjoy August since I probably won't start Chemo till the end of the month. Next week we are going to see my family, (Dad, Mom, 2 sisters, 1 brother, 2 brother in laws, 1 sister in law, 4 nieces) and Preston's brother Wes, and sister in law Debbie... and hopefully more)

Thank you for your prayer and encouragement.

Feeling Good

I am amazed at how good I feel. The discomfort and bruising from the lumpectomy is minimal, no ill effects from anesthesia. This is much better than the biopsy. Wow, what a difference! The projected good news about the lymph nodes is encouraging as well.

By the way, I really like the glue and tape strips instead of stitches. They keep the area dry, don't feel like it is pulling.... yep a definite improvement..

I was able to get out yesterday and water flower pots in the barnyard (they needed it!) and of course when I get in the area where there are weeds to pull.... I just can't resist. I pulled quite a few :) Preston made me promise to only use my left hand. I mostly complied. It was great to get out and DO something. :)

Preston didn't let me help with digging the new steps in the barnyard. He made me sit and just be an adviser/supervisor.

Lumpectomy

Short version: Surgery went well and it appears there is no cancer in the Sentinel Nodes. Now waiting for lab results for confirmation.

Long Version: This morning I woke up earlier than necessary so I got up to enjoy a leisurely morning with no breakfast. I checked Facebook and my farm on FarmTown :) While doing that a 7 A.M. I got call from the hospital asking me when my appointment was. That made me laugh out loud. Shouldn't they be telling me when my appointment is? Anyway, the jist of it was... we have openings earlier. Come as soon as you can.... but don't speed, be safe. Crazy huh!

So, Preston grabbed his breakfast and we went. We were able to fairly quickly negotiated the admitting and pre-op stuff. They did have trouble getting the IV started (was wishing Ben was doing it ;) But after they warmed up my arm they got that going.

Off to surgery at about 10 A.M. Surgery took about 1.5 hours

After surgery Dr. James told us that it went very well, he found 2 sentinel lymph nodes that looked very good. The part I like was that he remove a good sized hematoma from the previous biopsy site and this should improve the healing and comfort of the right breast. YaHoo!

We are very pleased with the report from surgery and expect that the lab results will confirm the doctor's initial assessment.

I have eaten and feel good in that regard. I am a bit woozy and bit uncomfortable in surgery areas. I am hopeful that Tylenol and Advil will control that, but I do have a prescription for Oxycodon if I need it. (I hope not)

I am overwhelmed with all the love, care, support and prayer from all of you; my wonderful friends and family. God has surrounded us with His peace and comfort.

Thank you, may God bless you for being His hands and heart in my life.

MRI Results

Today we met with Dr. Charles James (surgeon) to get the report on the MRI.

Short Version: No other evidence of cancer anywhere!

Long Version:

I went to this appointment with a fair amount of anxiety. The last few appointments had delivered progressively worse news. I was anticipating the worst.

When the nurse called me back I sensed a lighter tone.... wishful hoping? Then she put us in a different room than the 2 previous appointments. I am thinking....maybe there is a good news room and a bad news room ;)

Dr. had just returned from a vacation in the Colorado, Utah area with his family. They did some rafting on the Colorado River. We visited about that and compared rafting trips. We rafted the Payette River in Idaho (South Fork Canyon) He shared that they were disappointed, they were not participants in the raft trip..just spectators. There were only class 2 and 3 rapids. It was more of a float trip than rafting. We on the other hand had a fabulous participative raft trip with many 3 and 4 class rapids and some great pictures to prove it. I hope to have those by the end of the week to share with you :) We had a great chat!

Then he said. "I have good news for you! The MRI shows no additional areas of concern. I still want to do surgery and check the lymph nodes. It is very unlikely I will find anything. But it is better to be safe than sorry."

And I agree!

Here is verbiage what what I assume is the summary of the report:\
IMPRESSION
1. Status post right breast lumpectomy with benign-appearing postoperative seroma cavity; birads 6
2. negative for residual disease within the right breast
3. benign-appearing left breast parenchyma, demonstrating scattered foci of type I progressive enhancement consistent with proliferative breast disease.
4. Negative for multicentric or multifocal breast carcinoma.


As I understand it Chemo and Radiation are still in the picture. I won't see the Oncologist until after the 31st when I get the results of the Lumpectomy and Lymph Node Surgery. I have more surgery on Thursday the 23rd.

We are celebrating this Good News.

Praying for God's continued peace.

I have Breast Cancer

This blog is for those people who want to be kept “in the loop” in my journey with breast cancer. I know that many of you are prayer warriors and welcome information that can make your intercession specific. I hope that my journaling here will help you with that. Many of you are concerned and what to know what is “Going On” with me (us). My plan is to share information about what is happening medically, as well as spiritually and emotionally. I am not sure where this blog will take us (you and I), but my primary goal is to keep you in The Loop. I will try to not do the TMI (Too Much Information) but… I don’t know what your level of TMI is, and honestly each of you has a different level. So I think I will do it this way. At the beginning of each blog will be the Short Version, and then the Long Version will follow.

Short Version:

I have been diagnosed with Breast Cancer. We are still waiting for all of the test results to know exactly what we are dealing with. It appears I will most like have to do Chemo and Radiation. There are many decisions to make. I am not sure I have the courage and fortitude for this kind of journey. I would covet your prayers for us in the days ahead. Peace, Courage and Wisdom are high on my list of needs.

I am blessed by the number of you who have readily volunteered your support and concern. It helps tremendously to know I am not alone, I have all of you to pray for me and help if the need arises. I have no idea what is ahead of me and cannot predict what my needs will be.

The LOOOONNG Version:

Tuesday, June 9, 2009 I had my annual gynecological exam which always (in recent years) included a mammogram. That is the one thing I do to take care of me. I must confess I have never done self breast exams. I know, I know…. I should.

Monday, June 15^th I got a call from Walla Walla Clinic’s Radiology Dept. saying that they needed to redo some pictures from the mammogram, could I come in tomorrow afternoon. I went thinking that the pictures weren’t clear enough and just needed to be redone. It became clear when we got there that was not the case. There was a smaller squeezer on the machine. I was informed that this was to get a clearer picture of a specific area and would be more uncomfortable. Instead of a general… spread out squeeze it was more directed pressure. Yep, it hurt. The technician can back from showing them to the radiologist and said “She want an ultrasound – right now” I took a deep breath and said… okay. While Radiologist came and looked at the ultrasound pictures and determines that a needle biopsy was needed – right now. I said …. Right now? Yes, unless there is a reason not to. Are you okay with that? I thought “ I am here… it will save another day and another trip, I am busy getting ready for camp so this will be the wisest thing to do. Get it over with!

Not a fun experience. I can’t say it was painful, but very weird thing to experience, mostly because they worked hard to get that biopsy, as they couldn’t get the needle to go into the “mass”. It kept bouncing over or under or around it. At least that is what I think was happening- I wasn’t watching… just listening. The main thought that was going through my head was “I sure wish Preston were here, that would be helpful .” They finally got what they could and let me go.

Friday, June 19^th Preston and I are in Milton-Freewater do last minute errands getting ready for a week at Oregon Camp Cedarbrook. I got a call from the radiologist telling me that the lab results show highly suspicious cells but not enough to make a determination, and that I need to see a surgeon soon. Do I want to see him today or Monday? I told her “I am leaving tomorrow for camp and will be gone all of next week.”

“Well, then, you need to see him today. The Surgeon’s office will call you in 5 minutes to set up the time.”

I thought, “You are kidding, right? I really don’t have time for this. I need to focus on packing for camp. I have plenty on my mind preparing to direct camp, leading a staff of 39. Really, do I have to do this TODAY.” But we went (Preston & I) and met with the surgeon. We set up the appointment for the biopsy (so they could get a real sample) for Tuesday, June 30^th Biopsy would go out for several tests to determine the type and what it was sensitive to.

I went to camp with the thought in mind that I had had this done 11 years ago and it turned out to be nothing at all so all was going to be fine.

Camp was great.

June 30thThe surgery went fine, Dr. was reasonably certain he got it all and he thought it looked suspicious. He suggested that we set up an appointment on the following Friday to get the results. (He forgot that it was a holiday weekend. J) I am telling you, the swelling and bruising were IMPRESSIVE and uncomfortable! I am not anxious to repeat that again.

July 6^th we met Monday, (It was a holiday weekend) and even then they didn’t have the full report. They did know it was cancer…. but not much more. At this time we learned that there are 3 factors that are measures to determine the stage, treatment and future. (Bear in mind this is what I remember from a very shocking, numbing meeting.) They are T for tumor , N for lymph nodes, and M for Metastasis. He said because my tumor was 1.5, we caught it early - this made the T a T1 on a scale of 1-4 The M and N are still up in the air and need more tests and to determine that. So we set up another appt for Friday the 10^th to hear more details. By the way the Dr was quite surprise at the bruising and stated that it was a good thing to wait until after his vacation to the Grand Canyon to do further surgery. This surgery will be to go deeper on all the margins of the previous biopsy (to make sure they got it all), and to check lymph node J Sounds lovely huh! I am not looking forward to that!

The surgeon told me there was a great group of Breast Cancer survivors who meet monthly and handed me a gift bag of gifts from them. I was surprised by my reaction to that. It went something like this.

“I don’t want or need another group…let alone that one. I don’t need whatever is in that bag. It is NOT for me. But this I know: My family, my church family, my God are going to be my support group. “

I was not the one who brought the gift bag home with us… Preston did. I didn’t even what to touch it! It seemed repulsive. I suppose I may change my mind as this journey progresses. When I finally brought myself to look at what was in that bag (about 1 week later) I was not helped by it at all. I don’t mean this to sound harsh or trivialize the heartfelt concern of these survivors I have not met, but it seemed silly, trite, cheesy. I suppose that might say something about where I am in processing all this new information. I wonder what I will think about it in 6 months.

On the 10^th we got the written lab results. Here is a summary what we know so far.

Not Hormone receptive

Measures 1.5 x 2.2 x.1 cm That mean that the T is now T2

Looks like infiltrative lobular carcinoma associated with situ carcinoma, lobular in situ carcinoma

This type apparently is not easily picked up by regular mammograms… so the MRI may pick up more and may find some on the other side.

Grade II/III

Pathologic Stage: pT2 pNX pMx ( x mean unknown) I don’t know what p is (possibly, possibly)

There is much more on the lab results pages…If you are interested in more details ---just ask.

So now we are waiting for the results of the MRI and the other biopsy tests which they didn’t have the results from yet on the 10^th.

It has been challenging to keep my mind from imagining the worst, anticipating the worst. I have my ups and downs with the emotions. I have found that keeping busy, and having projects to do or something to look forward to have been very helpful. Right now I have several good sized projects I need to work on….so don’t be coming up with any of those for me ;). I do want to hear about what is going on in your lives. Focusing on mine is not very uplifting or fun. We will get thru it and come out on the other side. I am trusting God to be with me daily, and provide exactly what is needed for that day.

Our next Dr appointment is Monday, July 20^th to learn more good news about test results^.. Further surgery is planned for Thursday, July 23^rd.