We have a surgery date!

We have a surgery date!  It is August 22nd.  Although we would like that to be sooner, we also want to make sure that we have the best doctors.  So, because of difficulty lining up doctors' schedules, July being a popular vacation month, and the busyness of the doctors that we have chosen, that is the best we can do.  The breast surgeon (basically the architect of my treatment) does not seem too concerned about the date being a few weeks away.  She assured us that I have probably had this cancer for awhile and that it is a slow-growing cancer.  If she was very concerned about getting this out as soon as possible, she would urge us to go with a different plastic surgeon. Even if we did go with a different plastic surgeon, it would only be a difference of a week or two. So, we have decided to go with the August 22nd surgery and stick with the doctors that we feel most comfortable with.


Some of you may be wondering about my doctors appointments in Pittsburgh last Tuesday, the 15th. Here is a picture of us having so much fun at Allegheny General Hospital:

Overall, it was a successful day because we were able to fit in the genetics counseling/testing, an MRI, and an initial consult with my plastic surgeon.  It was great to have it all on one day, because then I didn't have to worry about taking too much time off of work. Our genetic counselor, Kyla, was awesome and very patient with all of our questions.  Both my mom and sister Natalie were able to come to that appointment with us, which is great, because the results of the genetic testing may ultimately affect them.  At the appointment Kyla basically explained genetics, genes, and DNA.  She explained the breast cancer genes (BRCA-1 and BRCA-2) and how they are passed down.  I gave a saliva sample and they will be testing for mutations in my genes that may make me susceptible to cancers (like breast cancer). If I have one of these genes, it would explain why I got breast cancer at age 27.  However,  it would also mean that I am very susceptible to other cancers in my lifetime, as well, like ovarian cancer.  It would also mean that I got the gene from my mom or dad's side of the family and that my siblings have a 50% chance of having the gene as well.  Any future children would also have a 50% chance of have the gene. Needless to say, we are hoping that when we get the results in 2 1/2 weeks that I do not have the gene!  However, if it turns out that I do, I will have regular screenings, my siblings would get regular screenings, and family members would have the opportunity to get genetic testing as well. Overall, it was a lot of helpful information and Kyla could not have been better at helping us to understand it. They promise to get my results to me within 3 weeks.


Next was my consultation with Dr. White, my plastic surgeon.  After meeting him, Craig and I feel like I am in really good hands for my reconstructive surgery.  He is a highly recommended doctor with excellent bedside manner.  He basically went over all of the options for reconstructive surgery and which ones he thought I would be a good candidate for.  Essentially, implants are the best option for me because I don't have enough fat on my body to make a boob or two. It was a weird, backwards compliment!  He explained the whole process to us, the risks and results, and has high hopes that I will come out of this surgery and heal very well.  It is a multiple step process to fill the implants, so I will have several follow up appointments with him in the weeks following the surgery.  Some friends still maintain that this is all my elaborate scheme to get a boob job. Perhaps. Anyway, I have one more appointment with him before my surgery, and it will be on August 5th.


Lastly, I had my MRI.  I was so tired by this point, that I pretty much fell asleep during the MRI.  It was great.  Fairly quick and mostly painless.  The point of the MRI was to get a better picture of what might be going on in my left breast (and lymph nodes), and to see if anything suspicious is going on in my right breast. There is a really high false alarm rate with MRIs, so they warned me that I would most likely have to come back for an additional biopsy if anything lit up in the MRI. Dr. Erb (my breast surgeon) called the next day with the results. She said that the lymph nodes under the left armpit look normal, which is great.  They will still do the sentinel node procedure during my mastectomy to test the lymph nodes and make sure. She said that there might be something going on with the right breast because it looked similar in one of the quadrants to what the left breast looks like.  This could very well be just my hormones or something different going on that day.  Or it could be cancer.  It is recommended that I have an MR-guided biopsy of the area to find out what is going on.  Honestly, I am not too worried about it.  It is probably nothing.  It could be cancer, but I am already having surgery.  The worst case scenario is if it is invasive cancer, but that doesn't seem likely to me because my right breast checked out normally on the mammogram.  We are hoping to schedule my biopsy on August 5th, the same day as the plastic surgeon appointment, so that I only have to take a day off of work.  We should get the results of the biopsy by the end of that week.  the results of the biopsy and the genetic testing results will guide us on single mastectomy vs. bilateral mastectomy. 


Other than my appointments, we are just weighing the pros and cons of treatment possibilities like single vs. bilateral mastectomy, and hormone therapy (tamoxifen). We have some time to make those decisions, though.




The other big news from this last week is that I started my new job!! More on that in a later post...


Katie

Wait, you have cancer?!

Yes, I do.


I hope that I got to most of you to let you know individually about my diagnosis.  For those of you that are hearing this for the first time, I figured that it would be helpful to hear a back-story about my diagnosis


I did sporadic self-exams in the past and I found a lump in my left breast in November 2013 that I went to the gynecologist to get checked out.  They were not too concerned because young women having dense, fibrous breasts is very common.  Most commonly, it is a fibroid (fatty tissue) that goes away.They sent me that day to get an ultrasound, just to make sure.  The radiologist that did my breast ultrasound ended up telling me that she did not see anything unusual and that it was just "abundant glandular tissue."  Basically, fatty tissue.  What a positive way to phrase that! She told me that it was normal and to just come back if it got any bigger or changed a lot. No biggie.


Fast forward to a few months later, May 2014.  I am realizing that the lump is starting to hurt a little bit and it is all the time, not just during my period. And, in fact, I realized that it actually IS bigger than it was in November.  However, I am not an alarmist, so I make an appointment with my new gynecologist at West Penn Hospital and think it is probably just that fatty tissue.  Again, the gynecologist is not too concerned, but she wants me to get an ultrasound again, and she wants me to get a mammogram this time. Perfect.  Fine. Scheduled for later that week.


Wednesday morning in June, I am thinking that I will do a few quick tests and be back to work by lunchtime.  They did the mammograms of both of my breasts.  Things seem to be going fine. However, they were not fine, because the radiologist comes in the room, sits down, and explains to me that she is VERY concerned about what she is seeing on the mammogram.  Apparently, she saw quite a bit of calcification, which can be a red flag to cancer.  She wanted to do a biopsy of my breast that morning.  This was heavy news to hear.  I was not expecting it.  I got emotional, obviously, and they asked me if I wanted to call someone to come be with me.  Since we weren't expecting anything like this to happen, Craig was actually out of town for the morning preparing our new apartment in Edinboro.  So I called my sister, Natalie, who lived a few minutes from the hospital and made herself free to be with me.  It was really wonderful to have her there since Craig could not be there right away.


So, basically, the rest of the morning they assigned a nurse, Barb, to "babysit" me. Barb was awesome.  She and her counterpart, Jane, had me laughing so hard that my face hurt.  They also were very gentle with me and explained each step of the procedure to me as it was happening.  In fact, Barb sat behind me during the biopsy, held my hand the whole time, and explained what was happening.  I felt so blessed to have these great West Penn nurses with me that day.  I could tell that it was serious that day because their words of comfort were not, "It's probably nothing!"  They were, "There are great treatments for breast cancer." And, "There still is a small chance that it is nothing!"

We had two terrible days of waiting for the results of the biopsy and then Craig and I got the call that it was cancerous.  So, here's the deal.  It is a very treatable cancer, from what they can tell.  It is a localized form of cancer called DCIS (ductal carcinoma in situ).  To be honest, this is the best type of cancer to have.  From what they can tell, it is slow growing and only localized to the milk ducts in my breast.  It has not broken through the ducts and become invasive, from what they can tell.  Due to how extensive it is throughout my breast, I will need to have a mastectomy.  To be real, this sucks.  A mastectomy is not something that I wanted at age 27, before I have had my children. But we are hopeful that the mastectomy will be the worst of it.  And I will have reconstructive surgery.  When they do the mastectomy next month, August 2014, they will be testing my lymph nodes and the rest of my breast tissue to check for cancer.  We and the doctors feel hopeful that it is not the case, since my first biopsy came back as "not invasive," but it could happen. If that is the case that the cancer is more than what we think it is, we will be looking at the possibility of other treatments, like chemotherapy, radiation, and hormone therapy.  If it is just the DCIS that we think it is, the mastectomy should pretty much take care of it, with the possibility of hormone therapy after (taking a daily pill for 5 years).

Why did I get breast cancer at 27?  I don't know.  It does not seem to run in my family.  The only family member that has had breast cancer is my maternal grandmother who had it post-menopause.  Also, I like to think of myself as a healthy and active girl.  It seems to be one of those fluke things that just happened.  However, in order to rule out any genetic component, I had genetic testing done (still waiting for the results!) to see if I have one of those mutated 'breast cancer genes' (BRCA-1 or BRCA-2).

So that is the story.  The next step is a few more tests and doctors appointments before my mastectomy and reconstructive surgery.  Then, we will take it from there!  Craig and I feel incredibly supported.  Friends and family have rallied around us to support in whatever way they can.  Just so everyone knows, I do not mind if people know that I have cancer, and I am generally fine to talk about it.  Most of the time we feel like our normal selves, and sometimes we get tired or irritable or scared.  I pray for strength and peace for us everyday.  And I feel God's presence behind and before us.  Mostly, I feel it through the love and support of our dearest friends and family.  Thank you, if you are one of those people!