Two down....

Only one more pre-op to go!

Pre-Op #2 was this past Friday with my breast surgeon, Dr. P. First of all, let me just say that if you don’t already know, I love this surgeon. I knew that it would be a great appointment because it feels more like visiting a friend. I’ve gotten to know this surgeon over the last 3 years and vice versa. It is very easy for me to talk candidly and honestly with him and not feel embarrassed or reserved. Having said that, I also knew this appointment would probably be difficult because of the subject at hand. This appointment would not be focused on reconstruction, obviously. This pre-surgical appointment for a bilateral mastectomy with Sentinel Node Biopsy spent little time discussing the actual mastectomy procedure since it’s pretty cut and dry (no pun intended!). We spent a lot of time talking about the Sentinel Node Biopsy, procedures and possible outcomes. The “possible outcomes” meant possible cancer diagnosis and treatments.

Over the last few months, you’ve gotten a glimpse of the processes that sometimes consume my brain. Dealing with an upcoming mastectomy has been difficult for me. Dealing with the added information that I’m in a waiting pattern (AGAIN!) to find out if I have breast cancer in my lymph nodes is another beast in itself. When I first began blogging, we had determined that surgery was my best option given my history and my genetic predisposition, BRCA1+. All the bad stuff was supposedly removed during those awful biopsies, so my double mastectomy was more preventative than treatment. I knew that if I didn’t have the mastectomies, it would only be a matter of time before breast cancer would return, and the fear that drove me to this decision was that the cancer would return with a vengeance.

Dr. P talked in great length about this testing. After the lymph nodes are mapped with the radioactive dye, he would remove 3-5 and sent them to pathology immediately. There, they would be instantly frozen for testing. My surgeon will have a preliminary pathology report, about 90% accurate, in his hands before the mastectomy part of the surgery is complete.

Should they find evidence of cancer in the Sentinel Nodes, the surgeon would then perform a lymph node dissection to determine how many other nodes were affected. This would happen during the mastectomy-portion of the surgery. He would remove any them immediately. I would probably not have an expander placed on my left side if this were to happen because I would need to have radiation. The extents of treatment would be determined by how many lymph nodes were ultimately removed and further pathology reports. Ward wouldn’t even find all this out until it was over.

Should the sentinel nodes come back clean (Dr. talk for “no signs of cancer”), then Dr. P would complete the mastectomy (estimated 2.5 hrs.), turn it over to Dr. A for placement of both expanders and reconstruction, and go talk to Ward and family that will be waiting. I’d be all set while we wait for the full pathology report. It takes about a week to come back. All breast tissue, nipples, and the sentinel nodes would be extensively tested. Should everything come back negative for cancer, then I just enjoy the reconstruction process. Should it come back positive for cancer, well, then we’ll move onto oncology for more treatment options.

Dr. P and I both feel pretty sure that everything will come back nagative and I'll be on the road to recovery. There's just that chance.

One thing I know about this whole thing is that there are a lot of chances for any number of different things that could happen during this entire process. Anything can happen. Of course, that rings true even in normal circumstances! :)

Now, I only have the anesthesia pre-op left to do. I will be making a trip to the hospital the day before surgery to get that one out of the way. That appointment is on Halloween......I wonder if they'll just tell me this has been all one big trick!  Hahaha....that was a pretty bad joke. :)

I'm the one who will get the best treat. No cancer and nice, new boobs!

As of today, we are 3 weeks away.