Today, I had a meeting with both my breast and plastic surgeons. I would love to know what their combined IQ is - seriously. The purpose of the meeting was to get "on the same page" regarding my surgery. Really, it was them talking, me shaking my head, and suggesting I just pull down my dress so they can touch the boob in all their glory while discussing incisions, etc. ... which I did.
In any event, Dr. Chiantella confirmed that there is no scar tissue evident in my MRI, which is amazing. She will remove the tissue around the area where the tumor started ("ground zero") and send to pathology for residual cancer cell and receptor testing. If residual cells are found then the radiation will take care of it. Regardless of positive or negative residual cell results, I will have radiation as a precaution. The receptor testing was Dr. Heyer's suggestion. He wants to know if there are positive receptors for maintenance drug purposes, since I currently don't have a maintenance drug to take with triple negative breast cancer.
Dr. Heyer and I discussed a low dosage of chemotherapy post radiation, which I am not opposed to. I can't recall if I discussed this on my blog or not, but he was thinking of giving me just one drug, Taxotere and a lower dosage than previously administered. My 18-week chemotherapy cocktail consisted of Taxotere and Carboplatin every three weeks. For maintenance purposes, I would get only Taxotere once a week for three weeks then one week off. The administering of Taxotere is not limited as in some other chemotherapy drugs. This means, you can only get so much of a drug and then need to start on something else, because your body becomes immune to it. As far as side effects, the biggest complaint is discolored nails and, of course, mental and psychological wear. Fatigue is hard to gauge. Of course, everyone is different but he said it's mostly your mind set. You just need to be positive and have a good mindset. Now, chemo maintenance is not a definite. He wants to know the MRI and pathology results first before making a decision. So, at this point the MRI results are outstanding and now praying for a good pathology report.
Now, the discussion today focused on what exactly they are going to do and if I would need some type of plastic surgery. They expect the removal of tissue to be small, so it may not have a significant scar where I would need plastic surgery. This all depends on where Dr. Chiantella needs to cut, how much, and if the area where the tissue is removed heals correctly. A breast indention is possible. If this happens then it would be in the future that I would have fat from another part of my body removed and placed on the indention. Also, I may need a lift on the right breast since once a breast is subject to radiation it usually tightens and draws up. So, for purely cosmetic and symmetrical purposes, they will lift and maybe minimize the right breast. Again, this is a year or so down the road.
Tomorrow at 9:30 a.m. I will have a wire inserted in the breast which will help guide the surgeon to "ground zero" where she will just carve out a piece of the surrounding tissue. She is going to feel my lymph nodes for sizing. My tumor began in the back on the chest wall, so if you are looking directly at me then to the side of my aureola all the way back then that is the starting point of all this. As you can imagine, the tumor was big since I could see it bulging from the top of my breast. Once that procedure is done, they escort me to the outpatient surgical center where I will get prepped for surgery. They will draw a bunch of lines on me (I really didn't understand all that talk, so I sat there and just shook my head while remaining topless and listened to them). I do know that sometimes what's inside could be different then what shows on the MRI, so that will be indicative of how much she removes. I will be in recovery for a couple hours and then go home.
I apologized in advance for what I say or do since I will be given some crazy drugs. It appears I am pretty funny when I am high since during my mediport surgery I put on quite a show for Kwiatek and Amy which I remember none of. I talked about Michael Jackson's milk. I do recall waking up and asking them "When are we getting this show on the road, people?" I was oblivious because the "show" already took place. I remember nothing else. Dr. Gottlieb assured me that anything I say or do will be kept a secret ;)
Post surgery, I have four weeks to heal then radiation begins. I have no idea how long radiation will last, but will know in the next few weeks. Probably six weeks, every day.
So ... keep me in your prayers and either myself or Kwiatek will keep everyone updated.
Lots of Love and Light,