Siobhan and I popped into Peter Mac today for the post surgery follow up. It was a happening day in outpatients. It was a bit like the old days footy finals series where you needed to take your fold up stripey patterned nylon chair and stake your claim in the queue between the rabid knitting nannas and the old blokes reliving lost youth and coodabeen legendary status, and sleep out for the night before the tickets went on sale! Seats and patience in Outpatients were as rare as an undercover seat for a GF between Geelong and filthy Collingwood.
So to put this into context about what we were about to find out - its been just under a week since I had the surgery and I am here to be informed about what the plan is for treatment, if any is required. I have cut a paragraph (see below) from a previous post to revisit the elements under consideration. All this gobbledy gook is second nature to me now but I know for you, dear readers, that it may as well be latin. Its amazing how quickly all this non-conversational medical crap can sink in but I cant seem to remember where I put my car keys!! And just to gross you out I have taken two happy snaps (breast and underarm) to let you know that I am healing well. The Surgeon removed my bandages and was tres happy with my healing capabilities! Just in case its not perfectly clear - the healing breast is the first photo below. A boob at this angle does look a tad odd.........
Just to take you through the next bit, here is the selection criteria, so to speak, when one finds oneself with a confirmed breast lump then the following provides a nifty plain speak summary of what you need to look and hope for..........if the lump is small, say >2cm, with no cancer cells in the lymph nodes and the cancer cells have hormone receptors and the cells are HER2 negative and the cancer grade is low and the surgical margin is clear then the cancer is LESS likely to come back or spread. If they are the opposite of that, then it is likely to come back or spread.
So we head into my appointment with my Surgeon and my Breast Nurse (that is the worst nomenclature for a clinical title I have heard since someone floated the idea for a Nurse Unit Manager - a NUM to be called a Business Unit Manager!!!) Its like my left breast has its very own Nurse..... sorry I digress.
In the Histopathology report I was given, my cancer is beigely described as Invasive Carcinoma of no special type (NST). Can it get any more bland? From the wide local excision of the left breast they took a tumour 16 mm x 10mm or 1.6cm x 1.0 in size - so far so good - its a small lump. The cancer cells in that tumour were highly hormone receptive scoring an 8/8 for oestrogen and 5/8 for progesterone. So that also is a good thing. I have always been a high achiever!! The test as to whether it is HER-2 negative requires a further genetic test because the 'first glance" microscopic test isnt entirely conclusive, but it is suggesting that its negative at this stage - also a good thing - so far folks its three for three and yay for me.
Then we get to the not so good bits. The surgical margin isnt totally clear as there appears to be DCIS (ductal carcinoma in situ) in one of the margins. The tumour has been removed but these other little dudes if left to misbehave in the margins by themselves would get bored and turn into fully fledged cancer cells. So they need to come out. Secondly they discovered cancer cells in both the sentinel node and another lymph gland that they took out in the first surgey so I need to have all the lymph nodes taken out from under my left arm. Finally, the histopathology report grades the tumour - albeit only small, as a Grade 3 tumour. And I have to quote the report because perhaps one day someone, years into the future, will be able to translate this complex language of medicos and it will be because of my blog that us mere mortals will know what the fuck these people are talking about!!
"There are nests, trabeculae and cords of tumour cells with rare tubule formation and central sclerotic stroma (still with me??). The tumour cells have markedly pleomorphic nuclei and there are 15 mitotic figures per 10 high power fields placing it into Grade 3."
So what does this all mean ? Well first step is another date with the surgical team at Peter Mac next Thursday. What will follow is definitely a course of radiotherapy and in all probability prior to that because the tumour is Grade 3, a course of Chemotherapy, and also a whole pile of pills. If the HER-2 genetic test comes back early next week positive or the lymph nodes that are removed next week have more cancer cells then I am definitely in for chemo. If, when they revisit the margin where the tumour was in the breast and they find more DCIS, then we will be discussing more radical surgery as an option.
So not the trouble free news we were hoping for but it did lead me to formulate some future hair plans. Siobhan and I had a great laugh about what coiffure opportunities this could present. So dear Carlton Football Crew, in the event that I have to have chemo and I lose my hair, I want you to buy me a tasteful wig as my birthday present for this year. Note the use of the word tasteful, hence Craig, you will be in charge (with some consultation from Pauline and Viv) and I had better not end up looking like a drag queen (given that many people believe I already sound like one!!!)
In the mean time I am off to Peter Mac the day after Anzac Day for a Bone Scan and a Cat Scan - it seems that they get to a stage where they like to do a total once over just in case any of these mischevious little cells have done a runner and migrated into the different landscapes and territories of my body and become what vile Tony Abbott calls "Illegal Refugees".
Trust me, it would be the one and only time I would ever agree with that bastard !!!
I'd much rather "Cell"ulite!!
Kellyxxx
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