All or Nothing

You've got to ask yourself one question: "Do I feel lucky?" Well, do ya, punk?

Hoo Boy. Met with Dr. O'Holleran today. The tricky thing about having a rare cancer is that there's not a lot of research out there. What little research there is, points to the fact that every year with LCIS your chance of developing an invasive breast cancer increases.

Since I've had this cancer a bit longer than originally thought - probably a few years (it's slow moving, so how could more than half my breast have it, otherwise?) what are my odds? Do I have it in my right breast too? Maybe. Maybe not. Since it doesn't show up on mammograms the only way to know is to do a random lumpectomy or an MRI.

Next step is to talk to an oncologist. I have a referral and am waiting for a call back tomorrow to schedule a future appointment.

The options seem to be: 1) Do nothing. Hold my breath and hope that if I do get an invasive breast cancer that it is caught right away. 2) Bi-lateral mastectomy.

Other things I am considering: Get an MRI. Consult with a plastic surgeon re. breast reconstruction should I decide to go forward with a bi-lateral mastectomy.

Other things to ponder - if I do have a bi-lateral mastectomy followed by reconstruction, I can get tattoos for nipples. What amazing designs could I get? Alan has already nixed smiley faces and kittens. Harrumph.

Advice from those who have been there, done that

The thing about having done volunteer work with Team in Training is that I've met some AMAZING survivors, who have been through much worse than me. And they are giving me some pretty great advice. As I think of it, I'll post some of what they've said, because they could inspire anyone, not just me.

"It doesn't change who you are. It does not define you. Ultimately over time it will change how you think about yourself. It'll be another layer of who you are.

Keep your chin up. It's gonna be shitty for awhile. Try to smile and enjoy spring. Maybe buy a punching bag..."

-Susan

Another reason why I love my husband ...

"If you want new tits, we'll get you some. I'm just glad you're not dying." - Alan Home

Not what I expected

What I expected was "Great news - we got it all out! The margins are clear!"

The news I have is just confusing. So, good news first, there was no invasive cancer found. Bad news is that the amount of non-invasive (LCIS) was extensive. It couldn't all be removed, or Dr. O'Holleran would have had to remove at least half of my breast (and possibly more).

Now what? I explore my options. What are my options? I don't know yet. I meet with Dr. O'Holleran next week to discuss what he, as a surgeon recommends. The words "bi-lateral mastectomy" came up several times (do you hear me swearing? 'cause I totally am having a moment right now.) Then I meet with an oncologist (as yet, TBD) to discuss other options.

I have time to become educated. Since it's not an invasive cancer I get time to educate myself on my options. There's a 20 - 40% chance that I will develop an invasive breast cancer in the future. Unless, of course, I have a bi-lateral mastectomy, then there are no breasts left for cancer to invade.

I've googled the crap outta LCIS and there's not a lot of info out there. Or, not a lot of HELPFUL info. Like this: " LCIS isn't cancer. But being diagnosed with LCIS indicates that you have an increased risk of developing breast cancer."

Or this: "Women with LCIS have an increased risk of developing invasive breast cancer in either breast."

"LCIS does not require treatment in the way you might normally think of cancer treatment, such as needing to have surgery, radiation therapy, and chemotherapy. You and your doctor may decide that you should undergo careful observation to watch for any signs of invasive breast cancer."

"Keep in mind that LCIS is not an immediate threat to your health. You have the time to consult with your doctor and weigh all the pros and cons of risk-reducing surgery."

Sigh.

Post-Op Notes

They tell me the surgery went well, but I don't remember any of it, only the before and after. The before wasn't fun - as posted previously, I had a mammogram and a needle inserted at the mark. I thought I might be in trouble when they took a plastic Dixie cup and taped it over the needle. That's some high-tech medical procedure right there. First class.

Luckily, that was as low-tech as it got. All of the nurses and the Doctors were great, excluding one, which I snapped at when he set the blood pressure monitor and paper work on my left breast (post surgery) and asked what I'd come in for. "A lumpectomy on my left breast, so if you could remove all that stuff you just set on it, I'd greatly appreciate it." Sigh. Other than that, no complaints.

I feel pretty good today, at least, I'm not in pain. I just tried to go for a walk, got about 2 houses away from ours and realized it was a bad idea, so back inside to the boring couch for me.

I'll call tomorrow to schedule my follow up appointment, and to pester them for the results of the pathology, which hopefully will be available by Friday. Fingers crossed that the margins are good!

And look - I got my very own QR code! From Dixie cup to high-tech, so fancy.

Surgery Details

As many have asked, here are the details for Monday. (As much as I understand anyway, I realize as I write this there are some gaps).

I arrive at 8:45 AM at the Short Stay Unit. I'll then go to the breast center for a mammogram on the left breast, where they will locate the titanium mark that was inserted during the biopsy. They will then insert a needle, which is attached to a wire.

Then, I'll head to surgery, where I'll talk to the anesthesiologist. Surgery is scheduled for 11:15 AM, and since I'll be out cold, I'm told it will take about 25 minutes. Were I to opt to be awake and have a local, it would take about 45 minutes.

During the procedure, Dr. O'Holleran will remove the cancerous section, and the titanium mark, along with healthy margins. The removed part (let's call it the "icky bits" will be taken to pathology to ensure that the titanium mark was removed. It it wasn't, the Dr. will go in again and pull more icky bits out. Once more, the icky bits will be checked for the mark. If it's still not there, then I will get to keep that titanium bit in me. Only 1% of the time does the mark not get found.

Then, they stitch up the outer part (not the inner, or Lefty would be all puckery, and then how would those tassels look?!)

Then, I go to the Short Stay Unit for 2 - 3 hours. After that, I get to go home, where my plans are to lay on the couch and sleep.

I'm getting nervous - I feel like I've had seven cups of coffee today, when I only had one this morning. I'm not hungry and I'm kind of shaky, but other than that, all is well.

Does the surgeon have a sense of humor?

Shall I wear these to surgery and find out? 

A pouch full of anchors. 

Sweet Emotion

Most days, I am up. I have realized that there's a direct correlation between how many hours of sleep I get, and my emotional state. Pretty obvious - 7 hours of sleep = happy Miriam. 4 hours of sleep = emotional basket case Miriam.

I was a bit surprised how ANGRY I was after mulling over the news. I eat healthily (seriously, there's a lot of kale in my diet!). I exercise 5 - 6 days a week. I maybe have an adult beverage twice a month. Since January I've healthily lost 12 lbs. So what the frack? I guess it doesn't matter if you do everything right, you're not immune.

And the annoying thing is, I feel great! I don't feel sick in the least. In my daily gratitude journal, a frequent line is, "I am grateful for my health. I am grateful that my body allows me to run, dance and play." When I'm stressed out or have a bad day, after work I rarely have a martini, but instead go for a run, or pop in my Jillian Michaels DVD for a heart pumping weight workout. And after this surgery, I won't be able to do those things that keep my stress levels low. At least, not for a good month, possibly two.

Here's what I've landed on, after discussions with my amazing friends and the surgeon. Because I am so healthy, how do I know it didn't make a difference? I know it could be much worse. And, because I am so healthy, after the surgery, I will probably heal quickly!

I've always said I'm neither an optimist or a pessimist, but a realist. The glass is half full, but it has a chip. I'm going to continue to look for the silver linings, because that's who I am, and I welcome any silver lining offerings you may have to share.

Not the best news, but not the worst

No need for alarm or drama, just wanted you to know that I've been diagnosed with breast cancer. Specifically: Lobular Carcinoma in situ (LCIS). It's rare, but not life threatening and is non invasive, and they caught it really early. Usually with LCIS it means that you're at high risk for developing an invasive breast cancer in the future. For that reason one of the recommendations is for a double mastectomy. Luckily, despite all of the cancer in my family, breast cancer isn't one of them. Because of this I've opted for a lumpectomy. Surgery is scheduled for March 18 at Sequoia Hospital in Redwood City. They will do another biopsy then, to determine if it's only LCIS, or LCIS and an an additional cancer, and they will check the margins. If the margins are less than 3mm, I will also need to undergo radiation therapy.

It has been an emotional month of mammograms and a painful biopsy. Luckily I have an amazing support group, and an amazing medical staff to help me through it. Right now, I'm just trying to focus on school and surrounding myself with people who love me, cancer cells and all. 

Lots of people are asking what they can do for me, and I really don't have a great response. Treat me normally? Do what ever I ask for, cause I have freakin' cancer? Just send me lots of love and good energy, and make me laugh!

I'm hoping this is a short journey - one that will be over before I know it! I hope to be back training and running another marathon before the year is over!

Lots of love!

Miriam

The Timeline

2/5/13 - Annual mammogram. Yay to being 41!
2/6/13 - Ominous message on home answering machine from the Patient Navigator.
2/7/13 - Talk to Carol (aforementioned mentioned Navigator). Something looks suspicious on my left breast, and I need to go in for another mammogram.
2/19/13 - Follow up mammogram on left breast. Talk to the amazing Dr. Jain immediately after. She walks me through the images of my breast, explaining what's normal and what's not. Turns out "smudgy dots" are not normal.
2/25/13 - Biopsy on left breast. Piece of titanium is inserted as a marker.
3/1/13 - Learn pathology results. Can't get Joe Jackson out of my head. Diagnosed with Lobular Carcinoma In Situ (LCIS)

3/5/13 - Consultation with surgeon. Lumpectomy scheduled for 3/18/13.