"March 27, 2011 Update"

I can't believe it's been a week since my breast biopsy on March 22nd. It's been quite a whirlwind so far. The pathology report came back two days later conclusively for invasive ductal carcinoma. The other thing that's going on is lobular carcinoma in Situ, which is contained and in fact not cancer at this point but is a marker for potential bilateral disease and puts me at a higher risk for recurrence. It may mean it will show up in the right breast as well at some point or it may already be there and light up upon MRI. We'll see, but either way we may need to make some additional decisions.

Smaller sites were detected in other areas of the breast as well that look questionable. So, all this together confirmed what the radiologist performing the biopsy already suspected, that the results would come back indicating a stage II cancer. She was right on and I appreciated her candor and preparation ahead of time of what I'd be facing.

I saw a breast surgeon Friday, March 26th at St. Joseph's Hospital. His name is Dr. Michael Schultz who helped build the St. Joseph's Cancer Institute and heads up the cancer/breast cancer center. We LOVED him and saw no need to consult another breast surgeon. Jeff and I have total trust in him and have never felt so wonderful about any doctor!

The 25th was the first time I'd called his office and his Administrative Assistant unexpectedly called early the very next morning saying the surgeon wanted to get me in as soon as possible. Goodness, I was just diagnosed Wednesday and Friday afternoon he's seeing me...Wow! He really wasn't supposed to be there that day but he stayed late to see me after doing surgery. Dr. Schultz's policy is to especially see just diagnosed breast cancer patients ASAP, understanding all of the fear and emotions that are involved throughout this journey. I was so impressed.

He's expert in his field, focusing completely on the breast and comes with a ton of experience... 30+ years. He comes very highly regarded. He's thoughtful, compassionate, funny and as sharp as they come. He patiently took the time we needed, thoroughly covering all we needed to know for now, addressing all of our questions and concerns. We just really hit it off...whew, what a relief! I felt so comfortable with him and KNEW he was the one. He makes himself available to you pretty much 24/7, enabling his patients to contact him personally either by phone or email anytime.

In fact, the entire staff was phenomenal and treated us like family. Each one I talked to couldn't say enough about their boss, emphasizing how wonderful he is and how they wouldn't work anywhere else. They all seem so genuinely happy to work here with Dr. Schultz in the St. Joseph's setting. I was more than assured I'd be in good hands. 

He gave me an examination and did another breast ultrasound indicating the tumor to be quite a bit larger than originally anticipated on the other two ultrasounds taken from American Radiology but may still keep me at a stage II cancer. They won't know for certain until surgery. Let's pray. He also biopsied one of the lymph nodes under my arm that he said looked a bit "plump". He'll let me know if anything unusual comes back on that, although biopsying of the lymph nodes will be done at the time of surgery to conclusively determine if cancer has spread there and needs to come out. Prior to that though, my upcoming MRI will give us a pretty darn good idea.

His staff is going to schedule a PET Scan/CT for me and get back to me with that date to see if cancer is detected anywhere else in my body. My MRI is scheduled for 
April 1.

As expected, a mastectomy of my left breast has to be done. We'll of course have to wait until after the MRI to see if anything is going on in the right breast as well. If so, another type of biopsy may be done and then we'll see what that shows.

As soon as all the results are in, a Multi-Disciplinary Conference is called to give a power point presentation of my case to include, Dr. Schultz, oncologists, plastic surgeons, radiologists, pathologists, anesthesiologists, a board of breast cancer survivors, Jeff, me, and honestly I don't remember who else (there are a total of 12 people involved), to meet together to go over all the finding, each giving recommendations to help guide us to our decision.

It's pretty much certain I'll have to go through chemotherapy after surgery. Radiation therapy isn't always necessary after mastectomy but can't be definitively determined until surgery when lymph nodes will be biopsied and tumor size is sure. Since I have tested positive as having a "hormone receptive" breast cancer, for several years following surgery I'll also be placed on some type of hormone therapy medication such as Tamoxifen. Tamoxifen works by blocking estrogen from attaching to estrogen receptors on these cells. By blocking the estrogen receptors, it is believed that the growth of the breast cancer cells will be halted, hence a lesser chance of recurrence.

Someone from the St. Joseph's group, "Survivors Offering Support", will contact me in a day or so to help connect me with an individual, a breast cancer survivor, who will also help me through the process. I'm sure that will be invaluable to me and a tremendous blessing.

I've also been given Susan, who is my "nurse navigator" who helps me through this entire process and whom I was told would be my best friend. I'm sure I'll get a better handle on the role she'll play throughout all this as things unfold, but she seems great!

Seems to me like I'm going to be surrounded by a bunch of fantastic, caring compassionate and expert people to help me through. Thank you, Lord! We prayed He would guide us to the right place and people and He has been faithful to do just that. He's so good and I praise Him for who He is and all He does. My eyes are on Him and His joy truly is my strength.