December 24, 2014

My appointment with Dr. Ching, my breast surgeon, did not exactly go as planned, but in a good way.  I was to go over the MRI report with her, and then she wanted to do a biopsy of what she believed was a lipoma (common benign soft tissue tumor) on my left breast.

The report from the MRI showed that there was no cancer on my left breast, and the lipoma did not show up at all, which confirmed Dr. Ching’s belief that the growth was benign.  The cancer, however, lit up like a Christmas tree, both with and without contrast dye.  On the scans you could clearly see that “one of these is not like the other” as Dr. Ching said several times.  The MRI also showed 2 other, smaller growths which could either be part of the original growth, or the beginnings of a multi-foci cancer.  Either way, those will get removed during surgery along with the main tumor and sentinel lymph node.  One area of concern is how close my tumor is to the skin; depending on how much has to be removed to achieve clear margins, the proximity to my skin may be a problem.  Dr. Ching will be removing 1 cm over and above the tumor and the 2 other growths, so she’ll be removing at least 3 cm of tissue.

Next we discussed what might happen during and after surgery.  15% of surgeries are not able to get clear margins, which means a 2nd surgery.  I hope I’m in the 85%.  Post-surgery, I cannot move my arm for at least 2 weeks except to do 4 exercises.  No holding a Kindle to read, no knitting and definitely no computer work.  I guess I might want to sign up for Netflix streaming, and it’s back to doing routing tasks with my left hand.  I learned to use my left hand when I had right shoulder surgery, but with that surgery I could use my hand.  Not using a hand at all will be very interesting.

We discussed that even though I had a consult with Dr. White in Plastic Surgery on Friday about reconstruction, that I’d pretty much decided to have a “lump and lift” so that my breasts will be of more even size post-surgery. (The lift is to address “ptosis of the breasts” – sagging breasts.  Apparently I’ll be perky afterwards…)  I still need to find out all the information about the reconstruction, and to be comfortable with Dr. White, but assuming it’s a go after Friday’s consult, the wheels will begin to move to schedule the dual surgery (excision and reconstruction).  The disappointing news was that the surgery schedule is full for the first week of January, and already quite full for the 2nd week.  The earliest possible date is January 13, assuming the plastic surgeon is even available that date.   More likely the surgery will be the 3rd week of January.  I just want this thing out of me, plus the later the date, the later my full recovery.

Then I was prepped to have the biopsy.  After laying out all the instruments, and a little bit of a wait, Dr. Ching came in and started to sterilize the area.  Then she said, “wait, if you’re going to have the lump and lift, Dr. White can remove the lipoma when he does the reconstruction.  Let me see if he’s available.”  So she gets Dr. White, who does a short exam, and says he can remove it no problem, and that I was also a good candidate for a lift.

So that was it.  I got dressed, confirmed that the next time I’d see Dr. Ching is for the surgery and picked up a copy of my MRI report.   At least I don’t have to ice my breast for 10 minutes every hour for Christmas Eve!

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