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Amie's Breast Cancer Journey #2 June 10, 2015

Once morning came the phone rang and the Doctor who delivered the original news to me reported that my breast MRI results were in and that we needed to meet.  Paul and I arrived at the office quite, nervous and fearful.  My Doctor once again made us feel comfortable and at ease.  Reviewing the breast MRI the radiologist was able to determine that the cancer was not detected in my right breast.  It was shown that the cancer was at the 12:00 position in my left breast. It was about 1.7 cm and it appeared that the cancer had not entered my lymph nodes. However, it could not be confirmed until after removing the cancer whether or not my lymph nodes were in fact clear of cancer.  Specific details about cancer such as grade, type, receptor status and exact measurements could not be determined until the cancer was removed and tested by pathology. My Doctor said that we know I have stage 1 Invasive ductal carcinoma in the left breast at the, 12:00 position.

There are many different treatment choices for accomplishing the task of removing cancer, under the umbrella of breast cancer.  One thought to keep in mind while reading my journal, is that this journey pertains to me. I have learned  that all of the ladies before me  who have experienced a journey like mine have a different story. Everyones treatment choices and procedure order, is different because each and everyone of us is an individual with different prioritized needs.

Collectively my Doctor, Paul and I discussed my treatment options. It became pretty obvious, pretty fast, that the cancer would need to be surgically removed from my body.  As many of you who know, me know that I have never had surgery or anything invasive done to my body before.  Wisdom teeth removal and a colonoscopy can hardly compare to the decisions that I now had to make.  I was given the option to have the cancer and lymph nodes removed during a surgical lumpectomy procedure.  Once the cancer was removed it would proceed to pathology for assessment, and samples of the cancer removed area would  be tested to see if any cancer seeds remained behind.  Pathology would take about three weeks to produce the results.  In the mean time I would heal and begin radiation of the area for 5 days during the week for 6 weeks.  After the 6 weeks of radiation I would likely need chemotherapy. If and when the pathology report came back that cancer seeds remained behind I would need a second surgery to remove more tissue.  I happen to be a small A cup so how much breast would I have left I wondered?  During this procedure a dye is injected into my breast that could leave a blue tattoo mark behind for a period of time.  There would be a scar and maybe a hollowed out area where I was missing tissue and a possible blue tattoo hmm I thought.  At this point my Doctor brought up another point.  I would qualify for the BRAC1 and BRAC2 oncogene testing package.  If this test came back positive for either of these genes I would be at a higher risk for the cancer coming back and my clear right breast was it at risk?  The oncogene testing is done at Juravinski Hospital and takes about eight weeks to get the results.  I wanted the cancer out of my body as soon as possible. If the cancer was surgically removed during a lumpectomy and I was positive for the BRAC1 or BRAC2 gene I would be  having both of my breasts removed to reduce my risk of the cancer returning.

I instantly new what I was going to choose. The option that I felt most comfortable with was having both of my breasts removed and necessary lymph nodes.   For me regardless of the procedure my breasts  would never be the way they were, so the only decision I was comfortable with was having them removed.  This whole ordeal is very emotional and I decided that having my breasts removed at once could save me multiple future procedures depending on any new findings as I went along this journey.

My Doctor then addressed with me the option to reconstruct new breasts.  Do you want breasts I was asked?  Well yes, I just assumed that I would have to wait for a year or so before I could consider reconstruction of new breasts.  It was brought to my attention that based on my body size it would be difficult to find donor tissue on my  body to create new breasts from.  This being the case future reconstruction may not have been an easy option for me.  My Doctor suggested that my new breasts be placed in at  the same time my old breast tissue are removed.  I would have a tissue sparing bilateral mastectomy with breast reconstruction and necessary lymph node removal.  This means that the skin tissue from my old breasts will be saved to make my new breasts and nipples.  Breast implants would be placed under my pectoralis muscle during my surgery.  I would not be able to complete radiation treatment with reconstructed breasts. The radiation disfigures the breast implants.  At this time we don’t know the details of my cancer but it is likely that I will have to have chemotherapy regardless of the surgical option that I choose.  Living in this wonderful country all of the treatment options for me are covered under OHIP.

My surgery is expected to take up to eight hours and is scheduled for Friday June 19, 2015.

– Amie Banting

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