About a week and a half after surgery, we got a call during dinner from the breast cancer surgeon with the final pathology reports. It was the second time we cried tears of joy in our new story.
2. LYMPH NODE, "SENTINEL NODE #1," LEFT AXILLA (DISSECTION):
-ONE (1) LYMPH NODE, NEGATIVE FOR CARCINOMA.
3. LYMPH NODE, "SENTINEL NODE #2", LEFT AXILLA (DISSECTION):
-ONE (1) LYMPH NODE, NEGATIVE FOR CARCINOMA.
The lymph nodes were 100% clean.
It seemed like she could have just stopped right then and there. But she continued.
Margins were clean.
Skin was clean.
HER2 Negative.
Tumor measured 2.1 cm in the greatest dimension (which was pretty much what they were guessing).
The only negative result we received was that the invasive portion of the cancer (the tumor) was an Elston Grade 3 of 3. We didn't really know what that meant, or frankly, didn't really even care at the time of the phone call since we were just so freaking excited to confirm the lymph nodes status. We didn't know at the time that the Elston Grade would become a big factor in our treatment plan.
Come to find out, that Elston Grade basically represents the "aggressive potential" of the tumor, so a "low grade" (or a 1 on this scale) tends to be less aggressive than "high grade" (or a 3 on this scale). So it turns out, I have a pretty aggressive form of breast cancer.
Fast forward to our oncologist appointment, exactly four weeks after surgery, December 16th. It also happened to be exactly two months after my official diagnosis on October 16th.
(On a side note, I'm just going to skip over any more "16ths" in the upcoming months. Kthanksbye.)
I wanted to take a picture of the waiting room but I couldn't bring myself to do it. It was all decorated for Christmas, but you could have heard a pin drop in that place. My mom was on daycare pick up duty so Wes came along with me and so did my Dad. It was just one of those appointments where you wanted that extra person to help listen, in case you started to hear things that got you upset. There was just something about this waiting room, and I realized it the minute that we walked in. There were only a couple of other folks there, but no one was there alone. Everyone had a support system. It wasn't a doctor's office where you go alone. It wasn't like going to get a check up. It was just different. There was a couple to our left, where the woman just looked miserable. She had her head on what I was assuming was her husband's shoulder, and she had clearly gone through, or was going through chemotherapy. That certainly made me take a step back. At one point, the nurse navigator came out to introduce herself to me and say that someone had told them I was coming, so they were expecting me. She said that she was sorry that I had to be there, but that she was glad they could try to help. I remember thinking and wondering how she could just talk so freely with the other people all in the waiting room. She wasn't quiet, she didn't whisper. Everyone knew I had breast cancer. It didn't take me long but I then realized everyone there had some form of cancer, so it wasn't ever a secret, or something to hide. The two couples there, came and went and we were still waiting. Cracking a few jokes here and there to keep our minds off of what we were there waiting for. After waiting over an hour, we finally got to meet my oncologist, who is now basically the team lead in my story.
The appointment lasted about and hour and a half, and it was once again like drinking from a fire hose. The first part was a lot of questions for Wes and I, about our lifestyle, family history, kids, where we worked, what kind of people we were. Then it was Dr. W reviewing the final pathology report. There was a point where Dr. W had one treatment plan in mind, then he found the Elston Grade result and the plan quickly changed. There was no doubt in his mind what my plan should be. a 20-week chemotherapy plan followed up by a minimum of a five year hormone therapy. The hormone therapy was pretty much a given for us, ever since we found out we were ER+, but hearing that chemotherapy plan officially was a bit of a blow.
The next half hour or so (that's what it seemed like at least), was spent talking about the Tamoxifen hormone treatment, fertility and the possibility of ovarian suppression. After that, it was on to the chemotherapy plan, which will include four cycles of AC (Adriamycin and Cytoxan), one dose every two weeks for four doses (so a total of 8 weeks), with a shot of Neulasta in the skin the day after each chemotherapy treatment to reduce the risk of infection. This will be followed by twelve weekly doses of Taxol (so a total of 12 weeks). We are supposed to kick things off next week.
Since diagnosis, chemotherapy has certainly been one of our biggest unknowns but pretty much for the entire time, I have been mentally trying to prepare myself thinking it was going to be a part of my treatment plan. I would never say that I wanted to go through chemo, but from Day 1 I have told myself that I would do anything, no matter what it was, to keep me around for as long as possible. If it sucks now, but means that I'll be here to pick out wedding dresses with Emma, I'll do it. If it sucks now, but means that I'll be here to watch Jack become an amazing father to his children, I'll do it. If it sucks now, but means I'll be here sitting next to Wes on our 50th wedding anniversary, I'll do it. So although it was certainly a shock to hear it, and a shock to hear that it would be four months worth, and a shock to officially be told that by the time you arrive for your second treatment your hair will be gone, there is no other option in my mind. After hearing the percent chance that my cancer could come back without treatment, and then hearing the percent chance it has after treatment, there's absolutely no question.
We ended up leaving the appointment at about 6:30PM, tired, nervous for what was to come, but I think also feeling confident in our path forward. We felt confident in Dr. W. He didn't sugar coat things, but was trying to get to know us, so he was personable too. We weren't a number to him. We were a young couple, with two very young kids. And he flat out said it was his job to keep me around for the long haul. And he sounded like that's exactly what he was about to do.
So that's the plan! I've been busy getting lots of appointments and check-ups out of the way before starting chemo (you can't do things like go to the dentist on chemo, etc, anything that has a risk of an infection). I even started back at work which felt amazing!! Next on the list is to get a major haircut, which is pretty much the first recommendation I'm gathering as it can be pretty traumatic when it starts to fall out, and maybe even pick out a wig for those days back to work.
You know, at first I felt like I just wanted to skip over 2014 since it was going to start out so sucky. But now, I think of it as the start to the rest of my life. Any mom out there would be eager to start whatever it was, that was going to keep her around for a very long time.