Saturday, July 23, 2011

Biopsy Results Appt.

Okay, here's the latest from Dr. Local Breast Surgeon that Dr. Internist sent me to - seems like local doctors refer you to local doctors, and I guess I'm okay with that.   She is nice, but very, very young.  And I have learned that you ALWAYS get at least a 2nd opinion so that you can have peace with whatever the plan of action.  Insurance pays for it & good surgeons expect you to do so and are not insulted.

Dr. Local Breast Surgeon said today, July 22:
The pathology report does confirm have Invasive Lobular Carcinoma in my left breast.  This type of cancer has an increased risk of occuring in the other breast so the treatment of choice is bilateral mastectomies.  There are 3 Grades - 1, 2, or 3.  Mine is Grade 2. 

Next step is to have a breast MRI of both breasts & my underarms to see if the cancer has spread.  She uses Insight Imaging in Fort Worth.  Dr. Local Breast Surgeon will have them call me for an appointment for next week.

She said reconstruction would begin at the time of the mastectomies.  She uses a Fort Worth plastic surgeon for reconstruction.  She said he would insert expanders - and keep enlarging them until I get the desired size.  I think then he inserts the implants.  It will take several surgeries  and months or years to complete reconstruction.  There is even a nipple reconstruction phase.  Seems like a lot of trouble since I'm the only person that ever sees my naked body.  But, there's always hope to find Mr. Right, right?

She said 3 hours before surgery they will inject the sentinel lymph nodes with a dye to determine if cancer has invaded the lymph nodes.  Then during surgery she will inject another color of dye to determine further lymph node involvement.  I guess this lets her know how much to take out.  The Pathologist looks at these two tests to determine the "Stage" of the cancer - Stage 1, 2, 3, or 4 - with 4 being the worse.  Let's pray for 1!!!!

Dr. Local Breast Surgeon recommends a local oncologist at Arlington Cancer Center. 

The Fort Worth plastic surgeon called me this afternoon to set up a consultation with him next Tuesday in Fort Worth.  I can keep or cancel this appointment according to out the 2nd opinion goes.

Oh, Dr. Local Breast Surgeon also said that the entire body MRI to determine if the cancer has spread to the bones, liver, etc., is done after the mastectomies.  INTERESTINGLY, I talked to another friend of mine who went through the same thing last year and used one of the highly recommended breast surgeons below, and she said they put her through all kinds of MRIs and tests to determine the extent of the cancer on the body BEFORE they did the mastectomies.  Wow - that is scary if that step was going to be postponed when maybe it shouldn't.

End of story for today.

I put a call in to Dr. Internist this morning to ask him to refill my Xanax prescription for my anxiety.  He only gave me 10 days worth last week - to which the pharmacist said, "Why did he give you so few?"  I also asked his office to call me in a sleep aid.  Tylenol PM is not getting me to sleep or keeping me asleep.  Well, he did not call in either, so I'm dreading the weekend on my own.  I'll call again Monday and see where they dropped the ball.  The pharmacist felt sorry for me and even said he would fax my doctor and asked him if he would prescribe me a sleep aid - the pharmacist knows my cancer story.  I cannot be choosy about doctors becaue when you are on Medicare it is impossible in my area to find a family doctor that will accept you...and only a handful of internists will accept Medicare with Aetna TRS-Care as the secondary insurance.  Your reward for being a lifelong teacher in Texas and getting old!

Wanting to hurry & get a 2nd opinion, names I had to choose from were either a breast surgeon with Texas Oncology at Baylor in Dallas or breast surgeon with Texas Oncology in Beford.  I chose to get a 2nd opinion in Beford because it is closer.  Both were highly recommended and are experienced breast cancer specialists.

I was fortunate the Bedford breast surgeo will see Monday at 4:30 for a consultation.  Praise to the Lord for getting in to see her so soon!  I have to take her my CD of the images of my breast sonogram and diagnostic mammogram and the pathology report from the biopsy is being faxed to her this afternoon.  High school girlfriend, Paula, has offered to take me for support as I think all 3 of my daughters will be unavailable - one out of town, one at a teacher workshop, and one works evenings.
Thanks a million to high school girlfriend, Brenda, for taking me today, taking notes, and helping me ask questions.  You definitely need two sets of ears and two brains when taking in all this shocking and foreign news and information.
Please continue to remember in your prayers as I begin this journey.  Feel free to share with me any advice as I am running around like a chicken with my head cut off right now.

Mayo Clinic - ILC - ILC
Web MD - ILC
John Hopkins - ILC

Internet Description of Invasive/Infiltrating Lobular Carcinoma of the breast:

Invasive or Infiltrating Lobular Carcinoma (ILC)

illustration of invasive lobular carcinomaInvasive or infiltrating lobular breast cancer (ILC) occurs when the cells in the milk lobule become abnormal. The lobular cancer cells look different from normal lobular cells and multiply without stopping. They spread outside the lobule into the surrounding breast tissue. ILC does not mean that the cancer has traveled to other parts of the body beyond the breast, but it has the ability to do so.

The terms well, moderately or poorly differentiated may also be used to describe ILC. Cancers that are well differentiated look more like normal cells in the milk lobules, while those that are poorly differentiated have lost many of their normal cell features. Moderately differentiated cancers fall in between.

Surgery, radiation, hormonal therapy andchemotherapy can all be used to treat ILC. Most women will receive a combination of treatments, although not necessarily all four types of treatments. The types of treatment recommended will depend upon the size of the cancer, whether the cancer is in the lymph nodes, features of the cancer cells themselves and your general health.

THOUGHT FOR THE DAY:  Hoda'ism:  The Diagnosis:  "My lumps were bad actors.  Malcontents.  Badasses." - Hoda Kotb