Month: December 2017

results

When Negative is a Positive

When looking for signs of malignancy in a pathology report, a negative result is a good thing. A positive result is a bad thing. My biopsy was positive for cancer. Bad. Treatment? Take it out. Done. 

This week I received the first pathology report that gave data on 3 things that were removed during surgery: Lymph Nodes, Right Breast and Left Breast. Since I knew that the Right Breast contained cancer cells, it wasn’t expecting any huge surprises, just more details. The Left Breast was removed prophylactically (for my convenience) so I wasn’t expecting anything there. But the Lymph Nodes? Now that data was going to be important. 

Path report snippet

Such great news! Negative! Woot Woot! 

Before we go too far along, let me explain a bit about the lymphatic system – that will give you an idea of why this is such a big fucking deal. 

The lymphatic system carries lymph – a clear fluid (from Latin lympha, meaning water). Lymph works in conjunction with the circulatory system (which carries blood). It travels along and filters through lymph nodes (we have between 500 and 600 in our bodies). Here’s a look at the area of interest to me:

Diagram
In other words, armpit. 

Lymph nodes and the lymphatic system are very important in the cancer world, because when you have cancer, the lymphatic system acts as a highway (to hell). It carries cancer cells all over the body where it can take root, grow and kill you. That process is called metastasis. I’m sure you’ve heard of metastatic cancer. Sucks. 

When cancer cells travel in lymph, they will get caught up in the lymph nodes. This is why, when looking for any spread of cancer, the surgeon first figures out which nodes the cancer tumor drains to, and then does a biopsy of those nodes. With breast cancer the surgeon takes out one or more axillary lymph nodes. They are in the armpit as you see in the diagram above. In an earlier post I told you a bit about how I was prepped for the sentinel node biopsy. I found out later that only one node “lit up”, which was a good thing since the surgeon only had to take one out.

sentinel node biopsy
This is what they do to figure out where the “hot” node is.

Of course, since it’s deep in the armpit, the surgery involves digging and scraping through the pectoral muscle so it’s a bit tender. But I digress. My “hot” node was negative, and that’s what’s important. No cancer in my lymphatic system. Phew!

The second set of results were details about the cancer in the right breast – which we knew a bit about already, mainly that it was Ductal Carcinoma in Situ (DCIS) with microinvasions. That means that there was cancer in the duct with some invading out of the duct.  Details from the pathology report:

  • the cells are Stage 3 invasive ductal carcinoma
  • there were multiple foci of microinvasion in the 4cm x 3.6cm area (as shown in the MRI … so mastectomy was the right call). 🙂
  • the two foci were 2.5mm and 2.1 mm
  • there were clear margins around the larger area
  • It is named “high grade comedonecrosis” or “Grade 3”, positive for EIC (extensive intraductal component) Which translates roughly to “really fucking bad”, as my surgeon pretty nearly said, but without the swearing. 
Pathology
Pretty easy to understand, all things considered.

The data revealed that it was bloody good that they did a mastectomy, rather than a partial mastectomy (otherwise known as a lumpectomy). It was a bit of a crap shoot to do it since MRI results can often be a “false positive”. I decided to err on the side of caution and had both breasts removed. Glad I did. 

Next step is to meet my oncologist. He / she will read the next pathology report that identifies my cancer cells’ receptors. These receptors indicate what makes my cancer cells grow, and so from that, they determine the treatment plan. But that’s for another blog post. 

Thanks for hanging in! 

sticky goo

Coming Unglued

I’m coming up to 3 weeks since having my breasts removed. Since I left the hospital I have subconsciously been measuring my progress by the amount of gluey bits that I’ve been able to remove from my body. I know this because now that it’s almost all gone, I’m still not healed. And I’m appalled. But I’m getting ahead of myself. 

glue in the armpit
Just kidding – these are bruises from where they taped me to the table. (OMG, really? Yes.) But note the tape going WAY up into my armpit!! Seriously excessive.

I came home a few hours after surgery. I was hopped up on oxycodon and therefore didn’t care that the tape attaching the bandages to my body came high up my chest, straight around under my armpits and across my back. The next day, when I realized that the tape was preventing me from moving freely, I pulled back a few centimetres along the perimeter and tucked it in on itself, like a rebel. Thus began my journey into tape removal, and in my mind, recovery. 

big ass bandages
This first bandage was more like a halter top. Note my work on the edges to make a nicer finish.

I guess that my tape removal = healing theory came from the premise that this healing thing was going to continue on a predictable trajectory. Tubes out, big pad of bandages off, staples out, smaller bandages off, steri-strips on, steri-strips falling off, … no tape. Done! HA! How easy was that?? 

steri-strips
Look at how the glue turns black – even on the edges of the steri-strips! Yeech.

Now, as I have gone off all drugs except for the odd extra strength ibuprophen, I’m ALMOST glue free, and yet … what’s that I hear? Oh. It’s nerve endings yelling at me! Wearing a shirt hurts. Wearing anything hurts. That is, unless it’s really tight. I feel like a deep pressure junkie. I stand around pressing my hands flat against my chest to make the sensation go away. It’s not quite pain, it’s more like a humming, or the feeling when you’ve had frostbite and then you come into the heat. Burning. Pins and needles. It’s very distracting. Driving with an ice pack under the seat belt is distracting (but feels so great!). 

It’s actually fascinating to probe around the scar tissue and feel the edema in some areas (soft and pillowy) and scar tissue (?) in others (hard and unrelenting). I don’t know exactly where the surgeon dug and scraped to get at the sentinel lymph node, but I can guess. 

scar
This is a nicer section of the scar. (There are some very nasty spots!) Note the bits of glue. Sigh.

So ya, I’m almost 3 weeks from surgery and still unable to do basic stuff without wincing, such as:

  • wipe the table
  • pull open the cutlery drawer 
  • drive standard 
  • braid my hair
  • take off a shirt (how come it’s easy to put it on?? makes no sense)
  • sleep on my side 
  • push myself up from a seated position

At my last appointment my surgeon drew me a diagram to explain it. There are nerves that run up through the breast tissue from the chest wall to the skin on top of the breast. He’s cut all of that tissue out, and in the process cut the nerves. So now I like to think that they are talking to each other. “Hey!! Where are you??” Not sure how long it takes for the nerve endings to chill out and the swelling to subside so that the skin can meld with the chest. 

chest diagram.
This is my version of the doc’s drawing. Lou can weigh in on how well I did.

In the meantime, tomorrow I will work on removing the last few bits of glue.