It's not about the breast

Today was my last visit with my surgeon before surgery.  He helped me feel more informed and I use this word because the fact is is that "they" the Doc's of the world do not know what, how, or why breast cancer was, is , or in the future maybe formed.  And the 10% recurrence rate is a relative value, for all of us.  If you get cancer than X is your chance.  My numbers are not 10% but my numbers are either 0 or 100%. Not a mixture, not a smaller or bigger percent but either I don't ever get Breast Cancer back or I do, and it will come back 100% not sortof, not kindof, not a little, but if it does come back it does.  End of Story.  Okay, so the spiritual side of me can shift all those cells, and I will get to that work when I can.

First, I need to realize what I am working with, what the hell I am trying to shift.  The other fact is that I did visualize my body in complete harmony and I still got cancer.  The doc's and books say I should call it what it is, Infiltrating Ductal Carcinoma.  So, that is what I have and I know it doesn't make me what I am, but I have this cancer in my body right now.  Right now I am sick.  Right now I don't feel sick.  My heart is absolutely exploding with pain and grief, and sadness but I could be a poster child for health.  I am that model that is promoting health but takes a break and smokes a cigarette behind closed doors.  

Whether I get a lumpectomy or a mastectomy there is no survival difference.  I will survive, all the Doc's are saying that.  It is a difference of a Quality of Life.  Which today I understood on a deeper level verses the superficial "Range of Motion" I might have due to a mastectomy or wether or not my husband will be attracted to me still.  The real quality of life that my Surgeon spoke about today is that it might come back.  Which CANNOT be mixed up with survival rate, they are different.   No one can tell me any different.  They will have new numbers, numbers that are again for the general public, after my surgery.  Depending on how many lymph nodes are involved.  I will then again be faced depending on that outcome with new "life"decisions.  

My quality of life will be measured with questions only I can answer.  Because if the cancer comes back, there is a big possibility he said that it will come back in another place other than my breast.  So it is NOT ABOUT MY BREAST!  It is about my life, and how much of a risk taker am I.  It is also about the Doc's not knowing ANY real number for me, for my body, and for my immune system on wether or not it will or won't come back.  And if it does, where it would come back to, and when it would.  No one will ever be able to answer this for me.  So my faith comes into play here.  I have decided for sure to do the lumpectomy and before surgery I have got to get myself ready for that decision.  I have to look at it as it is "giving" me a choice, a choice after surgery, depending on lymph node involvement on wether to go back and do a mastectomy it is sparing my breast.  The question I will never know, until "it" comes back, "if" it does, is how long I am sparing this breast.  Which brings me back to It is About the Breast.

A basket full of decisions

I talked to my dad today about the decision I need to make about freezing my eggs.  He reminded me that the 40-60% chance that my kids, if I carry the genetic gene would as well if they got it, then have a smaller percentage from that number if they actually got it.  So...I have decided I am going to do it as I am not delaying my treatment.  Even if I was, the surgeon today said that biologically it wouldn't do a thing to my cancer, waiting a few weeks.  Emotionally it is an intense place to be, if I went there.  But I am not going to because I have to stay in the present moment and be still with my decisions.  

Tonight I spoke with my Oncologist.  He is an amazing man and he said that he has been working on compiling the numbers that would help someone like me answer my question.  The one in the earlier post, am I the 75% of the 10% since I am a Triple Negative?  He said there are no stats for this yet, and to go back to the known big number.  Leaving me at 10%, which is only a 9% difference.  The short term recurrence rate is 10% if I do the lumpectomy but long term success rate is the exact thing.  I am pretty sure I am going to go for the lumpectomy because I can always go to the mastectomy if the caner returns.  I have a 90 % chance that it won't.  D posed a question to me today.  If the cancer was in my leg with the exact same sats what would I do?  I didn't have to think, I'd keep the leg.  My surgery is scheduled for July 1st.  I have a few weeks to decide.  

Deal or No Deal Seriously

Met with the Surgeon today.  He helped calm me down with a few key questions and statistics.  I asked how soon after I get my mastectomy can I get my reconstruction done.  He said, "What is your goal?"  I said, "To Live."  Well then, if your goal is to live and if you were my daughter I would suggest not waiting for the whole process of getting reconstructive surgery, (its a whole process, unlike fake boobs) and start with your treatment.  I am wanting to give myself the best odds, and that is to kill this cancer as soon as I can.  He said because I am thin, reconstructive surgery is going to be a bit of a challenge.  I will have to cross that bridge when I come to that.  

He told me that Since I am so Young and Since its a Triple Negative I have (D and I again remember different numbers here, funny what stress does to our brains, we need to remember to bring a tape recorder) a 10-30% chance of me developing breast cancer a second time if I do a Lumpectomy.  I quoted the first surgeon's statement, "There is 30 years of research showing there is no difference in survival rates if I get a lumpectomy vs. a mastectomy."  He said that he disagrees with that as it really boils down to A Quality Of Life issue.  If I want to have the lumpectomy and risk getting it back and fighting this thing again I gave you my chances above. If I get a mastectomy I have a 1 % chance of getting cancer again.  

This is a no brainer, I am taking the deal of Mastectomy.  If my cancer was one of the other 3 that feed on things that they know about and if they could give me whatever drug to decrease my chances of getting it again, I would take that Lumpectomy.  But I am not going to risk this again.  If two months ago, someone said, "If you go down this road you have a 10-30% chance of getting it, heck even a 10% chance of getting breast cancer, and if you go down this road you have a 1% chance."  What road would you choose?  I choose to stick to the road that is going to insure my life for the next 55 years.  I am so young, and there is so much ahead of me that I have a larger amount of time that this could come back vs. a woman getting this in her 50's.  

Hard questions that I can only answer.  I am the one who will have quality of life issues, dealing with the pain of tighter tissue and restricted movement due to this surgery.  And if I go under, and they do find more and the tumor is bigger and more nodes are involved than expected, I would be getting the mastectomy anyways.  My Oncologist is going to call me tonight and talk with me about all of this.  I am interested to hear what he thinks.  Can you believe I am getting to deal with this?  Amazing.  The Why's are all around and I am ignoring them.    

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Okay I just spoke with my Surgeon.  It is a 10 % recurrence rate for the lumpectomy without the gene bit.  Those numbers are high, much higher and I could be freaking out over nothing and warping my brain about things that will not matter.  But I need to weigh this all, and need to decide before surgery.  If I do the lumpectomy or the mastectomy either way I am going to be watched like a hawk for the next 5 years or so.  If a second cancer does appear they will catch it very early and then off with that boob!  What my surgeon did say is that he is concerned that I am under the age of 35 and that it is a Triple Negative.  

I have a question for my Oncologist now since he works closely with young woman with Triple Negative.  What I need to know is from that 10% (guys I got a D in Alegbra 2 with a tutor) you get the four sub-groups, the feeders on Progesterone, Estrogene, Her2Nu, and my lucky devil Triple Negative.  What are the rates of recurrence with women UNDER 35 and that have the Triple Negative?  Are we 75% of that 10%?  Phew...Right now I am leaning towards the lumpectomy.

If I get the lumpectomy and during surgery if they find more nodes than one that is cancerous the Surgeon said it does not changed my recurrence rate.  It isn't higher.  This is why I do Chemo and radiation.  The lumpectomy will allow me to be a better athlete, a massage therapist, and allow me to be closer to the person I am now.  I love to go snowboarding, ect.. Although I am not sure if I will be able to do that, if I fall will it cause me to have lifetime lymphadema?  I asked the Surgeon how will he know if he got all the cancerous nodes out, he said that he wouldn't know for sure, and this is again why I do chemo and radiation.  Another interesting thing he said is choosing a mastectomy gives me control with what I can have control with.  It is bringing my recurrence rate down to 1%.