Posts tagged Pathology Report

Just the Facts: It has been a busy couple of days.  I had my post-surgery follow up appointment with my surgeon yesterday (Tuesday), which went very well.  Then I went to my plastic surgeon to have my four surgical drains removed.  Today I went back to be checked because it seemed like I was retaining too much fluid, but all is well.

Details: I am 8 days post-mastectomy and reconstruction surgery as of today.  Yesterday I saw my surgeon for a follow-up visit.  He was very pleased with how I am doing and we mainly ended up discussing the pathology report and our next steps. He referred me to an oncologist and had an appointment set with her for April 23.  We will meet and discuss the pathology report in greater detail, then she will most likely order an Oncotype DX report for me, which will boil down all my decisions about chemotherapy and hormone therapy into hard numbers.  The surgeon reiterated that most likely, chemotherapy won’t be recommended since my lymph nodes were clear.  Hormone therapy (tamoxifen) will VERY likely be recommended.

Here are some “highlights” from the path report for those who have an interest in such things:

• There were two tumors (This princess actually had two peas.)  One was 1.5cm and the other was 1.2cm.  They were both invasive carcinoma.  There were also a few occurrences of In Situ Carcinoma (not invasive) that accounted for the other worrisome spots on the MRI.
• The margins were clear with a range of 2-5mm, which is excellent.
• Three lymph nodes were removed and all were cancer free.
• The left breast was completely benign.
• Both tumors are highly estrogen sensitive and at least partially progesterone sensitive, which makes the cancer highly treatable with hormone therapy.
• The tumors were HER/2 negative, another reason chemotherapy is likely not needed in my case. HER/2 positive cancers are always treated with chemo.
• The tumors were a low grade, meaning very slow growing.

After discussing the report with my surgeon, he asked that I make another follow up appointment with him for three weeks from now.  After that he won’t need to see me for a year.

The plastic surgeon’s office is where we’ll be spending lots of time in the coming weeks, and that’s where Tracy took me right after we left the surgeon’s office.  They ask you to monitor and measure the amount of drainage that you have each day that you have the drains and come into the office when the output is at or below a certain level.  By Tuesday I had been at the magical level for 48 hours and called to see about getting the drains taken out.  (Managing life with them is no treat!)

The nurse called early Tuesday morning and said I could just come in whenever it was convenient.  So we headed there about 11:00am.  Sparing the ugly details, I will just say that having those drains removed was gross and awful in many ways.  Afterward, I was relieved but also felt very disoriented and off-balance.  For the last week I had grown used to them, my 4 new appendages.  Further, they had been there since the loss of another major part of me.  Somehow the mix of adding and subtracting plastics and parts left me quite out of sorts.  After some lunch I felt better.

However, by late afternoon, I noticed that I was beginning to look quite fluffy and puffy, especially in the post-surgical area.  The fluid that would have found it’s way out via a drain was beginning to pool in the area and I started to get nervous.  My doctor had mentioned that the success of the reconstruction was dependent on keeping the fluid retention under control, in order to avoid infection and general failure of the effort.  I knew some fluid retention had to be expected, but it seemed too much, too fast.  I called the plastic surgeon’s office and the nurse asked me to come in today (Wednesday) because she wanted a doctor (mine wasn’t in the office) to check it out.

Through the evening it seemed to get worse, then better, and back and forth.  I really did not sleep well, partially trying to monitor the puffiness as I slept, as if there were anything I could do about it.  I somewhat expected the doctor to tell me that I would need to go back to the OR and have the drains put back in.

However, the opposite turned out to be the case.  The doctor I saw said that the retention was really very little, in the spectrum of things.  He said that it would 1)begin to be reabsorbed by my body  or 2)be removed by needle if it persisted or 3)be pushed out as we proceed with the tissue expansion process.  I already had an appointment to see my plastic surgeon tomorrow (Thursday) so he will check the situation again then and decide what, if anything, else needs to be done.  Whew!

Me: I feel good.  The ordeal with the drains has left me, well, drained.  (I couldn’t resist.) But generally I feel strong, energetic and healthy.  The after effects of 6 hours of anesthesia are not unnoticed, though, as I do get sleepy and groggy when I really don’t think I should.  I have been told that those effects could take 6+ weeks to wear off. I plan to ask my plastic surgeon for details tomorrow about EXACTLY what types of exercise I can safely do right now, because I want to move again, in that way, and I know it will help clear my groggy head!

What’s Coming Up? Plastic Surgeon tomorrow and every Thursday for a while, Oncologist on 4/23.

Other: Our family has been so hugely blessed by all the support and good wishes and prayers from friends.  Thank you.  Thank you.  Thank you.  I am not able to answer most blog comments but I do read them all again and again.  Thank you so much.