Let me start by saying that my thinking/decisions are changing fairly rapidly. Last week I had a 2nd biopsy, I was also on the verge of getting a cold, so I stayed home in an attempt to not actually get sick. In that, I succeeded. On Thursday morning my surgeon called.

To heighten the drama, let me digress a  moment. Dr. M was on her way out of town on vacation, but stopped by the office to take care of a few things and to check whether my results had come back. They had, so she called me to give me the news, even though she knew the nurse navigator was going to call me. She then spent 45 minutes with me, discussing the options and possibilities.

The news? Both of the two lumps biopsied are cancerous. This has gone from a fairly straightforward and moderate procedure to one that likely requires major surgery. Dr. M favors a partial mastectomy, mostly because there is now a fairly substantial amount of tissue that will be removed, all along the lower quadrant (the lumps are basically at 7, 5, and 4 o’clock). She also recommended that I talk with a reconstructive surgeon about doing the partial mastectomy and a reconstruction all at once. She also felt it was entirely possible for me to have breast reduction surgery on the right breast.

(Because, post-surgery, I will not be asking that my left breast be returned to D cup status, so my right breast will need to be altered to match.)

It was a fact-filled 45 minutes, and I don’t think I took it all in.

While we’d talked, V (the nurse navigator) called and left a message. So I returned her call. Good thing, too, because I suddenly remembered the other lump — the one at 10 o’clock, the one that can’t be seen except with an MRI and is very tiny (3 mm) so it is going to be very difficult to biopsy. When I reminded V. of this, she immediately said, “OK, in my experience, you need to start strongly considering a full mastectomy.” We’re talking about 2 quadrants having cancerous lumps, and now the possibility of a 3rd quadrant being infected has entered the picture.

If I have a mastectomy, its radical surgery, but I will not have to worry about getting breast cancer in that breast again *and* I won’t have to have radiation therapy *and* I won’t have to do that (HORRID) wire localization procedure. Peace of mind, one less therapy, and one less surgical procedure — that’s a silver lining.

That night, my Dad raised a question: what about the right breast? Did I need an MRI of it as well so we KNOW there aren’t anymore hidden tumors? I was on the phone with V. the next day. She told me that they *had* done both of my breasts and the right breast is completely clean. GOLDEN lining!

So, where am I now?

Looking at a lot of major paths to take, all of which branch off multiple times, and some of those branches overlap and intertwine. Each path offers benefits and problems. What was a fairly straightforward path initially has become complicated.

1. partial M, with lumpectomy of the 10 o’clock; reconstructive surgery and reduction surgery
2. full M with reconstructive surgery and reduction surgery at the same time
3. full M with reconstructive surgery and reduction surgery at some point in the future
4. no surgery, only radiation therapy
5. something not discussed yet

In every case, I will be on hormone therapy (Tamoxifen). This is because my cancer cells are estrogen positive (not all cancer cells are). This means that the presence of estrogen in my body feeds them, so one treatment I will undergo (a pill a day for 5 years) is to stop the supply of estrogen. As V. put it, I will basically go from 0 to 60 on menopause, except that I will likely still continue to ovulate (put another way: all the downsides of menopause, none of the positives).

I don’t know what I want, yet. I don’t know what my instinct says, yet. I don’t have all of the information I need, yet. I know that I am not my breast(s). I know that I am not very vain or particularly caught up in my physical being as needing to be attractive for my self-esteem to be stable or positive. I also know that I can’t envision how hard surgery will be on me.

At this point we don’t know when the surgery will be. I’ll let you know when I do.

The limbo continues.