Genetic Testing and 2nd Opinion

Genetic Testing

I got my genetic testing results back. I am one of the lucky 2% that come back with a defective gene that they can't tell if it is poss. or neg! How fun. So my family is willing to get tested and see if any of them carry it. This will help determine if it is indeed genetic or not but it is mostly for research as they have never seen this variation before!!! CRAZY!!! So no real results except that I think a double mastectomy is in my future. We will see what the doctors have to say about the ovaries.

2^nd Opinion

What a great day it was at Dana Farber. That place is amazing and the people are so kind and wonderful to work with. We saw the oncologist Dr. Karen Anderson (one of the top docs in her field) first. She was so good at explaining things in terms that we can understand. She did her exam and then came back to explain what she sees and what treatment options I have. She said that the type of chemo I am getting right now is exactly what I would get from her. So we are on the right path attacking this from the inside. She also said that since the tumor has already shrunk some my body and cancer is responding very well to the chemo to kill it!! She said that this usually shows less of a chance of recurrence!! It isn’t guarrenteed but it is a good sign!

After I finish all the chemo treatments I will be having surgery of some type and then will be looking at 7wks of radiation. This will consist of 5 days a week for 7 weeks. The treatment is short (1/2hr) and hopefully we can do that in Enfield so I don’t have to go to Hartford EVERY DAY!!! Radiation is a given no matter what the surgery is that I have. Once all of these treatments are complete I will be put on Tamoxifen for 5yrs to keep the estrogen levels down to lower the risk for a recurrence. This is also the standard treatment.

Next we saw Dr. Susan Troyan the surgeon. She also did an exam and then came back to discuss my surgical options. This was the main reason for the 2^nd opinion. This was also the scariest part of this whole thing for me.

Dr. Troyan said that given that my tumor has shrunk already from the chemo and seemed to be mobile that I would be a good candidate for a lumpectomy. She did say that there are some calcifications on that side that could be absolutely nothing or they could be cancerous. They won’t be able to tell until they get in there and get pathology reports on those calcifications though.

Option 1: Lumpectomy and wait for path to tell us about the calcifications. If there are unclear borders of the tumor then I would need a 2^nd surgery to go in and try to clean up the borders (take more out). This would be a day surgery and I would need 2wks recovery at home.

Option 2: Mastectomy. This would eliminate a 2^nd surgery for the calcifications if there was a problem. With this surgery they would/could put in a skin expander for the reconstruction. I would be in the hospital for 2-3 days and then would recover at home for 3-4 wks.

Option 3: Double Mastectomy. Due to the unknown results of the genetic testing this may be an option to avoid a second or recurrent cancer. One thing I found out is that if I do decide on a double I would not have to have it done at the same time. I could do the one side and then when the radiation is done and 6 months has gone by after the end of radiation then they would do the 2^nd side with reconstruction of both sides. This is a consideration given the unknown genetic test results.

Ovaries: We may want to keep these as long as possible!! If I have a recurrence or feel that, again due to the unknown genetic test results, I want them out to lower the risk of ovarian cancer, I can have that done at a later time closer to menopause.

One thing I have realized through this is that this will be a fight I will be dealing with for the rest of my life. Once the cancer is gone it doesn’t mean that I am done with it and never have to worry about it again. When you are diagnosed you know it will be a lifetime battle but it really doesn’t sink in until you are looking at decisions that don’t have to be made for years and years to come!

So as you can see we had a lot of information given to us but it was an incredible day. I feel more at ease given all these different options and knowing that we can do things slowly and not all at once.

I am also so thankful that God held the snow off for our trip and that Cheryl L. could come with us! She had some great questions and really helped us remember all the questions we had and get all the information we did.

The next step with be to talk with my surgeon and see what he has to say about all the options and what he thinks is the best thing to do.

For right now I am headed to my LAST A/C chemo next thurs!!!! That will put me at the ½ way mark in my chemo and the next half will be more tiring but I won’t be nauseous like I have been on the A/C!!! I am actually excited to get that treatment done! Almost half way there and the tumor is already smaller!!! PRAISE THE LORD!!!!