The Results from the Pathology Report – The Stage of my Cancer Revealed
Today I went in for a post operative check-up with my surgeon, Dr. Berg. The pathology results came in. My dear, dear, friends…this is going to be a long road for all of us.
After they removed my breast tissue, they did what is called a sentinel node dissection of the first three lymph nodes to check “just in case” there is any crazy insane chance in hell, that there may have been an invasive cancer. DCIS (Ductal Carcinoma in SITU) is supposed to stay in the ducts and be non-invasive. When I had my mammogram and biopsy, they pretty much knew it was “just” DCIS. The only way to really tell if there was anything else, was of course after the bilateral mastectomy (surgery that removes both breasts) when they send the tissue to the pathologist. The pathologist found cancer in nodes removed. What this means, is that he was NOT just facing DCIS. DCIS DOES NOT invade. Cancer in the lymph nodes means invasive cancer. They went back into the breast tissue and found a tumor the size of 3mm with a tiny spec of cancer cells in it..I would guess the size of a pen mark. That little bit of cancer cells was enough to travel and invade my lymph nodes and into my blood stream.
What does this mean?
I have invasive cancer. Dr. Berg said that they (a bunch of doctors of all sorts of specialties) met up at their conference and I was the big discussion…again.. on what would be the best treatment for me, how odd this is, how rare this is…they have no one to compare me to with my age and since I have no family history, whatsoever, of cancer. They all talked together and said that since this is so aggressive, the best treatment for me would be to remove all of my lymph nodes in my right side (these are known as the axillary nodes). Once I heal from that surgery, I will then start chemo.
Next Tuesday, Jan. 8th, I meet up again with my Oncologist, Dr. Chowhan at the Cancer Center of Indiana, in New Albany. He is going to be the one to decide on which treatment would be best for me. If it were up to me, I honestly would prefer them all removed..at least I KNOW I did all I can to remove any percentage of cancer in there. Hell, It really MAY be up to me, now that I think of it. Since Dr. Chowhan is an Oncologist, of course I would want his guidance and experience on what he thinks is best for me.
Believe me when I say this.. When Dr. Berg told me that the cancer spread to my lymph nodes, I started crying out loud like a child. Shocked the hell out of me
1.) That it had spread 2.) That I was publicly crying like this. I’m an incredibly private person when it comes to crying. Of course that was normal and to be expected. But every time I have learned this or that through this journey, I’ve been strong-and not in a facade´sort of way..really strong about this news. It’s after I tell my family, that it sets in and I cry. Tonight, I cried for myself first. Immediately. Screaming inside my head “I THOUGHT THIS SHIT WAS NOT SUPPOSED TO SPREAD…!!!!!????!!!!” It turns out, it’s almost like I have three different breast cancers going on.. Paget’s disease of the nipple was first. (dude, seriously read how rare this one is)…then all the dumb calcifications in my ducts..the DCIS, then this tumor mass that held the small piece of cancer.
Here are all of my staging and grades:
(Click this link to read in “human terms” while going back and forth to what these grades mean in definition)
Histological Type of Invasive Carcinoma: Invasive Ductal Carcinoma
Tumor Size: Size of Largest Invasive Carcinoma: 3mm
Histological Grade: Nottingham Histological Score:
Glandular (Acinar)/Tubular Differentiation: Score = 3
Nuclear Pleomorphism: Score = 3
Mitotic Count: Score = 2
Overal Cancer Grade: Grade 3; Total Score=8
Tumor Focality: Single focus of invasive carcinoma
Ductal Carcinoma in Situ (DCIS): Present; positive for EIC
Architectural Patterns: Comedo
Nuclear Grade: Grade III
Necrosis: Present; central
Pathological Staging (pTNM)
Primary Tumor: pT1a
Regional Lymph Nodes: (sn) pN1mi
Distant Metastasis: Not applicable
SO……What I need are my right axillary lymph nodes removed and undergo chemo.
I am doing well tonight. I am just so freaking glad you guys are all still here with me and have my back, sides and front!!! I LOVE YOU