I went to see a breast surgeon (Dr. Ewing) today. She is based out of UCSF but has a consultation office here in Marin. She was warm and knowledgeable and I like her very much. We discussed the next steps that will hopefully lead over the next few weeks to information that will allow us to make treatment decisions.
Next week I will meet with a radiation oncologist and a genetic counselor at UCSF. The radiation oncologist will give us an informed opinion on whether or not I will be able to undergo any further radiation treatments if needed (the issue here is my lifetime load of radiation, having already undergone 9 weeks of daily radiation treatments for the Hodgkin's back in 1992). If not, then lumpectomy is out because it always has radiation as a complementary treatment. The genetic counselor is because apparently there are additional genes to analyze besides the ones that I already tested for last year (the BRCA-1 and BRCA-2 genes, which I was negative for). Not exactly sure what those results will tell us but Dr. Ewing seemed to think the info would be helpful, so fine, take some blood and let's see.
The step after that is the following week, when I have an MRI scheduled (9/29) and then a follow up with Dr. Ewing at UCSF (10/2) where she and the team review all the test results to date and figure out if there's any others they want to do while I'm there. Then depending on that we'll start talking about treatment plan. What we're trying to do with all the tests etc is to figure out the boundaries of the cancer and where it might have come from (so we know where it might possibly have gone/will want to go in the future).
My understanding at this point is that the favored option would be a lumpectomy (removal of the cancer area(s) and a margin of flesh around it to ensure we get it all) + lymph node biopsy, to then be followed up with prophylactic radiation treatments and hormone therapy to keep it from coming back. (Hormone therapy will put me into early menopause, by the way...sigh. Just what I needed on top of all this, but I'm not gonna argue.) If we can't go that route, then the next question is what kind of mastectomy is advisable given the placement and type of cancer cells we discover. I may even wind up with a two-fer if the tests show the current presence of cancer or the high future possibility of occurrence of more cancer in the other breast (I guess this is part of why we want the genetic test info). I won't know whether chemotherapy is going to be a part of the mix until we know more about where and how large the cancer currently is. I believe that no matter what I'll still get the prophylactic hormone treatments afterwards, so I'm definitely going home with the menopausal door prize. Ugh.
I'm not gonna worry until it's time to worry, but it looks like at minimum I will have some surgery recovery and menopausal symptoms to deal with, and at worst I'm going to have to also replace an entire wardrobe because I'll be going from a G cup to a no cup. And if you were around for last year's "Out of My Closet" challenge you all probably know that means replacing quite a bit of wardrobe....;)
That's all I know at the moment as far as the medical info goes. I'm still ruminating on all the mental/emotional processing this is triggering. More to come on that I'm sure. This is quite a process I've been thrust into/back into here. Yowza.