Friday I had an appointment with my surgical oncologist… whom I absolutely LOVE by the way! I completely trust her opinion…. My MRI showed that it was normal…. meaning there appears to be no cancer present on the photos…. I’m cautiously optimistic! This could mean so many things… everything basically hinges on this surgery!

I will be having a bilateral mastectomy (both breasts removed) regardless…. there may be microscopic cancer cells present and we want it all removed… including my nipples, because the cancer was so close to the nipple. I will be having lymph nodes removed from BOTH sides because I had atypia (pre-cancerous cells) in the right breast and they were not convinced that there was no cancer present…. however, to avoid delaying chemo… we opted to have the biopsy done at the time of surgery instead of before surgery…. They will remove 3-4 lymph nodes from both sides…. They will be cut in half… if there is ANY cancer present in either side…. All of the lymph nodes will be taken… and sent off to final pathology which will take about a week to come back… as well as the tissue in the breast…. so we will not know for sure if there is no cancer present in the breast until after pathology.

If there is cancer in the breast…. I will need radiation of the breast…

If there is no cancer in the breast… I will not need radiation of the breast…

If there is no cancer in the lymph nodes at initial pathology but it comes back as cancer and all lymph nodes are not removed….. I will need radiation of the lymph nodes to kill the remaining cancer cells…

If there is no cancer present at all in the lymph nodes… I will not need radiation of the lymph nodes…

If there is cancer present at the time of initial pathology in surgery… all lymph nodes will be removed on the side with cancer and no radiation will be necessary…

Most importantly, we do not want to leave ANY cancer behind and risk the cancer returning… even microscopic cells can cause it to return or spread….

I will be SHOCKED… my gut feeling tells me I am not completely cancer free…. but I would LOVE to be proved wrong….

I am getting expanders immediately… which is considered partial reconstruction… it allows the breast tissue to expand to save some of the skin….

If I don’t need radiation… I can get reconstruction after I heal…. and that means I can get implants…. and that means I can choose the size of my breasts

If I need radiation… that means I will probably need a DIEP flap surgery… which is where they take skin and fat from my body…. which means my breasts will not be very large because I don’t have a lot of fat… Most likely they will take fat from crease of the upper leg under the butt….. because that is where I have the most fat… most likely…

Phew…. a lot to keep track of….

So much hinges on this surgery…. and I have decisions to make…. ultimately, radiation is my decision… there is a trial that with my stage, my age… etc… I can refuse radiation if I want…. if there is no cancer present…. Trial shows that there has been no recurrence…. BUT, I have to make that decision…. to forgo radiation would be AMAZING….. but….. radiation basically zaps any remaining cells….

Radiation can cause heart disease…. and radiation increases the lympedema risk to about 50% if the lymph nodes are radiated…. My risk of lymphedema will be 30% with surgery alone… which means 70% do not get it…. but it also means if there are 3 of us in a row… 1 of us will get it…. I will need to do a lot to prevent it…. no lifting, no purse straps on that arm, no repetitive motion… so many things will change….

Thursday is the big day…. and the next 3 days I’m on complete lock down because I have a TON of editing to complete…. I have had a ton of fun…. with my BFF here, the beach trip and my husband and I celebrated our anniversary this weekend since I’ll be recovering when our anniversary comes…. we had an amazing time… thanks to our clients who gave us a donation so we could enjoy a night out….. I bought the neatest dress at a place at the beach called Body Central… it was so reasonable $29.99 and I got 10% off! It was my splurge… ❤ But I felt so good…. and then Cindy from Cindy’s Hope Chest allowed me to pick out 3 wigs… and I wore my husband’s favorite last night…. I really felt beautiful…. and we had a lot of fun…. It has been an amazing week! ❤