April 2, 2012 Mamma Morano update -- some silver lining for the moment

April 2, 2012 Mamma Morano update -- some silver lining for the moment

As you know, my family now knows "the routine" once you are diagnosed with breast cancer.  This is not something I would have wanted to be an expert in that is for sure.  However, it certainly comes in handy when trying to help a loved one who is not as capable to maneuver through and interpret all the cancer jargon that is quickly thrown at you after diagnosis and when treatment options are presented.

We already knew to that my Mom had a small cancerous tumor in her left breast that had already spread past her milk duct (small is good, but leaving the milk duct, not as good).  After the initial relief that it was a small tumor, the review of the options started.  My Mom’s options were as follows:

1.     Do nothing: this was not really an option, but my Mom, kept trying to go here.  I think that she did not want to believe that cancer was found and that she her fear was presenting itself.  Doing nothing for my Mom or anyone else is really not an option if you want to avoid the cancer from spreading and avoid early mortality.

2.     Lumpectomy (targeted tissue removal) and Sentinel Lymph node dissection (taking only the lymph nodes that are identified through radioactive blue die that is injected prior to surgery): given the small size of the tumor and Mom’s age, a Lumpectomy is a viable option.  This option would be guaranteed to be followed by radiation.  Chemo therapy would only be required based on the final pathology report provided post surgery (after the removed tissue is examined).  Hormone therapy would most likely be recommended as the cancer seems to be hormone receptor positive (this is a good thing).  The con with this approach is that if additional cancer is found at the margin of the tissue that is removed or in additional lymph nodes, a second surgery would be required.

3.     Mastectomy (removal of the left breast) and Sentinel Lymph node dissection (taking only the lymph nodes that are identified through radioactive blue die that is injected prior to surgery):  This option would be a more aggressive surgery, however, there is less likely a second surgery unless more lymph nodes require removal or if there is cancer found in or near the chest wall.  This seems unlikely based on the location of the cancer that was found.  Based upon the full evaluation of the cancer from the pathology report post surgery, radiation may not be required and chemo therapy may not be required.  Hormone therapy would still most likely be recommended.  The main con is the aggressive surgery and potential second surgery to remove more lymph nodes.

My Mom has been referred to a different surgeon than the one I had.  I have to say that although she seems quite competent and organized from what I can tell and that I could probably relate to her, she went way to fast for what my Mom needed and her bedside manner for my Mom’s needs were just not up to snuff.  So that is where I came in and ensured that I understood the results so far and the details that needed to be considered in weighing the options.  I did some interpreting as the surgeon went way to fast in terms of wanting a decision without all the information I thought was required at this stage of the game (ie before an surgery).  For instance, we knew the basic nature of the cancer from the mammogram, ultrasound and biopsy. However, we did not have additional information that would help us with the final decision.  The additional information I thought was required included a bone scan (since, if the cancer was to spread, breast cancer tends to start with the bone structure) and Breast MRI (as an MRI generally provides a higher definition view of the breast tissue and could potentially determine if there is additional cancer in either breast).  The surgeon agreed to our request to have these tests completed before any decision was made.  So off my Mom went with my Dad to the journey to complete these various tests over the 1 – 2 week period based on when appoints could be made. 

A follow up appointment was made with the surgeon for March 27^th to review the results of all the tests.  This is how it played out:

·         Mammogram – January 2012:  showed signs of cancer

·         Biopsy and Ultrasound – February 2012: confirmed cancer tumor and indicated that the tumor was small in nature

·         Bone Scan – March 2012: results show that the cancer has not spread into her bones – yeah!  The results show some degeneration in her knees, but we already knew this and this does not relate to cancer, more likely arthritis.

·         Abdominal ultrasound (additional test ordered by the surgeon) – March 2012: does not show any cancer in her liver or pancreas – yeah!  There seems to be cists on/near her liver, but the surgeon and the report indicate that these are not cancerous. 

·         Breast MRI – March 2012:  Only shows the same area of cancer that the mammogram and biopsy had shown – ie does not look like there is additional cancer in the rest of her left breast or any cancer in her right breast – yeah! 

·         Blood work looked good – March 2012: yeah!

Now based on this information, I felt that my Mom would have much more information to make a decision.  As the doctor explained the results, as I breathed a sigh of relief (these results were good news from my perspective!) and as I helped interpret the information, my Mom wanted to get one last opinion/input from her own doctor.  I was good with this as I wanted the final decision to be hers, not mine. 

The next day, with the input from my Mom’s doctor, a decision was made.  My Mom is now scheduled for a Mastectomy with a Sentinel Node Dissection on April 20^th, 2012. 

In this case, I am very happy with the decision that was made as I seems logical and in my Mom’s own words, I noa needa to looka good at mya age, I already hada my babies and noa needa my breast anymore – well I think she looks great no matter what.

While I know that my Mom is quite scared of cancer in general, the new journey she finds herself in and she continues to worry far too much about me, I know she will get through as she has gotten through so much in her life up to now.  Strength does run in the family and this is something that I am very happy to share.


More to come as my Mom’s journey now unfolds (we are keeping a watchful eye on my Dad to make sure he can take all these jolts that have befallen his family)….