Surgery Info

Way back in March I met my surgeon and I really liked her. On Wednesday (7th) I finally met with her again, and was thrilled that Rick could come with me so that he could meet her too; I knew he would like her as much as I did. My surgery is going to be next Wednesday (Sept 14th) and I am VERY excited about it. I can't wait to check another part of my treatment off the list. To me, this one seems easier than chemotherapy because it will happen quickly and not drag out across many months.

My surgeon specializes in breast surgery, which is nice! Since my tumour had gotten quite large before I started chemo, the area she will remove from my breast is significant relative to the size of the breast. This means that my lumpectomy would leave me quite deformed without a bit of a rebuild. After surgery I will have a new, smaller, 'redesigned' right boob. We discussed operating on my left breast at the same time to make it match, but had to put this plan aside because of my still-not-healed wound since it increases my risk of infection overall. I'm sort of glad it is not an option because I had not considered this possibility and appreciate the think time.  Also, if the tissue they remove from my right breast during surgery has any signs of cancer in the area around the tumour, they will have to go back and remove the entire breast. In that case I wouldn't want to have messed around with my perfectly healthy left breast for no reason. Altering the left breast will remain an option for later.

I will also be having some lymph nodes removed next week. If they are clear, that will be amazing! If they have signs of disease, I will have additional surgery to remove more/all of them. I'm really hoping this is not the case, not just because I want to avoid more surgery but it would significantly increase my risk of serious lymphedema side effects in that arm. Lymph nodes help fluid move throughout the body and keep the fluid levels balanced. If you are missing too many of them in one area, fluid may build up in that part of the body. I am not thrilled about the prospect of dealing with a swollen arm for the rest of my life, so I want to keep as many lymph nodes as I can!

The green bits in the image are the lymph vessels and nodes;
some of the nodes in the armpit will be removed.

The day before surgery I am having two procedures done. One is to insert a magnetic 'seed' into the area of the remaining tumour (or scar tissue) so that the surgeon can be sure she is removing the correct tissue. Since breast tissue can be a bit lumpy, it is important to ensure that the BAD lump is properly identified. They implant the seed with a needle like the one they used for my biopsy in the spring, so I know it won't hurt too much.

The second procedure on Tuesday is to help identify which lymph nodes should be removed during surgery. The lymph nodes they will remove are in the underarm/armpit area. On Tuesday they will inject a radioactive substance into the breast (which I'm told will hurt!), then wait a while to see where the radioactivity travels. The lymph nodes that become most radioactive are the ones marked for removal. During the surgery they will also inject a blue dye that does the same thing, so the blue colour will help mark the lymph nodes that should be removed. You can see in the image above why this is necessary; lymph vessels and nodes form a pretty tangled web. Without the help of the dyes, it would not be clear which ones were collecting fluid from the affected area of the breast. The dyes help the surgeon to be discerning and helps patients like me avoid losing all of their lymph nodes at once.

The consent that I signed for the surgery will allow the surgeon to make informed decisions while she operates. If upon inspection she thinks she needs to remove my entire breast, then she will. If she thinks that she needs to remove my nipple (because of cancer or because it no longer has good blood supply) then she will. So, waking up after surgery I will find out what she saw and learn about what she did. Not my favourite kind of surprise, but whatever the case I will be one step closer to recovery.

So...send good vibes that they don't find cancer cells where they shouldn't next week! I won't find out the results until about 2 weeks after surgery, so I'm preparing for more 'fun' waiting. ;) My mom is coming up for my surgery and the few days following, so we will be in good hands. She had similar surgery when she had cancer so I know she will be a good companion. I don't know yet what time my surgery will be, but I'll add an update here when I get confirmation on Tuesday.

Some morning walk pics from this week, as well as pics of a couple of things I made. :)

Yummy peach cake

Shawl finally finished

Calm Kempenfelt Bay this morning

I love this spot and its reflections...can you see the horizon?

The hound and I

First day of school hike with Lisa