Plot twist

“You do not realize now what I am doing, but later you will understand.” - John 13:7 

On the morning of my surgery a week ago, the radiologist found another mass in my breast via imaging. The whole process was unexpected and scary, since this meant I heard new information about my case while sitting half-naked in a mammogram machine (talk about being in a vulnerable position!). My body's fight-or-flight response kicked into high gear, and I nearly blacked out as the radiologist inserted an extra wire into my exposed boob all while I was smashed into the machine. We had to take a *pause* in the process so I could stop sweating profusely and breathe normally again. So, that was fun...

Needless to say, everything got delayed by several hours last Thursday morning with new images and my body's rebellion. Even so, the surgeon successfully removed the mystery mass as well as whatever was left of the lump (#byeFelicia!) and a few lymph nodes under my arm. He was confident he'd removed the problem tissue, and he said it seemed unlikely the second mass had survived the chemotherapy.

As a result of the surgery, I spent Thursday evening throwing up from anesthesia and the next several days sleeping a lot. I've been living in a compression sports bra to reduce swelling in the past week, and my healing seems to be progressing well.

All those shenanigans were really quite enough. The unexpected hits had come our way, but we'd triumphed nonetheless. Chapter closed... right?

I truly was unprepared for an early call yesterday morning requesting I come in the same day for an appointment with my oncologist. I spent the day in a haze. My last experience receiving a come-in-and-talk-to-me-ASAP call occurred when my biopsy results came back positive for breast cancer. Not a particularly happy moment to recollect.

Unfortunately, just like the meeting that November morning last fall, the oncologist didn't have good news for me yesterday. It turns out my pathology results from surgery are complicated. On the upside, the tumor is gone, and the tested lymph nodes are cancer-free. The second mass they removed was nothing. But, examining my tissue under a microscope, the pathologist found 3.5 centimeters of cancer in the lymph-vascular system in my breast that the chemo did not get to OR was resistant to the chemo.

From http://www.breastcancer.org/symptoms/diagnosis/vasc_lymph_inv

Here’s what that means, according to BreastCancer.org:
"The breast has a network of blood vessels (called the vascular system) and lymph channels (lymphatic system) that carry blood and fluid back and forth from your breast tissue to the rest of the body. They are the 'highways' that bring in nourishment and remove used blood and the waste products of cell life.

Vascular or lymphatic system invasion happens when breast cancer cells break into the blood vessels or lymph channels. This increases the risk of the cancer traveling outside the breast or coming back in the future."

At their weekly meeting during which they discuss breast cancer cases, the team of doctors at the Cancer Center - including the pathologist, radiologist, oncologists, and my surgeon - were really surprised by my results. The aggressive cancer cells in my breast busted through their confines and extensively infiltrated lymphatic channels, which could carry them ANYWHERE. My oncologist was disappointed and concerned to discover how smart and/or strong these cancer cells are. (I have a few other choice words I'd prefer to use as descriptors of these little buggers.)

Bottom line is that we don't know if the cancer has spread outside of my breast. And, we will not be able to know. I have to live with that.

Right now, I'm cycling through feelings of fear, anger, sadness, hopefulness, and helplessness. Ever my amazing champion, Sean is staying as positive as he can.

In the near-term, I will begin six-and-a-half weeks of radiation in June, as originally planned. We decided that after that is complete, we're going to do an oral chemotherapy for 5 months. If the cancer stayed in my breast or under my arm (fingers crossed and prayers sent!), the radiation will kill it. In case it escaped to any other places in my body, we will use the oral chemo to go after it. After the chemo, we may have other treatment options through clinical trials.

None of these treatments can guarantee anything, though. The oral chemo doesn't have the same success rates as the treatments I've already had. And, there aren't tests we can do to ensure the cancer is gone. It'll be three to five years before we'll have some confidence it's not coming back. In the meantime, we must try whatever we can to be vigilant. Another tumor could emerge in my breast, or the cancer could metastasize elsewhere.

I don't get to call myself cancer-free. Not now, and possibly never.

This is not the way I would have written this chapter.