The Decision

After the MRI (results are in The Details) Dr. DJ had us come back to her office to talk again about surgery.  This was one week to the day where I was told I had cancer.  I sat in her office staring at her gorgeous hair, not really listening because who really listens after you are told you have cancer. 

Sam and I had talked A LOT about what each surgical option meant and what it meant to us.  I hated that we had to have this talk.  No couple married only 3 years should have this talk.  I think it was probably the most serious conversation we had ever had.  This choice could affect us forever.  We weighed all options and came to a conclusion.  I will lay out the options we are given and go through our thought process. 

Lumpectomy
This is a breast conserving surgery.  The tumor will be removed with enough clear margin--cancer free tissue--and your breast will be sewed back up.  This will leave the breast typically deformed, but you will still have your anatomical breast.  This ALWAYS requires radiation treatment for 5-6 weeks for 5 days per week. 

(Image: http://www.thecancerblog.org/blogs/archives/The-cancer-blog/1160919567-Nov-18-2006.html)
 http://ww5.komen.org/BreastCancer/Lumpectomy.html

Mastectomy
This can be done as either one sided or both.  All of the breast tissue is removed including at least your sentinel node--first lymph node--and possible all of the lymph nodes in your arm pit.  This typically does not require radiation treatment.  This is where plastics comes in.  Reconstruction can be started right after the breast tissue is removed.  Tissue expanders will be placed, so when a woman leaves the hospital she will leave with some breast mound. 
http://ww5.komen.org/BreastCancer/Mastectomy.html

After meeting with the genetic counselor and the plastic surgeon Sam and I felt we had a lot of information to go over together.  We had a lot of pros and cons to go through and we are confident in our decision.  Like most things in marriage, this was a compromise.  We needed to make sure both of our worst fears were eliminated. 

With a lumpectomy the thought of radiation never set well with me.  The plastic surgeon made it known that radiated skin couldn't be reconstructed as well.  The skin is burnt and doesn't stretch as much so adding an implant would be difficult.  I didn't want to stare at a shark bite in the mirror everyday.  Even though this would conserve my breast the chance of reoccurence is higher than mastectomy.  Being a 28 year old woman I have a lot of years for cancer to come back.  The genetic counselor asked us if we were willing to go through this process again; because with a lumpectomy you would be screened and if the cancer came back you would have to do this again. 

With a single mastectomy I would be able to preserve my left breast.  That way if we are blessed with another child after this nightmare is over I could breast feed that child.  Breastfeeding is very important to me.  I breast fed Camden for a year, I have counseled other new moms on breastfeeding issues and successes, and I hoped to one day become a lactation consultant when I was done with nursing school .  I feel strongly that breast milk is the best option for babies.  Leaving breast tissue would leave the door open for cancer to return on the left side and again having our family to go through this process again. 

Double mastectomy I feel gave me an answer to all of my fears.  The chance of reoccurence would decrease.  I wouldn't have to worry about additional screening showing up with more cancer and I wouldn't have to put my family through this again.  The reconstruction options would be the easiest.  Do both at one time and have them matching.  The bad side, I will never be able to breast feed again.  But I will not have to worry about breast cancer coming back.  

I have a lot of years left and the chances of reoccurence is very high for me.  We are still waiting on the genetic BRCA results to come back, but in short, 28 year olds don't typically get cancer.  Sam and I talked and talked and talked some more.  We don't ever want to have to do this again.  This has been hell.  This has been a nightmare.  I go to bed crying and I wake up crying.  I'm scare of uncertainty and I want to be a mother to another baby and I want to be around to be a wife, mother, daughter, and sister for as long as God has planned.  I feel like this will not defeat me.  It may define me and it will test my strength, but I will win.  We asked ourselves if the cancer did come back, what if I didn't find it so quickly? What if it comes back with a vengeance?  What if they can't operate and just take it out?

Our solution and our choice--yes OUR because my breasts are equally mine and my husband's--is to do a bilateral mastectomy with reconstruction.  If my one sacrifice is breastfeeding I will take it.  I will cry and I will be upset when I can't bring my baby to breast to feed him, but I will be alive for him and my family.  

My surgery is scheduled for February 15th.  I'm ready and I will attack this.  I have my team of surgeon's, doctors, friends, families and prayer warriors.  You are all my army behind me and together we will win.