I got my second biopsies results on Mon 21 Nov from the nurse specialist at the hospital, and to my delight and astonishment they all came out negative. The trainee nurse, sitting in to observe, looked completely thunderstruck and a bit worried as I whooped for joy as each result was read out as nothing showing - the node (B2), the dodgy cells (B1) and the fibroadenoma (B2) - all benign. I did actually say it felt like Christmas. Trainee nurse just didn't get what a relief it all was, not least because...
Because there is a good chance I won't have to have chemo. Neo-adjuvant chemo would have little effect in trying to shrink The Lump, with it being PR positive (progesterone receptive) and ER8 (highest end of estrogen positivity) but not HER2; and it would also not add anything to my life expectancy, other than about 1.5% on top of 93.9% survival for a min of 5 years. For me, at the moment, chemo would actually have negative health risks, not positive ones.
However, and it was a large however, if the lab found anything untoward in any material removed during the mastectomy, for example an area of grade 3 growth that might have been missed during the biopsies, then it would be chemo o'clock. The risk, however, of that happening was thought not too great, since the MRI and biopsies had been extremely thorough.
The nurse then had a good look at the offending article, and we worked out that, really, the lump must be larger than 3cm, and probably more like 4cm or 5cm, and we needed to get a shifty on, whatever the biopsies said.
So a rough plan was devised, away from thinking about neo-adjuvant (pre op) chemo, to having the mastectomy and removal of the node plus possible reconstruction first, then a course of radiotherapy. We then discussed starting Tamoxifen to start clamping down on the hormones that were fuelling The Lump - estrogen and progesterone. That should bring The Lump up short and start the process of stopping further spread or recurrence in the future. However, the decision to start Tamoxifen could not be taken until the next pathology meeting with the consultant oncologist.
We also discussed what kind of reconstruction I might want and I said that, from all the info I had been given by Macmillan Helpline so far (they had sent me excellent reems of print outs on mastectomies, reconstructions and a book on chemo), the DIEP flap looked the most plausible for future arm and back mobility. The nurse specialist was a bit worried about this, as it was not an operation her hospital could do, and explained I might have to wait several weeks to get a long-enough surgical slot with enough surgeons avaiable at the same time, and all in a different hospital further away from my home, more in the middle of nowhere than everything was currently.
So we booked in an appointment for me to have a chat with the consultant surgeon who was overseeing my care at this hospital for a couple of days time, and I went home literally rejoicing, to crack open another bottle of prosecco and celebrate not necessarily needing chemo.
