MR Guided Biopsies & Confirmed Surgery
Everything is slowly starting to come together. After seeing the plastic surgeon, I was convinced I didn’t want a mastectomy. Wednesday’s appointment with the director of surgery to review the results of my MRI done on August 30, as well as the FISH results, was the last step in the process towards a confirmed surgery date. We had a long conversation about everything. The majority of the discussion surrounded how much of my breast tissue will be taken, why a lumpectomy is the right choice for me, and what needs to be done in order to have surgery on the 17th.
I had already reviewed the MRI results on my own so we didn’t go into a lot of detail about the report. I confirmed that I would be seeing an Oncologist out of the Londonderry Dana Farber Center post-surgery, and then we got into the discussion about the surgery. Currently I still have stage two breast cancer. Regardless of whether I go up a stage or not, my post-surgery treatment probably won’t change. The surgeon shared that the pathologists will make hundreds of slides from all of the breast tissue that is removed during surgery. They will look at all of the slides and have a very clear picture of what kind of pathology my cancer is. This will confirm treatment (chemo or no chemo). At this point, I have learned that the only way to handle all of this information is to take it one step at a time. I can’t think about what I may or may not be facing in a month, it’s just too much, so I took the information presented regarding the pathology and FISH results and filed them away for now.
After going over the MRI, surgery, and FISH results (yes, I am HER2+ in one of my tumors as of now), we talked about what needs to be done before my surgery. The surgeon shared that they need to know what the mass in my right breast is for sure. This meant I needed to have a biopsy. They also needed to place clips in my left breast to mark the entire area that needs to be removed during surgery. At this point I have accepted and learned how to deal with a lot of the minimally invasive parts of a cancer diagnosis. It’s amazing how in a week I could go from dead set against another biopsy to letting them do ones in both breasts at the same time, guided by an MRI.
Which takes me to the final step leading to my surgery on the 17th. In order to get everything done that needed to be done, the surgeon asked if I would be ok with doing both the biopsy of my right breast and the clip placements in my left essentially at the same time. I was all for anything that would mean surgery could still happen on the 17th. This was the first time that the radiology department had done both breasts in one appointment, and I was a little excited to be a “first”.
On Thursday morning, less than twelve hours after my appointment with the director of surgery, I was back at The Elliot for a MR guided biopsy and clip placements. They placed the IV for the contrast solution, and then explained the whole procedure to me. I got into the same contraption as last time, only this time they clamped down my breasts in these grid-covered trays until they were completely compressed (like when they do the side view mammogram only the tray had open squares in it). I couldn’t move at all until it was all done. They put me into the MRI machine, did the full MRI (30 minutes) including contrast, and then pulled me out. They adjusted the trays compressing my breasts, and put me back into the MRI machine again. Then, back out, they were ready to start part of the procedure.
I’m not entirely sure what they did because I couldn’t see anything, but they injected the novocaine, which was much more painful this time with my breasts compressed, and then did something else, before sending me back into the MRI machine for a third time. Back out again, they started the actual biopsy and clip placement. The biopsy hurt a lot more this time, I could definitely feel it when they were doing whatever it was that they do to take out the sample, and the clip placements hurt but not as much. The strange thing was that I could feel them moving the needle around inside my breast this time because the tissue was all compressed. It was a very odd feeling.
They put me back into the MRI machine for a final time to make sure everything was all set and in place. In total, it took about 90 minutes for the full procedure. Then, I had to go get mammograms on both breasts to make sure everything was ok. I managed to be fine throughout the whole ordeal and felt one step closer to my surgery.
Tomorrow I have a pre-op appointment with the plastic surgeon and an appointment with my PCP. Tuesday I get a COVID test and Wednesday afternoon I meet with the surgeon to sign the consent form. Thursday I have surgery!
In total, between August 17 and September 17 (the day I have surgery), I’ll have been to 16 appointments. Today I cleaned the house and tomorrow I’ll keep working on cleaning. I’ve begun to make a list of things I want to do while being on house arrest post-surgery, and I have a stack of books about hiking to read.
As I was going through my bathroom, organizing things, I looked at my elastics, hair gel, and leave-in conditioner. It made me sad because I have spent the last five years growing out my hair (after having a pixie cut for a decade) and here I am potentially about to lose all of it. I know it’s just hair, and will grow back, but it doesn’t make it any easier to have to shave it knowing that the growing out process sucks (trust me, I’ve been through it several times).
Going through my dresser, I looked at the stack of bras that I won’t fit into in less than a week and that also made me sad. I have always said that I hate my breasts and want to get rid of them, but to be forced to do it has made me feel like I’m losing part of my identity in the process. None of this is easy, but all of it is necessary. Things that have defined who I am for years, my braids and my large chest, are going to be gone, but that doesn’t mean I’m no longer me. I thought about how I’ve spent all these years hiking and preaching that none of this is about me, it’s about the mountains, and yet here I am grieving the loss of my identity.
When all is said and done, I know that this is just one event in an entire lifetime of events and although this is really hard, I will persevere and by this time next year I should be cancer free. It amazes me when I look back over the last thirty days and how much I’ve grown and changed. I went from being absolutely terrified, kicking and screaming in the face of a diagnosis that I wanted to run away from, to fully accepting it, learning all about what this diagnosis really means, and developing a new life around it. It isn’t forever, but for now there are a lot of changes I’ve had to make, and not just me, but my husband as well.
In less than a week I will be facing a pretty major surgery and then a 4-6 week recovery. A month ago, all I would have been thinking about was how I was losing a month or more of miles in the wilderness, a month or more on the couch, and I would be really frustrated. Now, I see a month to spend with family, a month to slow down and read, a month to finally sit still and reflect on everything I’ve experienced in the last five years. I’ve accepted that this is a time of slowing down and reflecting for me. But as soon as I’m given the ok, I’ll be back in the wilderness making new memories among the trees.
