Oncotype DX results are good

Our Oncotype DX report came back today. We scored an 18, which means we have an 11% chance of having cancer elsewhere after 10 years. We're just barely in the "Low Risk" category. This is one of the more powerful pieces of good news we're likely to get.

Plastic surgeons

Our surgeon said we should take some time and check out what options plastic surgeons can offer us. This week we met two more of them. One fairly standard and one somewhat "old school", neither of them seem to be for us. Interestingly about half of the plastic surgeons charged us for 20-45 minutes of discussion, one was $240 for 30 minutes.

Plastic Surgeon #1

Today I started my many appointments we've setup for plastic surgeons. This is the first of 6 that do reconstruction around town. I called about 20 plastic surgeons to narrow my list to these 6.

Meet the oncologist

Today we met our medical oncologist, Dr. Stone. He says we can probably avoid chemo if we can get clear margins and we don't see any vascular involvement. We had a large tumor but it was low grade and had no nodes involved. He wants to run an Oncotype DX test to see if our tumor is likely to spread. It's $3,500.00 but that's alot cheaper than chemo.

We also run a BRCA1 and BRCA2 test (see more here) and that's another $3,500.00 It will tell if I have a certain genetic defect that opens me up to many types of cancer. It's awful if it's positive so we're crossing our fingers.

Lumpectomy

Today we had our lumpectomy. The surgeon really disappointed us though. He did not get clear margins, he said he had to stop because he was worried about the appearance of the breast when he was done. We agreed that the appearance would have needed some reconstruction but him quitting with positive margins just means we'll have to have more surgery later. In fact we were prepared for a simple mastectomy if that's what he decided.

The good news today was no lymph node involvement. Node status is one of the biggest single tipping points in determining if the cancer is spreading. Also we have no vessel invasion (LVI) found in the tumor. An LVI is not as serious as a positive lymph node, but it is a sign of aggression.

The bad news is the tumor is 23mm, much bigger than we had hoped, and there's more left to get.

We know our stage though, we're Stage IIA, more specifically we're T2 pN0 MX.

Needle biopsy

Today we had a needle biopsy. We thought this was a formality and would reveal another fibrocystic lump we'd have to remove. Not so and this is the beginning of a long road. Two days later our path report tells us we had two locations reveal cancer and DCIS, one at least 10mm, the other 12mm. We later learn there is only one tumor, but at this time we're scared there are two.

The good news is "low grade" and "low mitotic rate" and "lymphatic invasion is not seen", this means our tumor appears to be slow growing and mild. Also we're ER+ and PR+ which means estrogen receptors and progesterone receptors are on the cancer cells. That's good news because it means we can use hormone therapy to fight the cancer cells. Finally we're also HER2 negative, this is good because HER2+ is associated with more aggressive cancers.