The Mighty Sam drove me to my appointment. It was in the Capitol Hill Kaiser Permanente, and it is called the Multidisciplinary Breast Clinic.
At first The Mighty Sam came in with me, but they ended up saying he had to wait in the waiting area since they are being super restrictive because of COVID-19.
The first meeting was with the general surgeon. She did an exam of my rack. The right one was still sore from the biopsy, but it wasn’t too bad. She was able to feel a hematoma from the biopsy but not the masses themselves. She explained about how the cancer forms, where it is, and how it’s removed. Also the difference between lumpectomy and mastectomy.
She also explained a little about surgery itself – they do a contrast chemical thing where they can see which lymph node would get the first metastasis, and they take that node out as well. Lumpectomy would remove just the mass plus a margin of tissue, but mastectomy removes the entire inside of the breast (later I would talk to the plastic surgeon, who said he thought if that was the option we would still be able to keep my own skin and nipple).
She also said at this point my cancer is a clinical Stage 1, but that is re-assessed after surgery when they can do more extensive pathology on it.
After the surgery she said I would have to wear a sports bra and then do some exercises and walk right away.
The next appointment was with the plastic surgeon and his PA. He was super nice. He explained about all the different procedures. With a lumpectomy he often won’t have to do anything. There’s a procedure where, if there’s a divot or something from a lumpectomy he can inject some of your own fat, but it doesn’t always work well. I said I didn’t really care if I ended up with a divot.
He also explained the options for reconstruction: You can either reconstruct using your own belly tissue, or use implants. Since I don’t have much in the way of belly tissue, I am not a candidate for that option. So it would be an implant. Or implants. He said they can do reconstruction at the same time in a lot of cases, and also said that I am a really good candidate for that because I am, other than the cancer, healthy and fit.
Implant reconstruction works like this: a temporary implant is inserted behind the pectoral muscle. This implant can be filled from the outside. So you get it just like a third full at first, and over the next few weeks he gradually adds more fluid until it’s the full size. Then you go back into surgery and he replaces it with a permanent implant. voila! Reconstructed.
After that he did some measurements and had his PA take a bunch of pictures. “We might not even need these,” he said. But he also said something to the effect that he would be very pleased to do reconstructive surgery for me if I should need it. It was really nice.
After the surgeons I went down to the lab to give a blood sample for the genetic testing. Then we got in the car and it was time to talk to the social worker. I’ll write about that in the next post.
This is freaking amazing to me that they can tell which lymph node would get the first metastasis!! And that they can take it out as a preventive measure. I get frustrated sometimes because there’s still so much, medical science wise, that we don’t know. But it’s really impressive how much we HAVE learned.
And I’m glad that your reconstruction options were so positive!