Pathology Report - Or the Post I Didn't Want to Write

I've been meaning to write this post since my surgery. But I just couldn't bring myself to do it.

My focus throughout chemo was to have a complete pathologic response to chemo. Every article I read quoted statistics about how much better your chances of survival are if the chemo kills all of your cancer. When I got my MRI results that all the cancer was gone, I cried. It was my goal. I had done it. I would live.

And then I had my mastectomy and sentinel node biopsy. The surgeon checks for cancer cells in your sentinel lymph node during surgery (which, in my case they could identify by the marker left during the biopsy and from the blue dye (technetium sulfur) that is injected in your breast before surgery). Mine came back with cancer cells. So they took out nine more for a total of 10 lymph nodes. One contained a micrometastasis and one had a 1.2 cm metastatic carcinoma. Micro metastasis is a very tiny amount of cancer--like 500 cells. None of the other eight had any cancer cells.

I then had the skin sparing mastectomy. The pathology on the breast tissue and skin that was removed showed that there was still cancer in my breast as well. The largest remaining tumor was 3.3 cm. Tumor histologic type: Invasive carcinoma with clear cell (glycogen rich) features. Triple negative. Grade 3.

Hearing this news was devastating. I cried a lot. I knew some of this when I left the hospital but I had to wait a few days to get the surgical pathology report. When my surgeon, Dr. Coleman, called to discuss it, I told her that I couldn't stop crying and was upset. She told me to put the report in a drawer and not look at it again. She said that they had gotten good margins and I needed to move forward. She said that I needed to put cancer behind me. She explained that my tumors had not shrunk like a deflated basketball but rather like a spider web. So, I didn't have a 3.3 cm tumor like a basketball but rather just some strands that where dying. She said that the chemo HAD worked, just not as well as we thought.

Now, keep in mind that my various scans and MRIs that I had prior to chemo showed "extensive disease present involving the lower inner quadrant, lower outer quadrant and extended from the 5 o'clock position of the right breast to the 12 o'clock. The tumor measured 10 x 6 x 6.8 cm." The PET CT scan showed "at least 3 discrete hypermetabolic lesions in the right breast and 3 discrete hypermetabolic axillary lymph nodes." I was in bad shape. And I DID have a good response to chemo. But not the one I wanted nor the one that I thought I had achieved.

A few weeks after my mastectomy, I saw my oncologist. He thought I had a great response, too. I told him I was devastated.

And every time I thought about putting this in writing for the blog, I started to cry or I started to panic.

But here it is. I finally did it. I'm not crying or panicking (very much).