Surprises in the pathology report

The results came back yesterday, and though not completely a surprise, they were definitely disturbing. I'm still reeling just as she must have been when she first received the news from the PA, so this will just be an archive of what I recall of our conversation.

Five lymph nodes were removed in the operation, not six. Of those five, two were positive for cancer cells. This was what J feared most, because it implies that the cancer may have metastasized. At least not all five nodes tested positive. Additionally, they further tested the breast tissue that was removed and found more cancer cells that had not shown up in their previous MRI. That news was disturbing as well.

Finding out additional cancer cells were discovered during biopsy that did not show up in the scan opens up an entirely new world of concern. Now J is wondering about her left breast. Should she opt for essentially a bilateral mastectomy? The medical staff has informed her that her left side tested negative, and so they don't feel there is any need to do anything there, but what if they missed something? What if they didn't miss anything, but cancer that is there just didn't show up in the type of scan they did? J does feel occasional twinges of .... something .... here and there. They weren't enough to alarm her previously, just to tickle her radar, but now? Now they're a concern.

With the possibility that J would choose to get a second mastectomy, the question of whether she should also elect for reconstructive surgery arises. Previously, with just the one, the answer to that question was a clear no. Additional, or prolonged, surgeries, present additional risks, and that wasn't one she was willing to take. With both surgeries, though, it would be better to do the reconstruction at the same time rather than to do it later. I don't really understand the details, so I won't even try to put them down, but that is my understanding. Now it's a question of weighing the risks again. More things to consider.

Tears were shed. Emotions were high, and the world after the news was once again transformed to something very different from the one before the news. This was essentially J's worst fears confirmed. Almost twenty-four hours have passed, and she has an appointment today with her oncologist to figure out what to do next, and when. She wants to be as aggressive in receiving treatment as possible. My brother, an interventional radiologist, has been helping me to understand the medical terms and their implications, and he recommends getting a full body CT scan, specifically of the chest, abdomen, and pelvis. Hopefully J's oncologist agrees. With the possibility/probability of metastasis because cancer cells were found in two of the five biopsied lymph nodes, it feels like her entire body is now at risk. It is what it is, but with the prevalence of breast cancer diagnoses and research, this should still be very treatable. Fingers crossed, and a prayer said.