More surgery is needed.

Had my post op visit with the surgeon – the news is not good.  The tumor was much larger than he expected it to be, and the margins were positive for cancer. Additionally, the surgery pathology report states that there is lymphovascular invasion.  I’d never heard that term so I did some research and found a clear explanation on Dr. Susan Love’s Research Foundation site: http://www.dslrf.org/breastcancer/content.asp?CATID=28&L2=1&L3=6&PID=&sid=132&cid=1104

The surgeon was upset that the pre-op imaging indicated a much smaller tumor – just over 1 cm; but what he found was more than 5 cm.  He doesn’t like that kind of surprise any more than his patients do.  If he’d known its true size, he’d have sent me for chemotherapy before surgery to try to shrink it.

When they do a lumpectomy, they remove the tumor and a certain amount of the tissue that surrounds it – called the margins.  This margin tissue is analyzed for traces of cancer. In my case the margins contained tumor cells.

So there’s more surgery to be scheduled.  I have two options. 

• He can go in and remove more tissue hoping that he gets it all. The down side is that if the margins are still not clear, a mastectomy will be the next step, for a total of 3 surgeries altogether.
• I can have a mastectomy and simply have all of the breast tissue removed.

Seems like a no-brainer.  Just do the mastectomy. I can handle that.

But what has me concerned today is what I read about lymphovascular invasion (LVI). This can be present even when the lymph nodes are free of cancer (as in my case).  But the implication is that the disease has begun to spread. The further implication is that the cancer has mutated in such a way that it can create its own blood vessels and thus spread itself. Not a happy thought.

So today I’m a little bummed.

Tomorrow morning I meet with a Medical Oncologist.  Originally this visit was to discuss post-op chemo and begin setting that in motion, if necessary.  Now that meeting takes on a much different aspect.  With any luck I’ll have more and better information by this time tomorrow.

I’ll post again then.