Meeting with a General Surgeon

Today I had a meeting with Dr. D., a general surgeon who supposedly does a bunch of breast cancer surgeries in town. He was a really nice doctor, and very tactful as far as talking to me about my plans for a family before my parents came in. I appreciated that.

Dr. D. gave us a rundown about breast cancer in general, since he was the first doctor we had seen since my diagnosis. He also described the two typical surgical options a breast cancer patient is faced with: lumpectomy vs. mastectomy. With a lumpectomy, just the cancerous tumor and a margin of healthy tissue around it are removed to make sure all the cancer is out. Afterwards, the patient has to go through about 6 weeks of radiation, 5 days a week, to zap any cancer cells left behind. With a mastectomy, all the breast tissue, including the nipple (!!!!) is removed. This is clearly a more invasive surgery with a longer recovery time, and is sometimes (but apparently not always, which I had not considered) followed by reconstructive surgery. When the patient wants to try to stay around the same size of her original breasts, the reconstruction can take place at the same time as the mastectomy and sometimes no further surgery is needed. However, if she wants to go bigger, tissue expanders are placed behind the muscle to make space for an implant. The expanders have a place where a needle can be inserted through the skin and saline put in to make them... expand. About four months later, the plastic surgeon puts the implants in, and apparently that surgery isn't too bad. And about four months after that, the plastic surgeon can make you some fake nipples and have a cosmetic tattooist tattoo on some color. The fake nipples look really real, from what I've seen, but they won't have the nice special feeling the real ones have.

He implied that he was pretty certain my cancer was genetic, due to its early onset. This could be determined by a genetic test that can show mutations to the BRCA1 or BRCA2 genes, two of the known genes that cause breast cancer. If I were to be positive for a genetic cancer, then Dr. D. would highly recommend a bilateral mastectomy (both boobs) to significantly reduce my risk of recurrence. He also mentioned that he tried to perform the surgery within 3 weeks of diagnosis, which seemed soon. Both a good thing and a bad thing-- I want to get going on all this, but I really need some time to learn more and make the right decision.

That was definitely NOT what I wanted to hear. At the age of 25, you don't want to think about losing your breasts for the rest of your life. It's such a drastic measure, and it's a lot to have sprung upon you when you've only been diagnosed for two days. I don't like that option. I'd much prefer a lumpectomy, but if that's not safe for my health, then I know what I'll have to do. It'll just take a lot of getting used to.

The other thing he told me that I didn't like was that I was almost definitely going to have to have chemo. When the nurse told me the wrong cancer, there maybe could've been no chemo. But there will probably be chemo. :(

Dr. D. had one of his assistants make me an appointment with Dr. G., a plastic surgeon in Greeley whom he strongly recommended. My appointment was for Wednesday the next week.

I left the appointment feeling a little upset by my options, and definitely wanting another opinion.