Second meeting with doctor on 11/28

UPDATE AFTER THIS ARTICLE WAS POSTED: The BRACA results came back saying, Lucia did not have the six main cancer genes, which means there is no need for a double-mastectomy.

We met with Dr. Cochran today. He had a med student with him, Bradley Cagle. Dr. Cochran said there was not a lot of new data, though it felt like more data. It was probably the reality of the surgery date being upon us that made it feel more real.

We’re still waiting for the BRACA report, which we knew would not come before this meeting. The BRACA information determines if there is a need for a double mastectomy.

BRCA, BRCA1, BRCA2
‘Breast cancer genes’ in which some mutations may relate to the elevated risk of breast, ovarian, and/or other kinds of cancer. Sometimes spelled BRAC or BRACA; not always capitalized.

Dr. Cochran believes a mastectomy is the best option due to the distance between the masses and the number of them (seven). He seems to want to do a double mastectomy, though he’s not pushing it on us and realizes Lucia’s hesitancy, which I am hesitant too since they can monitor future cancer and it’s not a wrong option to wait. BTW, we do not feel pressured and we do feel in charge of the decision-making.

The ideal treatment is a lumpectomy, then radiation, and cosmetic surgery but he is not recommending this for her since the number of and spread out masses. A lumpectomy under these conditions does not leave a good cosmetic result.

We still do not know about post-mastectomy treatments, meaning, the use of chemo or radiation or just a pill (estrogen blocker). The lymph nodes are part of the decision regarding these post-op treatments. At the time of the surgery, the doctor will make another cut to get what he needs to test the lymph nodes. If the lymph nodes are cancer free, then Lucia might not need radiation or chemo; she can take the pill.

As for reconstruction, they don’t want to do the mastectomy and reconstruction at the same time. The reason for two separate surgeries (mastectomy and reconstruction) is because he does not want the reconstructed breast in the way of the radiation or chemo.

There are many types of reconstruction, the more common one is doing a “tummy tuck” (taking skin from the stomach area) to rebuild the breast.

A mastectomy requires a drain, which means overnight in the hospital. There would be a two-week recovery at home, and then we’ll look at the chemo/radiation/pill options.  It takes about 3.5 working days to get the lymph node information back post-mastectomy.

The next steps are:

  1. Get a pre-op chest X-ray and blood work. (We’re waiting at the hospital right now for these two things.)
  2. Set a date for surgery. It may be January due to no open dates for Pelham Medical Center (across the road from our home).
  3. Learn the results of BRACA report.
  4. Meet with a plastic surgeon. The two recommended are Dr. Birchenough or Dr. Orseck.
  5. Meet with the anesthesiologist
  6. Then the surgery.
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