The iPhone starts buzzing on the bedside table this morning.
“Hi, it’s Dr. Hwang. I was driving in this morning and I started thinking, ‘It’s been a long time since I talked to Heather. You’ve been really quiet! I guess that means you’re feeling OK?”
(Have I mentioned that I LOVE this doctor?)
I say that, mostly, I’m OK. The underarm incision is still pretty sore. She tells me that this is normal.
“Well, the pathology is back, and we’re not going to see each other until Monday, and I didn’t want you to have to worry over the weekend.”
Love, love, LOVE!
“So there was ductal carcinoma in situ (DCIS). We found a lot of DCIS. We took out a pretty big portion, I don’t know if you can tell yet. The margins are clean on three sides, but there’s one margin that is not clear. [If the tissue that they take out does not have a cancer-free margin on all sides, that means that they haven’t got it all.] This means that we’ll have to go in for a re-exision [doctor talk for cutting more out]. Probably in a couple weeks. If we can’t get a clean margin in that surgery, then we may have to talk about mastectomy. But we’re not there yet. I’m not recommending mastectomy at this point.”
I tell her I was bracing for this sort of news, and ask her to go on.
“Well, we also found some invasive cancer, ductal carcinoma. The tumor was small, about 1 centimeter. But it’s an aggressive kind of cancer. Your lymph nodes are clear, which means it hasn’t spread outside the breast, so that’s good. The pathology shows that it’s reactive to estrogen and progesterone. [This is good.] The first Her-2 test is negative. [Having a Her-2 reactive tumor is not good.] But they’re doing a chromosome Her-2 test; those results won’t be back until after our appointment next Monday. But it’s an aggressive kind of ductal carcinoma, so chemo may be on the table. It depends on the results of the test, and the next surgery. You’ll have to talk to the oncologist about balancing the risks and benefits.”
“OK,” I say. “Let me see if I understand. I’ll need another surgery to try to get the rest of the DCIS. If you can’t, then mastectomy may be on the table. The invasive tumor is small, but aggressive, so chemo is a possibility. Hormone therapy and radiation for sure. Is that right? The decision on chemo will depend on more pathology results and what you get in surgery next time.”
“Exactly right,” she says.
She asks about my family, whether I’m settling in. She asks about my daughter’s new school. She tells me the school puts on GREAT events, amazing catering. We talk about how over-pressured kids are today. We chat some more about stuff I can’t remember.
It’s good news, kind of. Also bad news. Yet once again, Dr. Hwang makes me feel strong, and hopeful. I guess it’s normal to idolize the person who’s trying to cure you of a scary disease. But Dr. Hwang rocks.