Appointments, Appointments, and more Appointments

We learned of Jodi's breast cancer a little more than a week ago and I feel like I have nearly earned an MD during that time. As mentioned in the previous post, we have met with the surgeon, but we have also either met with or are scheduled to meet with a plastic surgeon, a fertility doctor, and a geneticist. Additionally, Jodi has had a mammogram, an ultrasound, an ultrasound driven biopsy on her left breast, and an MRI. Tomorrow Jodi is scheduled for an MRI driven biopsy on her right breast, and on Monday she is scheduled for a bone scan. All of this will culminate in a surgery on April 29 to remove both of Jodi's breasts and at least one of her lymph nodes. Needless to say there is a lot to keep track of and we are doing our best to make sure we have a full understanding of all available treatment options prior to making any major treatment decisions.

Here are some of the interesting things we have learned about Jodi's cancer and breast cancer in general during the last week:

• No one knows exactly what causes breast cancer, but genetics, environmental carcinogens, viruses, and radiation are all thought to be contributing factors.
  
• Cancer begins when a normal cell in the breast is damaged and converts into a cell that has an uncontrolled growth pattern.





• On average, breast cancer cells double every 100 days. For example, a tumor that measures a centimeter in size (about the size of the tip of your pinky finger) carries about 100 billion cancer cells. If you do the math that should indicate that the original abnormal cell formed about 8-10 years prior to the cell measuring one centimeter.

• Jodi's cancer effects the milk ducts of the breast rather than the lobes (ductal cancer is more common).








• Her tumors are "invasive", meaning that the cancer cells in the tumor have multiplied to the point that they have moved outside the larger cell wall that houses them. Obviously, we hope that this has occurred recently and that the cancer cells have not had time to effect other parts of Jodi's body. See the "invasive" picture above.


• She has two tumors in her left breast that are cancerous and one tumor that has "benign characteristics" in her right breast (we get the right breast biopsied tomorrow to determine if the tumor is benign or cancerous)


• We won't know the exact size of Jodi's tumors until her surgery, but the area containing the two tumors measures about 6 centimeters (this isn't the size of the tumors themselves, but rather the size of the area between the two tumors, or the effected area)


• Jodi is having both her breasts removed for a couple reasons. First and foremost, there is a 15-20% chance of getting breast cancer again someday if she only has one breast removed. Second, it is much easier for the plastic surgeon to create two symmetric implants than it is for him to create an implant to match the remaining breast.


• Jodi's surgery on April 29 will not only include the removal of her breasts, but will also include the first stage of breast reconstruction.


• Breast reconstruction is done in three stages. First, the plastic surgeon will insert "expanders" into Jodi's chest to stretch her skin and muscular tissue so that the implants fit into her chest. Second, over time the plastic surgeon will insert saline water into the implants until they reach our desired size...I have had some fun joking around with that part of the process:). Third, a tattoo artist will actually tattoo Jodi's nipples back on...this caught us off guard at first, but we were assured that it is very difficult to tell the difference between a real and fake nipple.


• We will not know the type or extent of Jodi's follow up treatment (chemotherapy, radiation, etc.) until we get her pathology report and meet with an onchologist after her surgery.


• Lymph nodes are the body's means of processing/removing cellular waste, which is why the lymph nodes are a common secondary target of breast cancer.


• Women generally have between 20-40 lymph nodes near their armpit, and lymph nodes are arranged similar to a row of dominos. If the lymph node closest to Jodi's left breast is not effected, then none of the lymph nodes further away from her breast will be effected....similarly, if the first domino in the row doesn't fall neither will the rest.


• In addition to removing Jodi's breasts, the surgeon will take out the first line of lymph nodes and send them to the lab for testing. We will get the testing results during the surgery and if necessary, the surgeon will remove the rest of Jodi's lymph nodes before Jodi wakes up from her anesthetic.
  

That is a very high level review of all the information we have absorbed over the past week or so. The surgery is really the first real glimpse we will get into the extent of Jodi's cancer and will also play a key role in determining next steps in her treatment process. Please keep Jodi in your thoughts and prayers over the next couple of weeks. Also, feel free to click on the "comments" tab at the end of each post to pass along well wishes, etc. Thank you all for your continued support!!

"You gain strength, courage, and confidence by every experience in which you really stop to look fear in the face" - Eleanor Roosevelt