PLAN B

Well that didn’t go too well. Healthy margins is what we wanted to hear but it turns out the margins had other things on their minds. We’ve just come out from seeing the surgeon and it turns out that the original gameplan hasn’t really worked in the way that they’d intended it to. It looks like a mastectomy is our only viable option right now. I knew something hadn’t gone to plan when the meeting started with small talk. It was exactly how our very first meeting went 6 months ago. Small talk with a chuckle and the not so good news slipped in alongside the “Anyway……..”.

When a lumpectomy is performed, the surgeon cuts out a cube type shape (kind of like a dice) which includes the tumour, plus a lot of healthy tissue to make sure everything is gone. Sometimes when they check it in the lab, they’ll get one side that won’t be clear. This means they have to go back in and scoop out some more to be certain. In Sam’s case there wasn’t just one side that was dodgy but at least 3 or 4 (sounds about right) which means that the chance of a successful lumpectomy is very slim. They also found that in amongst the clear tissue were some pre cancerous cells (that had been there a while) alongside quite a bit of a scar tissue that had been caused by the chemo.

You could actually see the disappointment across both Nia and the surgeon’s faces as they were sat talking to us. Their eyes didn’t leave Sam’s gaze once.

“Does that mean the cancer has spread?”

“No, the cancer hasn’t changed at all and the good news is that it’s still hormone receptive, so we’ll still be able to use Tamoxifen as a way of treatment as well”

Sam’s had this feeling all week that something wasn’t going to go to plan. She’s started to distrust her breast during the last 7 days. She’s been convinced that there was something still there and I don’t think that feeling was going to go away anytime soon. She even said to the surgeon that if they’d told her that the margins were good, she still wouldn’t have believed it.

The surgeon went on to tell Sam that they’d also found that the cancer cells had invaded the vascular channels in the breast. These are the channels that lead directly to the lymph nodes. This means that because they can’t be sure that none of the lymph nodes are infected, they will have to remove all of those as well just to be safe. If they left them in then there could be the possibility that the cancer could spread outside of the infected areas and travel around the body.

The radiotherapy is still planned at a later stage, although I’m not sure what they’re going to aim it at. I just hope they’ve still got a plan in mind that they know will work and that they’re not adopting the “throw everything but the kitchen sink” technique and hope that something sticks.

The tumour was 36mm in size when they removed it. That means it only shrunk 4mm during the chemotherapy sessions (what??? Is that it??). I asked if this was due to the lowering of dosage for the docetaxel but I was assured that this would not have made any difference.

So, we seem to have jumped up a couple of notches on the “Oh S##t” scale in the space of 24 hours. The fear is back again. I think we’ve managed to control it over the last few months but it’s now come back with a vengeance. We’re going to speak to Nia tomorrow to talk about dates for the surgery and hopefully some of that fear can be alleviated, but as it stands at the moment, it’s almost like we’re back to day one.