Surgical pathology - 25 th August 2015

Now 11 days post nipple preserving mastectomy, sentinel node x2 removed and reconstruction with implant, 2 nd drain removed yesterday.

Saw oncologist today who told me my surgical pathology results- should have asked for a copy but will be seeing surgeon tomorrow.

The relevant details: tumour was 8 cm , still graded as a II, microscopic evidence of cancer cells in one node, proliferation rate 1%, only 2 mm margin at nipple border.

The size of the tumour is prompting the oncologist to offer a short ( 4 cycle) course of chemo with a booster for my bone marrow as I already gave a low neutrophil count (no identified reason for that!) but this will only offer a 5-10% survival rate improvement - if that - c/o the low proliferation rate - versus the impact it will have on the quality of my life- not just hair loss and vomiting but the longer term affects on mental capacity (chemo brain) and the ability to continue in my present role at work - which depends on me being able to function at a high level- can take 2 years to feel back to normal. 

The oncologist isn't convinced of the benefit- my choice..

She thinks I will definitely need radiotherapy and will refer me to someone for treatment to commence ASAP- that will be for 5-6 weeks

Then she has prescribed Letrozole for 5-10 years - as the tumour was hormone receptive and this will give me the best long term survival outcome - side effects "bearable" 

Meanwhile I have commenced Vit D + calcium supplements - bone density scan is good and I would like it to remain so??

Anyway - I will see what surgeon says tomorrow..