Monday, February 6, 2012

Lumpectomy 101

Pre-Surgery:
My call time is 6am at West Hills Hospital this Thursday for my Lumpectomy.  I will arrive and have a few things to do to prepare for my surgery.  Part of my pre-op last week was to have a mammogram so the surgical oncologist (Dr Schreir) can locate the tumor area (since their is no longer a tumor by touch). The radiologist will numb my left breast with a local anesthesia and put a needle into my breast under xray guidance.  A wire with a hook on the end will be inserted through the needle and then the hook will be positioned so the end of the wire is on the site of the calcifications. The wire will stay in and be taken into the operating room to guide Dr. Schreir in surgery.  They will also insert die into my breast, which will need to be massaged for about an hour.  The die will distribute to the areas in which the lymph node is draining to. 
In the pre-op holding room, Dr Schreir will then draw markings on my breast that shows where the incision will be made.  I will have an IV inserted, given some meds to make me not care about where I am.  Wait a bit for surgery, then I will be wheeled into the operating room and given general anesthesia. 
What happens during lumpectomy surgery?
The surgery takes a few hours (start time should be 11am).  Dr. Schreir will start with the sentinel node biopsy and then if there is any tumor present Dr. Schreir will remove it along with a rim of healthy tissue around it. While the lumpectomy is taking place the lymph nodes will be dissected and tested for cancer.  If more lypmh nodes need to be removed, then Dr. Schreir will perform a full auxiliary disection. If more than one is removed, the surgery and recovery time is much longer… Dr. Schreir and Dr. Meyering do not believe I have cancer in my lymph nodes, based on my CT scan from when I was first diagnosed, however, we won’t know for sure until I am on the operating table. 
I will likely have a rubber tube called a drain that will be surgically inserted into your breast area to collect excess fluid that can accumulate in the space where the tumor was. The drain is connected to a plastic bulb that creates suction to help remove fluid.
After lumpectomy
I will be moved to the recovery room after lumpectomy surgery, where staff will monitor my heart rate, body temperature, and blood pressure. I hope to go home the same day.  If in the operating room they have to remove more than one lymph node, I will stay overnight at the hospital.


If you don’t already know, this is my first surgery and up until the last few days, I have lost many nights of sleep over it.  So afraid to be put to “Sleep” and completely vulnerable, with my life in Dr. Schreir’s hands.  However, I have been focused on the beauty of this surgery…. Post surgery, I will be cancer free.  This WEEK,  I will no longer have cancer in my left breast.  What a feeling that will be, it brings tears to my eyes now to think about it.  
Thursday, I am hoping to get the news that I had a complete response to chemotherapy, meaning, the tumor was completely dissolved.  It is what my oncologists believe but we won’t know for sure until the pathology reports come back after surgery.  If you are praying or thinking of me this week, please hope/pray that there is a complete response.  Basically, if I had a complete response, it will take me out of the high-risk for re-occurrence (metastatic breast cancer) group and I will be in the “norm” group.
My Dad will be blogging for me on Thursday to update you on surgery.  I plan to take a week off of work to recover, but my timeline is flexible depending on how surgery goes.    
I look forward to blogging when I am cancer-free. XOXO

What are Lymph Nodes?
Lymph nodes are part of the lymphatic system, part of the immune system that helps filter bacteria and cancer cells from the body.  The lymph nodes, which are located in many areas of the body including the neck, the armpit, the groin, under the jaw, the back of the head and other places, produce immune cells that help the body fight infection. Because they help to filter cancer out of the body, they may become cancerous if there is a mass nearby that is attempting to spread through the body.  

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