What's Happened So Far

Sept 20: Jen goes in for a routine annual exam with her internist, Dr. Natalie Kim at the University of Utah. A "bump" in her left armpit was somewhat suspicious. She is sent to radiology for an ultrasound.

Sept 25: An ultrasound and mammogram were performed at the Hunstman Cancer Hospital. The ultrasound showed normal tissue in the left armpit. The mammogram showed "clustered amorphous and fine pleomorphic calcifications." in the left breast. The radiologist was Dr. Kathleen Puglia.

Sept 27: Met with Dr. Leigh Neumeyer, a general surgeon at the Huntsman Cancer Institute to discuss biopsy options. Advised that 65% of biopsies are negative.

Sept 28: Jen had a guide wire assisted breast biopsy. This involved going first to radiology for a second mammogram with placement of guide wires under radiographic guidance to place the tips of the guide wires at the site of the calcifications in the left breast. Jen has a syncopal episode (tries to faint), but the radiology technicians quickly catch her before she's out cold. Then she went to the operating room and the biopsy was done under light sedation and local anesthetic infiltration of the skin over the biopsy site. Anesthesia Doc tells Jen that a little drug goes a long way--"don't forget to breathe!" Jen does well after surgery and rides her bike in the Josie Johnson Memorial Ride the next day.

Oct 2: BIG BUMMER! Results of the biopsy showed a microscopic focus of invasive ductal carcinoma (1 mm) and ductal carcinoma in situ (pre cancerous cells) in several locations. The pathologist was Dr. L. Ralph Rohr. Ken and Jen break news to kids and family--and Andria comments "Mom, why did you have to grow a bump??" Laughter is good medicine!

Oct 5: Met with Dr. Neumeyer to discuss surgical options (left lumpectomy versus left mastectomy versus bilateral mastectomy). A lumpectomy is removal of breast tissue through a small incision at the skin areolar boarder. A mastectomy is removal of the breast from the chest wall. Recurrence rates versus surgical technique were reviewed. Overall, survival rates are the same with lumpectomy versus mastectomy. However, recurrence rates with a lumpectomy are 15-20% and 5% with mastectomy. There is a 15% chance of recurrence in the opposite breast.

Discussed radiation and chemotherapy. Radiation therapy used if only doing a lumpectomy. Radiation therapy used after a mastectomy if after resection, there is no discernable margin (from diseased tissue to non diseased tissue). Chemothearpy required if there is evidence of metastatic disease (spread of cancer from the breast to other tissues). At the time of surgery, Jen will be injected with a radio-labeled dye into her lymph nodes. This is done so that through the use of a probe that can pick up the radio labeled dye, the main lymph nodes draining the breast can be located. These nodes are called "sentinel nodes" The left side sentinel nodes will be biopsied for metastatic disease. --okay...in plain english cancer stinks and means you have to do torture to your body even though you feel perfectly fine!

Met with Dr. Jayant Agarwal from plastic and reconstructive surgery to discuss breast reconstruction options. Reconstruction options include saline implants, silicon implants, free flaps from the abdomen or back. Abdomen won't work for Jen, she has no abdominal fat--many people offer to be donors..too bad the technology isn't up to that level!

Oct 11: Breast MRI shows no evidence of residual disease in either breast.
Jen goes into nesting mode big time at the house...rooms get rearranged, closets reorganized (what does that have to do with anything????) and cans of paint that have been sitting gathering dust for at least 6 months are suddenly calling out to be used. Kitchen, family room and den get a face lift and then Jen realizes that maybe she should do some real preparation for being out of comission! Oh those genes run strong!!

Oct 21--Thanks to all of you who have sent love, prayers, flowers, meals, cards, calls and cookies our direction. The kids say you can send all the cookies you want! Feeling nervous and calm all at once but anxious to start the process of being cancer free for many years to come. Love to you all-- and don't eat in front of me because the fasting starts as of right now! ( you know that I am writing this at midnight--right??)

Oct 22: Scheduled for surgery at the Hunstman Cancer Hospital in the afternoon. Dr. Leigh Neumeyer to do Surgery, Dr. Agarwal to place tissue expanders and Dr. Talmage Egan to do Anesthesia --hear he gives a gourmet cocktail! -hope the pain meds are good and that my mouth can stay quiet while the meds are on board! Ken will write a more professional report later.