After ridiculously thorough research bordering on obsessive, I've reached the most sound medical decision I think is possible. In total I have seen 5 breast surgeons, 4 plastic surgeons, 2 medical oncologists and today met with 2 doctors of radiology. I had an ultrasound to look at the suspicious lesions revealed by the MRI. There are a number of them and biopsying them all would turn me into a human pincushion. The point is that my right breast has multifocal carcinomas. Removing the amount of tissue necessary to ensure getting all of it barely qualifies as "breast conservation" -- at best you could call it a partial mastectomy. And even then, relying on radiation to zap whatever microscopic stuff could be missed isn't the safest bet in terms of recurrence, not to mention the cosmetic results could be very poor.
Bottom line: I'm having a mastectomy.
It will be a skin sparing one with immediate reconstruction (tho the creation of a nipple/areola is done months later, to let things "settle"). On the bright side I will also be getting a tummy-tuck, that's what they use to fill in the emptied "breast envelope". However there are some dangers & complications regarding that due to my thrombophillia, but I'll write more about that another time. Fortunately there will be practically no scarring on the breast itself, it's not like the brutal versions done in the old days. I may have a small bit of incision emanating out from the newly built nipple/areola, but other than that the rest of my skin stays totally intact.
In retrospect, just on the cosmetic/emotional front this has really been more like a choice between losing or saving my nipple in my mind. In a way I feel like I'm going to end up with a "nipplectomy" because the rest of the breast will look pretty normal even after surgery. If I had chosen to try and keep my nipple,tho, I've been counseled there's a better than good chance it would have no sensation anyway as the one tumor practically touches the areola and no doubt getting it out would involve the decimation of nerve endings. In addition I would have to have 7 weeks of radiation, which now with the mastectomy is not necessary. Radiation has it's own set of health risks, but it also can wreak havoc on the cosmetic results in a case like mine.
I have been most helpfully guided in the end by very caring women medical professionals, which I will write about another time. There's something comforting and reassuring about that. I've also met the best and the worst of the profession over all and am especially motivated to try and somehow work to change the system after this is all over, because finding out information and getting good care shouldn't be the province of just the educated or middle class woman. But I digress :)
I am as at peace with my decision as one could be under the circumstances. My family, both Michael and Megan (Danny's too little) have also come to the same conclusions and are completely supportive of my choice. My Meggie is a wise little soul and really seems to get this -- I'm so proud of her. The way she helps take care of her brother is particularly touching and gives me a sense of both pride and relief. They have eachother.
As to my husband, the rock and saint, he has been with me every step of the way. I am hugely lucky. With the exception of two times when we didn't have anyone else to watch the children, he has come with me to every appointment, met with every doctor, held my hand through every test. Even on those two occasions we dragged the kids with us and he stayed in the waiting room for a couple hours, trying to keep a toddler entertained (no small feat) just so I could have a chauffeur and shoulder to lean on when I got done. I have written little about him only because he's a quiet and unassuming kinda guy...but he is truly a hero to me, and Honey when you read this know that I could never have survived this process without you. I can only entertain surviving what comes next because you are with me. I love you and I know you love me -- that's a gift beyond precious.
Okay, before I get any more soppy, I wanted to add that I don't have a date yet, and while I'm leaning towards one particular hospital and team of docs there's just a few loose ends to tie up before I commit. I'll post when I know for sure.
Now, back to the gratitude front....
Thank you a thousand times over to every single person who has read even a paragraph of this blog, let alone taken the time to leave me the most wonderful and supportive comments or send me lovely emails. You all have been such a huge part of what keeps me going, I cannot fully describe the strength I have received from knowing you are out there. You are in my heart as I move forward.
Blessings to all and I'll post again soon.