Sentinal Node Biopsy--Is it in my lymph nodes too?

Keep Calm & Beat Cancer


Since I found out I have breast cancer, my life has become a whirlwind of doctors appointments and learning more about breast cancer than I ever cared to know.  Not that I didn't care about those who had breast cancer; but because I had never learned the intimate details associated with this disease simply because it had never personally touched my life.  In only a few short weeks, I am using words and speaking "cancer lingo" like a pro.  I wish I could go back to the uneducated state I was in only a few short weeks ago--yet it feels like a lifetime ago.  

I had a Sentinal Node Biopsy on October 3, 2013.  I had spent a great deal of time online prior to the biopsy learning what to expect and what it meant.  I felt like I was prepared.  My MRI had shown no indication there was sentinal node involvement; and my surgical oncologist was optimistic.  Prior to the Sentinal Node Biopsy results, I was diagnosed as a Stage 2B Ductal Carsinoma Triple Negative due to the size of the tumor, which measures 5 cm on the MRI in my left breast in the 12 o'clock position.  I've had several other surgeries in my past, and while I was somewhat nervous before each surgery, none of them compared to how I felt before this surgery.  At the age of 40, I suddenly felt like my life was "on the line" and I may be reaching the end of my journey.  Everyone keeps telling me to stop thinking like that and I have to be strong and tough, but cancer is a scary word.  Add triple negative to that; and it's enough to cause quite an anxiety attack for even the coolest and toughest of individuals.  

I was fighting back tears as I was being readied on the operating table.  I looked up at my surgeon as they placed the mask on my face and told me to take some deep breaths.  He grabbed my hand and squeezed it saying "I will take good care of you".  It felt good to know he understood just how scared I was.  I wasn't just another patient but an actual person with feelings.  The next thing I recall was my surgeon leaning over me as I woke up and telling me the surgery was over.  He said my sentinal nodes were all clumped together; and in order to remove them, it created a rather large void under my arm so he had to insert a drain.  Due to this, I would need some time to heal; and he was going to have to postpone my first chemotherapy appointment scheduled for October 11, 2013.  It was about then the first wave of paint hit, and I realized my left shoulder/arm was aching so badly I felt like I had been in a sword fight and had lost.  I was admitted to the hospital and kept overnight for observation due to the surgery being more involved than expected.  I later found out 15 sentinal lymph nodes had been removed. Most people have 3 to 10.  Leave it to me to be unique and different.  

I had a follow up appointment on October 9, 2013 to find out the results of my biopsy.  I prayed every day for results showing no lymph node involvement.  I was finding it more and more difficult to focus on my every day life without bursting into tears.  I had only known I had cancer a little over a week, and it had already taken over my life.  Gone was my carefree life full of laughter and fun with my children (my son is 21, my daughter is 19, and my youngest daughter is 15).  Suddenly every minute of my life was about cancer, doctor appointments, surgeries, treatment options, and fear of the unknown.  I find myself crying every time I turn around.  I brush my hair and try to memorize what it feels like to feel my hair hanging down my back, blowing across my face and just how MY hair feels in general.  For I know it will be gone in only a few weeks.  I look in the mirror and I wonder if I will recognize myself in a few short months.  Finally, I stare at my breasts, and I hate them.  I hate what they have brought into my life.  I was drying my hair getting ready for the 2 hour drive to my doctor's office, and the clinic called my cell phone.  It was my surgeon's assistant.  My appointment was for 5 p.m., but he wanted to know if I could be there at 1 p.m. instead; and he also wanted me to meet with my oncologist that day as well.  My heart dropped to the floor.  It just didn't seem like a good sign that he was squeezing in an extra appointment and moving mine up.  I didn't ask for details as I knew she couldn't give me details over the phone, so I just agreed and hung up the phone.  I physically felt sick.  I went from being optimistic and feeling good for the first time in a week to being anxious and scared.  

My husband met me at the clinic, and my 15 year old daughter went with me.  Fearing the worst, I asked my daughter to wait in the waiting room, and my husband and I anxiously waited in the exam room.  My doctor first check the incision site as well as my drain.  He informed me he couldn't remove the drain that day since it was still draining too much.  I was told I was attempting to do too much and it wasn't healing fast enough. I was guilty as charged.  I had went to work the day before; and I'm not one to sit around and do nothing.  I despise depending on others, and I enjoy being independent and doing things for myself.  Yet another part of my life I was being forced to let go of.  He then asked me to take a seat next to my husband.  I knew in my heart he was telling me to sit with my husband because I was going to need the support.  I clutched his hand, and I was so keenly aware of the silence in the room I could hear the hum of the lights above me.  After what felt like an eternity, he began talking.  

As much as I thought I had prepared myself for bad news, I still felt my heart break a little more as he said "the biopsy did reveal some lymph node involvement.  I removed 15 lymph nodes.  1 of them had a tumor on it, and four others had cancer cells.  The remaining ten were clear".  I had silent tears rolling down my face; and I was squeezing my husband's hand so hard, my nails were digging into his palm.  More bad news to add to what I had already been dealt in such a short period of time.  I wanted an all clear on lymph node involvement so badly.  For me, it would be something positive to hold onto while I fought this monster.  I felt like my world came to a screeching halt yet again.  I wanted to scream.  I wanted to ask why--what had I done that was so bad to deserve this?  Yet, I quietly sat there with tears streaming down my face while all these emotions were coursing through me and these thoughts racing through my brain.  He then told me this changed the stage of my cancer, which was previously a Stage 2B.  I was now considered a Stage 3A.  

I numbly completed my appointment with him and went to another floor to meet my plastic surgeon who would be responsible for my reconstruction.  I sat in the exam room of his office looking at my breast with the ugly purple markings all over it indicating what areas would have to be removed--to include a large patch of skin in the 12 o'clock position of my breast.  My plastic surgeon was very nice; and I could tell he was trying to treat lightly with me.  It was obvious to him I was in a fragile state.  He was talking about reconstruction on my left breast only.  I looked him in the eye and said "I do not want to go through this again in a few years.  I want them both removed.  This cancer has a high reoccurrence rate, and I'm not giving it a chance--that's the only control I have left.".  I could tell he was shocked but he also agreed and understood.  He said I would likely have a more balanced appearance removing them both as it's very difficult to match breasts when only one has been removed.  

I then went to yet another floor and met with my oncologist.  She informed me my treatment plan was the same as it had been prior to knowing there was lymph node involvement--6 months of chemotherapy, a complete mastectomy, radiation, then a revision.  It would be a full 2 years before I felt normal again--whatever that may be after this experience.  My chemotherapy would begin on October 18 to give my body time to finish healing from the biopsy.  

I drove home with thoughts of my children, my husband, and my family running through my mind.  I'm the youngest of three girls, yet I had breast cancer.  I take care of myself, eat right, work out, work a full time job, a good mom--all the things we are taught to do as women, so why me?  Why did this happen to me?  I began having green discharge from my nipples (both breasts) in 2008.  I went to the doctor and was told it was nothing to worry about as it was only a hormonal cyst draining behind my nipple.  I questioned this diagnosis, and I went to Columbus for a second opinion.  I was told the same thing there.  I had my first mammogram at 39 years old due to several lumps I had.  All were determined to be hormonal cysts and harmless.  Nothing of concern was found and I received a "normal" mammogram result.  This tumor was not there then, was it?  No one saw it.  I had a mammogram again this year because of this particular tumor.  Yet I was given a "normal" mammogram result.  Because this one was painful and rather large, I didn't accept NORMAL as a possibility, and I pushed the clinic to further investigate.  Only then was an ultrasound done.  Then the MRI.  

All three scans indicated an abnormality; but none exhibited signs of cancer.  No one really thought this was anything of concern.  Had I not had a visibly large tumor, it would have been passed off as "no big deal".  How many women are given mammogram results of normal, they breath a sigh of relief and move on with their life while this monster is lurking inside them?  I looked at my daughter sleeping in the passenger seat, and I try to imagine not getting to see her graduate, missing her proms, missing meeting my first grandchild; and I became angry.  What right does this have to come into my life and destroy not only my life; but the lives of my children, my husband, and everyone who cares about me?

So, even though I have fear, I will fight.  Even though I wonder if I will go through chemotherapy, a mastectomy, and recovery only to have it return at some future point, I will fight.  Because I am fighting for my children and myself.  

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