Clinical Details

ADDED November 30, 2010
The type of cancer that Sarah has is often one that occurs in both breasts. Thus, Sarah's radiological oncologist thought that it would be good for her to get an MRI, which is more sensitive to picking up this type of cancer than is a mammogram. The MRI gives the doctors (and us) greater certainty as to whether there are other tumors present that weren't picked up on the mammogram and gives the doctor a clearer picture of the extent of tissue that needs to be removed during surgery. She had the MRI yesterday (Monday) and we got the results today.

The Lord answered our prayers (and your's) that there would be no cancer elsewhere -- yeah!!! Furthermore, it appears more definitive that the cancer has not spread to her lymph nodes, although we won't know for certain until after they biopsy the tumor. She still has to have surgery to remove the tumor (scheduled for Dec 6th) and will have radiation following the surgery. But, it's looking more and more like chemo won't be in the picture (at least, it will take a lot of convincing evidence from the doctors to get her to agree to it).

Please continue praying that the surgery will go well next Monday and that we'll glorify God through this experience.

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Sarah had a screening mammogram on October 12th that was read by an observant radiologist.  His report indicated that there was "indeterminate architectural distortion in the left breast" which required "additional evaluation".  I say "observant" because the type of cancer with which Sarah was ultimately diagnosed is not always caught on a mammogram. 

The "additional evaluation" involved a diagnostic mammogram on October 19th.  The report from those pictures was that there was a 1.2 cm distortion that was consistent with carcinoma.  This led to an additional procedure, a needle biobsy, which was done on October 25th.  We got the results from Sarah's GP on October 28th indicating that there was an "invasive lobular carcinoma" present. 

As you can imagine, that was a difficult phone call for us to get. 

Here's what we've been able to glean from the many helpful websites (Mayo Clinic, American Cancer Society and WebMD). 

"Lobular" means that the cancer began in one of the milk producing lobes of the breast; "invasive" means that the cancer has migrated outside the confines of the lobe into surrounding tissue.  It turns out that this type of cancer represents only about 10% of breast cancer cases and tends to be slow growing (although, Sarah's sister, who is a pathologist, has cautioned us against drawing too many conclusions from the limited information we currently have -- her comment was that all one really learns from a needle biopsy is whether or not cancer cells are present).  Given the fact that the tumor is small and that this type tends to be slow growing, we are cautiously optimistic about future prognoses.  However, while under 2 cm is considered Stage I and the most treatable, there are other factors that determine the stage which we don't yet know (such as whether the cancer has spread to any of her lymph nodes).  Treatment for this type of cancer has a very high success rate when it is caught early -- in fact, according to the Mayo Clinic, the 5-year survival rate (the point after which the doctors consider you "cured") is nearly 100%. 

The next step is to have surgery to remove the tumor (probably a lumpectomy) and to biopsy the sentinel lymph node -- the lymph node into which the affected lobe drains -- which will tell the doctors whether evaluation of other lymph nodes is necessary.  Through family and friends, we've identified the surgeon we'd like to see and plan to call his office on Monday to setup an initial appointment (sorry MSU fans, he's an U of M Med School grad).  The doctors have all told us that, medically, there is no particular hurry to have this done, although because of the wealth of information that we'll gain from the procedure, sooner for us is better than later.  We hope to schedule the surgery in the next couple of weeks.