Tuesday, January 31st, 2017 was the day that I had my surgery. I was scheduled for a lumpectomy (removal of the tissue where the tumor was), axillary sentinel node biopsy (removal of the first few lymph nodes in the armpit where the cancer originally spread to see if there were any residual cancer cells), and my port removal since chemo was complete! This meant three incisions, although all were relatively small and the procedure was relatively simple, all things considered.
I joined a clinical trial beforehand, which essentially gave me a 50/50 chance at a less aggressive surgery if any of my lymph nodes tested positive during the axillary sentinel node biopsy. Typically, if any lymph nodes test positive, they would remove all of the axillary lymph nodes in what is called a dissection. This was standard of care at the time, but the clinical trial was trying to determine if a less aggressive approach was just as effective, followed by radiation.
I did not want all my axillary nodes removed because it greatly increased the risk of lymphedema. I worried about my quality of life if my right arm was swollen from a buildup of fluid and I needed to regularly manage the symptoms. I did not want a permanent, physical reminder of cancer for the rest of my life,. Any chance at avoiding that was worth it to me.
So essentially, I went under anesthesia and would not know the results of the lymph node surgery until I woke up. The possibilities: no residual cancer and only sentinel nodes removed, residual cancer and only sentinel nodes removed, or residual cancer and all axillary nodes removed. Lucky for me, the 4 lymph nodes they removed tested negative, so I only had my sentinel nodes removed and I was no longer in the clinical trial. Even with sentinel nodes being removed there is a risk of developing lymphedema but it’s significantly smaller, and the best option I had.
The surgery itself wasn’t too bad. The doctors encouraged me to take the prescribed pain medication in an effort to ‘get ahead of it’ so I did as I was instructed. I didn’t know what to expect in terms of pain because the only other surgery I ever had was my port insertion, and this time it was three incisions at once. I don’t tolerate prescription pain medication well though, in terms of nausea, so I stopped the day after surgery and switched to extra strength Tylenol. Although I was in some pain, it was worth it to make the switch. The hardest part for me was trying not to stretch the incision sites, especially since one incision was on the left side and two were on the right side. I wanted them to heal well and reduce any chances of complications. Honestly, it all felt like more of an inconvenience than anything else. I was lucky in that I had time to rest and recover at home, at least for the next 3 weeks until radiation started.
After the surgery, I was officially considered having a pathologic complete response (pCR) and no evidence of disease (NED)! This meant that there were no cancer cells found in the tissue they removed during surgery and the lymph nodes. Thank you chemo for doing your thing!!
My doctors would never use the word cure, because there is always a chance of recurrence, so this was the next best thing. I didn’t feel immediately relief though, strangely. I guess it’s because I knew I still had radiation left and that my treatment wasn’t over. Despite no longer having any known cancer in my body, we needed the radiation to hopefully kill any lurking cancer cells that may not be detectable yet. The goal at this point was to maintain NED status and we were one step closer to finishing treatment.