Surgery Follow-Up and Pathology Report (Jan. 18, 2006)
This was the day that Jim and Laurie went back to meet with Dr. Knox for Laurie's follow-up visit. It was also the day we got the pathology report from Monday's surgery.
Up to this point we had been praying, as were many others, that the tumor would have been completely removed with clear margins and that none of the lymph nodes would be involved. The hope was that such a result would minimize the chances that Laurie would have to go through chemotherapy, something we did not want to do. The results were not exactly what we'd hoped for, but Dr. Knox assured us that the report was a good one. The pathology report revealed that a very small, almost microscopic tumor had started growing a few millimeters away from the first. This tumor did not show up on any of the tests to that point. Fortunately Dr. Knox removed it in the first excision, but because it wasn't visible, it was closer to the edge of the incision than expected. The result is that a few cancer cells were close to the edge of the removed tissue, indicating the possibility that additional cancer cells still remained in the breast. Dr. Knox informed us that a re-excision would be needed to get the remaining cells and get clear margins.
The pathology of the lymph nodes was also a mixed bag. The sentinel node revealed two small clusters of cancer cells in the node, one of 10 cells the other of 40, these were not visible to the naked eye. They were very lowgrade with an extremely low rate of mitosis (cell division). The second node was completely clear. Dr. Knox said this was almost as good as having no nodes involved. The cancer was trapped in the first node and had not migrated further. That node was no longer in her body and those cells weren't going anywhere.
The report, however, did make the possibility of chemotherapy more of a reality. That decision will come later in meetings with the medical oncologist next week.
Because of the small secondary tumor, a second re-excision surgery was scheduled for early Friday morning to remove the additional tissue.
This was probably the gloomiest day of the journey so far. We have a great deal of confidence in God's goodness and sovereignty, but we had prayed so hard for a clear report that the news was a little discouraging. At the same time, we know whose Hand holds ours and He will give the strength to get through each step of the process.
Up to this point we had been praying, as were many others, that the tumor would have been completely removed with clear margins and that none of the lymph nodes would be involved. The hope was that such a result would minimize the chances that Laurie would have to go through chemotherapy, something we did not want to do. The results were not exactly what we'd hoped for, but Dr. Knox assured us that the report was a good one. The pathology report revealed that a very small, almost microscopic tumor had started growing a few millimeters away from the first. This tumor did not show up on any of the tests to that point. Fortunately Dr. Knox removed it in the first excision, but because it wasn't visible, it was closer to the edge of the incision than expected. The result is that a few cancer cells were close to the edge of the removed tissue, indicating the possibility that additional cancer cells still remained in the breast. Dr. Knox informed us that a re-excision would be needed to get the remaining cells and get clear margins.
The pathology of the lymph nodes was also a mixed bag. The sentinel node revealed two small clusters of cancer cells in the node, one of 10 cells the other of 40, these were not visible to the naked eye. They were very lowgrade with an extremely low rate of mitosis (cell division). The second node was completely clear. Dr. Knox said this was almost as good as having no nodes involved. The cancer was trapped in the first node and had not migrated further. That node was no longer in her body and those cells weren't going anywhere.
The report, however, did make the possibility of chemotherapy more of a reality. That decision will come later in meetings with the medical oncologist next week.
Because of the small secondary tumor, a second re-excision surgery was scheduled for early Friday morning to remove the additional tissue.
This was probably the gloomiest day of the journey so far. We have a great deal of confidence in God's goodness and sovereignty, but we had prayed so hard for a clear report that the news was a little discouraging. At the same time, we know whose Hand holds ours and He will give the strength to get through each step of the process.
posted by Laurie Thames | 10:31 AM
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