A Child's Prayer

Heavenly Father are you really there and do you hear and answer every child's prayer
Some say that heaven is far away, but I feel it close around me as I pray.........

Yes He is.

Friday was surgery and as the previous post said things went very well. The tumor came right out, and they biopsied the two sentinel lymph nodes, the ones nearest to the tumor. They are taken and biopsied right then by the pathologist. They came out clean.

I was so nervous. I knew that I would have one drain, but if the lymph nodes were malignant also, I would have another drain. Before I went into the operating room, I asked my surgeon if he ever puts a drain in a node to be safe? He said no, and knew that I was scared and told me everything would work out. I was rolled into the operating room and that was the last thing I remembered until I heard my name in recovery. I tried to see if I had two drains, but I was so out of it, I couldn't tell. When I got to my room, there was my sweet husband and loving parents. I asked is there one or two drains? Keith said just one, and my mother said we will tell you in a minutes. When the orderlies left, my mother broke down and said, just one drain, we are so blessed. I just sobbed. I was so worried that it had spread into the lymph nodes. I will get the FINAL results this week.

Yesterday I took off my bandages and saw the incision for the first time.  It was a little traumatic, but got through it.  I am doing fine, it is just the drain that pinches.  It is a suction drain that goes into a clear plastic hand grenade looking object. It burns sometimes, but I know that it is all healing.

Tonight I got a call from Dr. Fisher to talk to me about the preliminary findings for the pathology report:

1.  3.9 cm
2.  Grade 1
3.  The margins were clear (negative or clean) around the tumor
4.  There were 2 lymph nodes taken out, but 3 lymph nodes were biopsied.  2 were clean, but one showed a 1mm cancer cell in one spot, Micrometastases.  1mm is such a small amount (the size of a guitar string) that there will not be a need for another surgery this week of more lymph nodes being taken, it will be addressed with the Medical Oncologist through chemo and/or radiation.

1.  The tumor was 3.9 cm or 1.5 inches, so it was smaller than was seen on the MRI, but definitely bigger than what was seen on the ultrasound.

2.  He said it was a Grade 1.
Grade is a “score” that tells you how different the cancer cells’ appearance and growth patterns are from those of normal, healthy breast cells. Your pathology report will rate the cancer on a scale from 1 to 3:

• Grade 1 or low grade (sometimes also called well differentiated): Grade 1 cancer cells look a little bit different from normal cells, and they grow in slow, well-organized patterns. Not that many cells are dividing to make new cancer cells.
• Grade 2 or intermediate/moderate grade (moderately differentiated): Grade 2 cancer cells do not look like normal cells and are growing and dividing a little faster than normal.
• Grade 3 or high grade (poorly differentiated): Grade 3 cells look very different from normal cells. They grow quickly in disorganized, irregular patterns, with many dividing to make new cancer cells.

Having a low-grade cancer is an encouraging sign. But keep in mind that higher-grade cancers may be more vulnerable than low-grade cancers to treatments such as chemotherapy and radiation therapy, which work by targeting fast-dividing cells.

Be careful not to confuse grade with stage, which is usually expressed as a number from 0 to 4 (often using Roman numerals I, II, III, IV). Stage is based on the size of the cancer and how far it has (or hasn’t) spread beyond its original location within the breast.

Grade is a “score” that tells you how different the cancer cells’ appearance and growth patterns are from those of normal, healthy breast cells. Your pathology report will rate the cancer on a scale from 1 to 3:

• Grade 1 or low grade (sometimes also called well differentiated): Grade 1 cancer cells look a little bit different from normal cells, and they grow in slow, well-organized patterns. Not that many cells are dividing to make new cancer cells.
• Grade 2 or intermediate/moderate grade (moderately differentiated): Grade 2 cancer cells do not look like normal cells and are growing and dividing a little faster than normal.
• Grade 3 or high grade (poorly differentiated): Grade 3 cells look very different from normal cells. They grow quickly in disorganized, irregular patterns, with many dividing to make new cancer cells.

Having a low-grade cancer is an encouraging sign. But keep in mind that higher-grade cancers may be more vulnerable than low-grade cancers to treatments such as chemotherapy and radiation therapy, which work by targeting fast-dividing cells.

Be careful not to confuse grade with stage, which is usually expressed as a number from 0 to 4 (often using Roman numerals I, II, III, IV). Stage is based on the size of the cancer and how far it has (or hasn’t) spread beyond its original location within the breast.

 

3.  Your pathology report may say that the surgical margins are:

• Clear (also called Negative or Clean): No cancer cells are seen at the outer edge of the tissue that was removed (the tumor along with the rim of surrounding tissue). Sometimes the pathology report also will tell you how wide the clear margin is — the distance between the outer edge of the surrounding tissue removed and the edge of the cancer. When margins are clear, usually no additional surgery is needed.
• Positive: Cancer cells come right out to the edge of the removed tissue. More surgery is usually needed to remove any remaining cancer cells.
• Close: Cancer cells are close to the edge of the tissue, but not right at the edge. More surgery may be needed.

An important note: There is not a standard definition of how wide a “clear margin” has to be. In some hospitals, doctors want 2 millimeters (mm) or more of normal tissue between the edge of the cancer and the outer edge of the removed tissue. In other hospitals, though, doctors consider a 1-mm rim of healthy tissue — and sometimes even smaller than that — to be a clear margin. As you talk with your doctor about whether your margins were clear, positive, or close, you also can ask how “clear” is defined by your medical team.

 

4.  Definition: Micrometastasis is a small collection of cancer cells that have been shed from the original tumor and spread to another part of the body. They can not be seen with any imaging tests such as mammogram, MRI, ultrasound, PET, or CT scans. These migrant cancer cells may group together and form a second tumor, which is so small that it can only be seen under a microscope.