My post-op appointment was a few days ago and it went smoothly. Dr. Tierney checked my incision site and, aside from some unsightly surgical glue residue (that stuff is tenacious) things are looking good and healing up. From there, we mostly discussed screening recommendations. In about 6 months, after the biopsied area has healed completely, I should schedule an MRI. Then a year from that, a mammogram. And so on. You know, forever. My main problem with MRIs (aside from it being expensive and terrifying, especially given my MRI-specific phobia, stemming from an episode of House wherein a man with an old tattoo's tattoo is ripped from his body because of something about old ink containing trace amounts of metal and MRIs being giant magnets) is that they're super sensitive. Meaning that I could end up with lots of unneeded biopsies, and even more unneeded anxiety. But it does sound like it would be important to at least get one as a baseline, even if I don't keep up with them so regularly. I can also start meeting with the nurse who runs the High Risk Surveillance Program and she can be a point person of sorts.
Beyond that, there's not much to be done. I can schedule with an oncologist to discuss a Tamoxifen regimen. Tamoxifen blocks estrogen and supposedly cuts your cancer risk in half. But it also has potential side effects like blood clots, stroke, uterine cancer (so cancer trade off?) and ominously, "vaginal problems." I get that it's a great, less horrible alternative to chemo for women who have cancer (my mom was on it for a while there). But right now? Not very appealing. If atypia keeps popping up, then a prophylactic bilateral mastectomy is something I might want to consider, but hopefully that won't be the case!
My surgeon took some time to review a print out from the Breast Cancer Risk Assessment Tool website. She had entered in some of my information and, bleep bloop bleep, the tool generated some magic numbers. My lifetime risk of invasive breast cancer is about 40%, compared with that annoying, omnipresent average woman's of 12.6%. My risk of cancer in the next 5 years is only 1.8% compared with average woman's .3%. So, I suppose that's sort of useful. But with answers come more questions (that may or may not be a direct quote from Fringe. Wow, I watch too much television!). Like, what's lifetime risk? Cancer by 45? By 70? What's invasive? Like Stage III, where I still have a fighting chance? Or Stage IV, like my mom?
I realize those are answers no one can give me. But how can you make such major decisions with such vague information?! I guess you make the best choices you can, the ones you can live with. Maybe that will mean following all of these recommendations to the letter, or maybe I'll end up eschewing all of them in the name of leading a happier, less stressful life. I suppose I will figure it out as I go. Incidentally, I know that everyone has to make these choices to some degree, that everyone is at risk for something, that I am not a special in this regard. But we're all pretty isolated in our own bodies and it's hard not to freak when it seems something might be wonky with yours.
So yeah, I am healing up well and things are getting back to normal. I am even wearing a normal bra! Hallelujah! That zip up post-surgery number was binding and decidedly unflattering! Contrary to what this blog may indicate, I promise I have not just been sitting around thinking about cancer for months. Going back to work has been a welcome distraction. Also spring is here and I am determined to take advantage of this "nature" I keep hearing about. I have lived in Seattle for almost a decade but have never been to the San Juan Islands (pathetic I know), so this is definitely the year!