Update - July 14, 2020

Two weeks ago, I had a lumpectomy on my right breast with the hope (expectation?) that they would be able to remove my 2.5 cm mucinous carcinoma. We had every reason to hope that my surgeon would be able to get clear “margins.” The next step would be 16 rounds of radiation and I would be on my way. It didn’t work out that way. The lump was removed uneventfully, and I recovered quickly. Here is a picture of me the next day after the surgery. I felt great.

Liz, Kathy, Bill and Adie

On Tuesday, the surgeon called me with the results and let me know that they were not able to get “it” all. Apparently, the tumor “invaded” the chest muscle and they would need to do additional surgery. Because of a conflict, my post-op appt. had to be delayed. She allowed me to come and pick up my full pathology reports, and her staff set up an appointment with a plastic surgeon at Christ Hospital. 

Liz and I obsessively researched everything we could over the weekend. She passed the path reports on to a few of her doctor friends in Columbus. It was beginning to sound a little scary.

When I went to see the plastic surgeon, she brought up computer images from the MRI I had on May 21^st. She got a little concerned with one of the images, let me photograph it, and then gave me her opinion. First, because of the discrepancy between the MRI synopsis and the post-surgery pathology reports, she is going to ask the radiologists for a second review. Depending on their opinion, they may want to involve a thoracic surgeon. All of this is preliminary.

So I’m going to spare you the images – under the category of “too much information.” This is the current status. There are steps to go through before I can report back.

MRI Results (May 21st) Predicted	Pathology Report (June 30th) Actu
Enhancement posterior to this mass, anterior to the right pectoralis musculature corresponds with a vascular structure without invasion of the right pectoralis musculature identified.	Excision #1 – Mucinous carcinoma -The posterior-superior margin is positive where the tumor invades the skeletal muscle.
	Excision #2 – New superior posterior margin: Skeletal muscle extensively involved by mucinous carcinoma reaching the inked margin.
	Excision #3 - New lateral posterior margin: Benign skeletal muscle, uninvolved by carcinoma.
	Excision #4 – New medial posterior margin: Skeletal muscle extensively involved by mucinous carcinoma reaching the margin.

Summary:

Skeletal Muscle: Carcinoma invades skeletal muscle.

Invasive Carcinoma Margins: Positive for invasive carcinoma.

Positive Margins: Posterior (posterosuperior)

The next step will be to wait for my surgeon to give me a call with "the plan." I don't think I'm going to like it.