John and I saw my surgeon for the consult. We were there for three hours, most of it waiting. It turned out to be very understandable, as the surgeon had been in emergency surgery at 3:00 in the morning and that pushed everything scheduled for today, off by hours.

Overall, we like Dr. Gunn. Once he realized that I've been around the block a few times and understand medical things more than most because I research so extensively, we were able to move along at a pretty good clip, discussing things in greater detail than most do. I absolutely had to know if he will see me as a whole person, with multiple health issues. We left feeling that he does.

My breast cancer is invasive; as in, it has broken out of the (milk) duct walls. It is growing at a medium rate - not fast, not slow. It is HR positive, meaning it is fueled by hormones (HR = Hormone Receptive). It is 2 cm in size. We don't know if it is in the lymph nodes and we won't know until they operate. The full body bone scan, MRI brain scan, and CT scans of abdomin and pelvis (to be done this Wednesday) will determine what stage my cancer is -- that is, if it has spread and where.

The preliminary plan is a double mastectomy because I don't want to ever have to face this again. The right breast, with the cancer, must go. I had radiation before with the first cancer in 2007 and cannot have any more in that breast. When they check the lymph nodes, they inject a dye or radioactive substance into the the area and watch where it travels in the lymph system around that breast. They pick the first three lymph nodes where the dye goes first and biopsy there. Sometimes they take more lymph nodes. It just depends. The first lymph nodes are the sentinel lymph nodes. there are other lymph nodes that are like "second in command" but I forget at the moment what they are named. Main thing is, if cancer is found in any of the lymph nodes, all must come out. Can't take any chances that a lurking cancer cell might be left behind. When I had cancer the first time, the three sentinel lymph nodes they checked were cancer free, so they left the remaining lymph nodes in there. When you have breast cancer surgery that is breast sparing (like a lumpectomy), cutting in that area can sever lymphatic pathways (like a road being cut so it can't be travelled on again). If they inject dye, looking for the pathway of lymph, the "road" might be cut and the dye might not travel that direction. So, if you are looking for, say, the path dyed blue, and it's not there, how would you know whether there was a "washed out road" or whether the cancer didn't head that way? You wouldn't. So, the best thing to do is to remove all the lymph nodes on the side where the breast cancer is.