Checking in with my Breast Surgeon

My breast surgeon in Austin is a tiny five-foot tall blond woman from New Orleans -- not the first image that springs to mind when you hear the word "surgeon."  She seems like a tough lady and didn't mince words yesterday when giving me her opinion of plastic surgeons; there are only two she is willing to work with in Austin.  Still, she was nice enough when I made her entire office smell like lentil soup.  While we were discussing reconstruction, she mentioned that I may be "too thin" for DIEP flap.  My instinct was to say thank you, but having fewer options doesn't sound like a good thing.  She did say that her preferred plastic surgeon is wonderfully "creative," so who knows what kind of breasts I will end up with!  Maybe something really cool that I don't even know about.  (And yes, that's a quote from Old School.)

To track my progress from chemotherapy, she used ultrasound to measure the tumors that I had biopsied and marked with clips, and she confirmed that they are getting smaller.  Complete remission from chemotherapy is rarely achieved for hormone-positive breast cancers and I've been warned to keep my expectations low, but my surgeon said it was a good sign.  She even printed out the sonogram, so now I can hang my shrinking tumor on my fridge door.  I'm tempted to draw a cartoon bubble that says, "Argh!  I'm trying to kill you!  Please don't feed me broccoli or blueberries!" 

Now for the bad news: she said I am not a candidate for targeted lymph node removal due to my advanced stage.  The oncologist at MD Anderson had mentioned targeted lymph node removal as one of their strengths, so I'm interested to see what their breast surgeon says about my case.  Either way, I will be at high risk for lymphedema and will likely start physical therapy soon after surgery.  At a support group brunch this weekend, I met a woman wearing a lymphedema compression arm sleeve decorated with tattoo art; it looked okay but I don't envy her in the Texas summer. 

Thinking ahead to when I have my genetic results back, my surgeon also said that she rarely pushes for a bilateral mastectomy.  Assuming I'm not BRCA positive, it sounds like she might recommend a unilateral mastectomy and have the plastic surgeon figure out how to make me symmetrical.  The word "droopy" was used, so she lost the goodwill that she had gained by calling me "thin."  :(