The Third Opinion

Photo: "Petit Bot" one of my favourite Guernsey beaches.
(We swim around the point from one bay to the other :)

The third breast surgeon that we saw also had an office in San Francisco. We had an appointment yesterday afternoon. Sometimes you can tell a lot about the doctor from the energy of their staff. Her office people were bright, happy and cheerful! Well, the doc was quiet but was compassionate and a had a good sense of humour. She also had her own ultrasound machine in the exam room so she got a really good view of the breasts right there and then! An excellent on site diagnostic tool.

Basically she agreed with the first doctors treatment plan except she felt confident in doing a lumpectomy with 1cm margins and with no subsequent radiation or tamoxifen therapy. The first doc recommended these adjuvant therapies with a lumpectomy.

She also said a mastectomy with a sentinel node biopsy was also an option if my risk tolerance for recurrence of cancer was low.

Three surgeons and three treatment plans. Now I just have to decide which doc I want and then what surgery.

***A Halloween Treat***

Photo: Lyla & Zeb are my *Halloween Stars*. Very cool "We are not amused" facial expressions. (Luckily, they understand their crazy mother ;)

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Hint: they are modeling some of my 'Be Happy' doctor visiting outfit.

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Have a great day!!!

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(BOO!)

The Second Opinion

Photo: One never knows what to expect.....

Ron And I drove to San Francisco for the next meeting with the 2nd breast surgeon. This doc was referred to me by my gynaecologist. I dressed up for Halloween as a special treat for the

medical community, not too way out - just interesting ;) (You might even get to see me, soon!)

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Hospital and doctor offices, etc. are very, well you know, have a certain clinical "Je ne sais quoi". I feel that spreading love and whimsy where there can be so much suffering can help lighten people's spirits.

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This doc had a very different treatment plan from the 1st doc. He would remove a small area of tissue with 1mm margins around the tiny metal marker. This marker was placed in my breast when they did the biopsy, positioned in the area where the tissue was removed. There was no lump or solid mass to begin with, so after the biopsy when all the microcalcifications were removed, they needed a visible marker to relocate the area.

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The doctor didn't recommend radiation or hormone therapy, as he felt the area was very small and at an early stage. If the pathology report later found that the margins were not "clean" (i.e. that there are still deviant cells present), then the doc would have to re-excise the area again.

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The doc quoted an earlier study of women with DCIS who had only an excision of the area and no further treatment. While there was some recurrence (less than 10% for low grade 30%-40% for high grade) they were able to effectively treat the recurrence.

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I decided to get a 3rd opinion. To have two breast surgeons differ so enormously in their treatment plans is unsettling. Who's right?! (I hope the second one :) I have an appointment Thursday with a female surgeon who comes highly recommended. Maybe this needs a women to sort this out ;)

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Until the next time....