decisions decisions - and candid talk about my breasts

(I am only going to apologize once to my dad, my brothers, my brothers-in-law, my father-in-law, and any other man who may be following my journey ... I'm sorry for all this information you're going to be privy to about my breasts. Deal with it.)

Just one week ago I didn't have to make any decisions about my long-term health. And then on Friday I was told that I'd been targeted by that silent killer ... cancer. And if I wanted to keep from being killed, I would need to make some decisions ... quickly. Its difficult to describe the sucker punch that kind of news is. And its not a fast sucker punch, either. Its oddly slow-moving, as each day the reality that I have breast cancer sinks in a little bit more. I've actually been a little surprised at how well I've navigated the last week of doctor's visits and countless discussions about options and treatment. I'm bound to break down eventually, but its nice to have my wits about me while making life-altering decisions.

Its been six days. I've met with a plastic surgeon, a medical oncologist and a geneticist. I've hashed out surgery questions with the physician's assistant, I've talked to Caleb and family and friends about their thoughts, and a few about their experiences. All this information is ... informative. And I've added every piece to the decision-making puzzle. But at the end of the day, the decision is completely mine.

Lumpectomy. Mastectomy. Bi-lateral mastectomy. Those are my choices.

Given a week to decide, what would you choose? 

So, let's talk about my particular case.

I have been diagnosed with triple-negative breast cancer. This "strain," if you will, is more aggressive and more likely to return. It also does not respond to any hormone-based medication, so my only course of action after surgery is chemotherapy. (I'll tackle that topic at another time.)

I am only 38 years old. I have three young children. Peace of mind that cancer has been truly eradicated, and that its chances of returning are as low as possible, is at the top of the list of desirables. When this is all over, I want to be as certain as possible that I have done everything I could have to keep it always behind me, never before me.

Almost from the beginning (you know, six days ago) I have leaned toward having a mastectomy. Its the most peace-of-mind inducing option. And again, eradicating cancer and achieving peace of mind is our topmost goal. Would I be sad to lose a breast? Of course! Its a part of me. But let's be honest,  it's also trying to kill me. So a mastectomy seems to be the most logical option.

Now, over the past 24 hours I have started to look into the implications of a bi-lateral, or double, mastectomy. Remove the healthy one with the evil one. On the one hand, that decision feels like overkill. On the other hand, can you really overkill cancer? Medically, its a good decision. Every nurse I've talked to has said it would be their automatic choice. Emotionally however, it's a very hard decision.

Even if it is found that I do not have the breast-cancer carrying gene (BRCA1 or 2), there is also my family history of breast cancer to consider. My grandma, her sister, and my three aunts have all fought this fight ... that's FIVE women in my direct genealogy who have been affected. I am the sixth. Even if I'm not positive for this particular gene, there's definitely something wonky going on inside the breasts in our family. And a bi-lateral mastectomy would take care of all the "what-ifs," those pesky little whispers in the back of my brain leaving me wondering if something is lurking in the tissue I didn't cut out. A double mastectomy silences ALL the voices.

And hey, then I have a boob job paid for and maintained by health insurance! (We have to focus on the positive here, people.)

I have a doctor's appointment tomorrow at 3:30 where we will sign consent forms and schedule surgery. That's almost exactly 24 hours from now. I wish I could talk to future me and find out what I decided!