Under the Knife: Going inside the OR for breast cancer surgery
I had chemotherapy before surgery to try to kill the cancer.
But the only way to know if it worked was to remove the tumor and look at it under a microscope. So, it had to be surgically removed.
But it’s important to note that my surgery was unusual because the cancer had taken an unusual path.
I was first diagnosed with breast cancer in 2010.
I insisted on a double mastectomy because I hoped to reduce the risk of recurrent breast cancer in the healthy breast.
But in April of this year, I found a lump on what had been my healthy side at the base of where my breast had been.
"Developing breast cancer after mastectomy is not common," said Dr. Kristin Skinner, chief of surgery at Pluta Cancer Center in Rochester.
Doctors believe that when the cancer spread, it took an unusual turn because the normal drainage patterns were disrupted by the mastectomy.
"Instead of going to the armpit, it went to the lymph nodes on the other side of the breast which lie underneath the breast bone," said Dr. Skinner.
The lymph nodes beneath your breast bone are called mammary nodes. I’ve decided to remove them as well. That’s one of many aspects that make my surgery unusual.
I feigned calm as I was wheeled down the long hallway to the operating room.
While the OR was cold, the staff was not.
They introduced themselves and chatted with me as they prepared me for surgery.
But the chatter didn’t last long.
The anesthesia was effective. It took only seconds, and I was out.
Then, the work begins.
Removal of the mammary nodes is challenging. They’re in the chest cavity beneath the sternum. Thoracic surgeon, Christian Peyre, performed that part of the surgery.
He made three small incisions through which he inserted a long instrument with a light and camera on the end.
Through a second incision, he inserted an instrument that grasps tissue and through the third incision, an instrument that cuts the tissue.
All this was happening inside my chest cavity.
The thoracic surgeon was intensely watching a monitor as he worked in the darkened operating room.
It’s like he was playing a very sophisticated video game. It’s minimally invasive and left only three small scars on my left side.
As my mother and close friends chatted in a nearby waiting room, the second half of the surgery began.
Dr. Kristin Skinner removed what was left of the tumor at the base of my left breast. She cut then cauterized, explaining each step to a resident and student.
"I’m feeling to make sure I’m not feeling any exposed tumor," she explained to the resident as she moved her gloved fingers along my chest cavity.
Cancerous tumors feel firm and less supple than healthy tissue. She was careful to remove the lump hoping to leave no cancerous tissue behind. Then, she walked down the hall to the pathology lab. She wanted to give them a roadmap, of sorts, of the now excised tumor.
The tumor, an oval-shaped mass that resembled chicken fat, was finally out. The work of pathologists was just beginning. Is this mass cancerous or just dead tissue killed by the chemo I had before surgery?
That’s the question only they can answer.
Again, my case is unusual. But the lessons learned are not.
In my next report, I’ll reveal what pathologists found and give helpful information in deciphering your own pathology report.