Breast Cancer Journey – Second surgery

5 May, 2025

Second surgery? Yes! (Here’s where I might repeat myself but I don’t know if everyone will read everything so overlaps are bound to happen.) About a month after my first surgery I went back to see Dr Escallon at Mount Sinai. We waited a long time for the doctor to appear, bustling in. I’d get used to this in future visits at the medical oncologist visits that were to follow. His stay was alarmingly brief – I recorded it so I  missed nothing and, playing it back, it was about three minutes long. The surgery had gone well BUT (casually mentioned) the margins weren’t quite cleared.  I was to see a medical oncologist who would decide whether I’d need chemotherapy. Radiation would also possibly zap that margin. I felt my anxiety ramping. Do you think I’ll need chemo, I asked. He glanced at my report. In my opinion, no, he said. I relaxed a little. There was a possibility that a second surgery might go ahead. There were too many maybes and perhapses. I left there mustering all the optimism I could. More of the waiting game. I was to realise more than before that much of this journey was about waiting. Waiting for appointments, waiting for doctors, waiting for scans, waiting for results

The reports of what happened with those two doctors are here.

I got a notice that Dr Escallon had retired and I was booked to see another surgeon. He’d agreed to do my surgery. Krish and I went in to see him. Dr. Lim is a tall attractive Chinese-Canadian man. He was the youngest person in my assigned team and had a personal and friendly demeanour. He said my surgery was going to be easy and that I’d recover more quickly this time. Although Dr Croke, my radiation oncologist, had suggested a mastectomy, he thought it wasn’t for me. ‘At my age’ it would be a challenging recovery. Whether I got radiation afterwards would depend on the result and what information they could get from Barts in London. I had been trying with no success to get answers from their Health Records. Dr Croke had also been trying. Silence.

Not as many pre-surgical things this time. There was a mammogram. Then I had a repeat of the online appointments with three different departments. On the day of my surgery, they put wires in again. I was still nervous but told the new anaesthetist my wishes. The greyness took me in. I woke up much drowsier this time. When we left the hospital I could barely make it to the cab. I felt pretty awful, close to fainting, to be honest but I made it home and resigned myself to more couch sessions.

My results were delivered via Zoom. My margins were now clear and my follow-up mammogram would be pushed to the end of the year. The surgeon, not Dr Lim but his holiday replacement, was all smiles. This time my tongue wasn’t numb.

I’d survived another surgery. Yay me.

Index of all my Breast Cancer Journey Posts

Pathology results (if you like [- and if you don’t, they were good):

Pathology & Laboratory Medicine 600 University Ave., Suite 6-500, Toronto, ON, Canada, M5G 1X5 t: 416-586-4800 x4457 f: 416-586-8628 Clinic ID: WCHOR Medical Record # WCH5407073 Clinic Name: WCH (WSU OR) Last Name: xxxxx Operating Rm Physician: LIM, DR. DAVID First, Middle: JANICE, SUSAN Procedure Date: 2025/05/06 DOB/Gender: 1947/03/06 / Female Accession Date: 2025/05/06   Report Date: 2025/05/15 Visit #: WCH10586118 FINAL SURGICAL PATHOLOGY REPORT SPS-25-12760 Copies to: PATHOLOGY DIAGNOSIS 1. Breast, lumpectomy (LEFT, revised anterior margin): – Breast with extensive reactive changes consistent with prior surgical procedure – Negative for carcinoma 2. Breast, lumpectomy (LEFT, revised posterior margin): – Breast with extensive reactive changes consistent with prior surgical procedure – Negative for carcinoma Specimen: 1. REVISED MARGIN, LEFT BREAST, ANTERIOR 2. REVISED MARGIN, LEFT BREAST, POSTERIOR Clinical History: Gross Description 1. The specimen container is labelled with the patient’s identification and as “left breast revised anterior margin”, and contains one piece of fibrofatty tissue that measures 3.8 cm 12:00 to 6:00 x 3.1 cm 3:00 to 9:00 x 1.3 cm from the old to final margin. The specimen is oriented with a short suture marked final margin, and long lateral at 3:00 as per the requisition. The final margin is inked with silver nitrate, and the 3:00 half is remarked blue. Tan-pink, smooth capsule is present at the old margin. Submitted in toto: -1 to -2 12:00 margin, perpendicular -3 to -9 intervening tissue, 12:00 to 6:00 -10 to -12 6:00 margin, perpendicular 2. The specimen container is labelled with the patient’s identification And as “left breast revised posterior margin”, and contains one piece of fibrofatty tissue measures 3.6 cm 12:00 to 6:00 x 2.1 cm 3:00 to 9:00 x 2.2 cm from the old to final margin. The specimen is oriented with a short suture marked final margin, a nd long lateral at 3:00 as per the requisition. The final margin is inked with silver nitrate, and the 3:00 half is remarked blue. Tan-pink, smooth capsule is present at one aspect. Submitted in toto: -1 to -2 12:00 margin, perpendicular -3 to -6 intervening tissue, 12:00 to 6:00 -7 to -9 6:00 margin, perpendicular Grossed by: M. Lin, Pathologists’ Assistant Miralem Mrkonjic, MD,PhD,FRCPC.Pathologist

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