An interesting meeting with the surgeon and my Macmillan nurse. It took place as always in a tiny room, the cancer affording me a chair, surgeon perched on the bed and Dan standing between the sink and the bin and the Mac nurse standing just inside the door!

But all that is by the by. The info was the main thing. 4 months of chemo since we last met. They asked how it had all gone…what’s the one sentence answer to that?!!  Well they got the gist. They liked my headscarf anyway!

The surgeon was really pleased with the scan results and is keen to get on with the surgery. He confirmed the radiographer’s thoughts – a full mastectomy is still required as well as complete lymph node removal from the right arm. So pretty massive. I had secretly been hoping they’d find only a lumpectomy would be needed but tis not to be. I did ask if there was any benefit at all to having a double mastectomy as the thought of having to do all this again is horrendous – I’m not sure I could do this again, of course I would if I had to but man, once is enough right?! But he was very clear, not necessary and more dangerous. There is a minor increase in risk of it returning to the other breast but only about half a percent more than the average population.

The scar will be a very neat line across the chest which curls into a smile towards my side. The lymph node removal is carried out through the smiley bit of the scar – ahhhh how sweet!

And there are various reconstruction options which can be carried out at the same time as the mastectomy. These are in brief are: a silicone implant under the chest muscle; a boob formed using skin, fat and muscle taken from other areas such as my tummy or back; fitting of an expander which is injected with saline over time in order to stretch the skin on the chest to create shape, to enable a further operation in order to have a silicone implant at a later operation, or an expander that stays in place, negating the need for a second operation.

All of these are possible for me.  The main advantage of having any of these is that your body looks more ‘normal’ straight away and in the main there is only one operation. However, it extends the length of  the operation from about 3 hours to 5-9 hours.  There are of course added prospective complications on top of those of the mastectomy. Recovery time is longer, which may delay the start of radiotherapy which I’ll be having for every day for 5 weeks once I’ve recovered from surgery. And each procedure result can be badly affected by radiotherapy which would be gutting.

The way I feel about it is that I want the cancer gone with as few complication and as quick a recovery as possible. I want to know it’s gone and that’s the main thing. I can then crack on with radiotherapy without the fear of it causing problems to a new boob on top of radiotherapy’s own jolly side effects.

I feel having a ‘simple’ mastectomy will give us all time to come to terms with the last few months, learn to accept the way my body will look for a while and get used to the scar. For me personally I feel that I need to have this time to accept the situation and that having a reconstruction straight away may hinder that in some way, maybe as some kind of denial of what has happened to us this year. We can then enjoy some time to be calm and just be.  And to start to come to terms with all that this cancer means for us for the future.

I can have a reconstruction from 6 months after radiotherapy, and the door for this remains open for years. It would mean another general anaesthetic and invasive operation, but we will all be stronger – physically, mentally and emotionally. This seems a better place to start from for us.

So, the date is decided, Monday 8th October at 7.30 am! I’ve struck a deal with my surgeon that there will be no partying for him the weekend prior to the op, he’ll get an early night and I’m first on the list so he’ll be focussed, and  as sharp as his scalpel!

The operation date is a couple of weeks earlier than we expected. Just a diary scheduling decision I think. The cancer won’t have grown in that time following all the chemo but if we waited 3 months plus then it would. I had hoped for a little longer, so I could get over this last chemo for at least 2 weeks then maybe have a month or so to build my strength up and live a bit more of a normal life for a while. But the up side of an earlier date is to just get on with it and all being well increases the (slim) chance of being finished with active treatment by Christmas as radiotherapy will probably start 5 weeks after surgery.

I’ll have a pre-op assessment in a couple of weeks then we’re good to go. And the recovery? Rest, rest, rest. I need to be better at not doing too much – I haven’t been very good at doing that between chemos. If I over do it I won’t make the best recovery physically or mentally, may cause radiotherapy to be delayed and may also cause lifelong physical problems. I won’t be able to drive for 4 weeks plus and picking up Tilly will be a no no for a while. We’ll be pulling in a myriad of favours to help us out I’m afraid.

So there we are, 5 weeks and 2 days I’ll be on the table, one boob gone for ever, perhaps to be replaced at some point. Perhaps a great big goodbye boob party is required, boob cake and all!