My Sole and Exclusive Discretion

Working in the Entertainment industry you quickly learn not to put anything in writing.  Although I've never been one to stick to the rules, I have developed a certain radar for when I'm "walking on thin ice".  As I was thinking about my next blog update, my radar went off.  I started thinking, what if I share some news and change my mind?  What if I make a decision and then decide the next day that I actually want to do the opposite?  So, with this in mind, I'm posting the following disclaimer:  By reading this blog you agree that Nicole Butte, in her sole and exclusive discretion, can change her mind and opinion on anything she writes!  Case closed.

Now on to my update.  In my first post I shared how I learned about the news.  Now I'd like to share where I am today, exactly 1 week and almost 2 days from the diagnosis.

I believe I have 2 choices to make on the immediate next step.  Lumpectomy with radiation, or Mastectomy with a small chance of radiation.  The 3rd option, although apparently not one recommended by the last 2 doctors I met with, is Chemotherapy first.  The "X factor" which I have yet to find out is my BRCA Analysis.  If that comes out positive, than the house of cards I've been meticulously building falls, and I believe the Doctors will all push me towards Bilateral Mastectomy.  You see, if I test positive for BRCA, my chances of getting breast cancer a second/third/fourth time basically quadruples (or some crazy stat like that), so they'll want me to be proactive and remove both breasts so that won't happen.  I am not really thinking about that right now, because there's nothing I can do until I get the results.

On to the 2 options I'm currently weighing.  Lumpectomy with radiation is a smaller procedure, an outpatient surgery with a 1-2 week recovery.  Mastectomy could be a 2-6 week recovery, depending on whether I get just one or both breasts removed.  With a lumpectomy I am guaranteed to need radiation, whereas with a mastectomy my chances of needing radiation are much smaller (although I won't find out for sure until after the surgery). The survival rate of both procedures is identical.  

Radiation is needed with a lumpectomy because it kills any extra cancer cells after the surgery, ensuring that everything has been removed.  The problem is that radiation in high doses is not good for a person.  The tumor is in my left breast, which happens to be the side of our bodies where our hearts are. Although the Doctors have told me that the chances of the radiation effecting my heart are unlikely, the fact that they brought it up at all definitely concerns me. 

Now to the cosmetic effects.  If you know me, you know I'm not exactly "well endowed"!  For larger women, a lumpectomy may not be a major cosmetic change.  For smaller women, we have less up top so when you take a little out, it shows a lot more.  I'm young, I live at the beach, I work in Entertainment, I love to shop, I take care of my body.  It's important for me that I will look in the mirror a year from now and be completely satisfied and confident with what I see.  

So that brings me to my decision.  Lumpectomy with radiation, or Mastectomy with a small chance of radiation. Now that I have a good understanding of the medical differences, I'm meeting with Plastic Surgeons to understand the cosmetic differences.  More to come in the coming week(s).

Other than that decision, here's the other things I've learned. Chemotherapy is looking to be more and more likely.  To date I've been told my chances are 95% definite to 90% - 95% definite.  That pretty much sounds like I'm going to need it.  That means I'm going to loose my hair and I'm going to be sick.  Time to start looking for wigs.  I've also learned that I will have to be on a drug called Tamoxifen for up to 10 years.  I need to research it more, but I believe Tamoxifen stops the body from creating Estrogen, which is the hormone that feeds my cancer.  By taking this drug, my body will stop creating the food that my cancer needs to grow.  The side effect is pre-mature menopause. Joy. Hot flashes and night sweats, here I come.

By this time next week I'm crossing my fingers a lot of the above decisions will be made, or at least the options a little clearer!  I'll keep you posted...