Hi Friends!

Looking forward to sharing today as the current situation offers "settled" news. I was gonna say "good" news, but this whole breast cancer road is something no one really wants to be on. That said, I do feel moments of extreme gratitude for simple things I might not have noticed before. Increased mobility every day, driving, showering and dressing independently, and a more settled stomach to name a few.

I finally met with a radiologist to discuss my situation more specifically. If you don't know, when cancer is found in the lymph system the "standard of care" is radiation. This is based upon research that is over 30 years old and has generally remained unchanged until recently. New research is being done to take into account individual pathology but it has been slow and is still going. They found cancer in one of my lymphs (out of 8) and my genetic testing shows low and ultra low risk of recurrent or distant cancer (two different tests.) At my best I have a 0-3% chance of recurrence, at the worst I have 5-15% chance, the latter being the most recent news from the most recent genetic test which is different than the first one. I could no longer brag about my "unicorn status" as an ultra low risk patient. (Look at it also as 85-100% chance of no recurrence of breast or distant cancers in the next 10 years, as that felt a little less scary but not as confident.)

So my team of docs are actually doing a current study for individuals just like me: Low risk, 1-3 lymph nodes testing positive for cancer. They believe that radiation may not be beneficial for those of us in this category and have developed a study to test this belief. The info has NOT been confirmed yet so we are in fact cutting edge on learning this for the future. And sadly, this data is the last piece of what I feel I need to make the confident decision about radiation or not. If I enter the study, I then am entered into a lottery where I either do radiation for 6 weeks (5 days per week) or do nothing, and then see what happens. It's essentially a coin flip. My surgical oncologist told me that they wouldn't put their patients at risk and believe that the radiation may be medically unnecessary. The radiologist says they're at that point where they're trying to dial in the exact tipping point for the benefit of radiation.. she says they simply don't know. Ugh.

So after weighing ALL the things and talking to many friends who've gone through radiation - quality of life, risk, tissue damage, values, and what we want our next 10-20 years to look like, I've opted out of the radiation pathway. And while I don't (and cannot) feel total certainty I will not get cancer again, landing on a decision informs all of my life choices going forward. Taking my own health very seriously, honoring my mortality, seeing the people I love, and considering "what do I want to do with this one and precious life?"

My new healing trajectory has given me confidence to continue moving forward and boosted my belief in my ability to get through reconstruction. After re-researching implants, I am again recommitted to the abdominal tissue transplant.. bigger up front recovery and more invasive, better for me in the long term. So we went in to schedule the appointment and got a pretty late date assigned for the DIEP surgery, and I burst into tears. I was originally told 3-6 months from the original surgery but this would have been a full 8 months living with these juice boxes for breasts. So after a "no cancer talk or decisions" weekend, I did the work to regroup mentally and get behind the plan. Last week, we went in for one last "fill" for the boob boxes and they offered us a new date which was perfect: July 22nd, 4 1/2 months from my initial surgery. Hooray!

So the next 3 months will be spent focusing on wellness and joy, building up all of me to get ready for the big surgery. There will be a couple of follow up procedures afterward, but that is truly on the final leg of the marathon, and that is the downhill portion.

We finally wrapped up all the meal and dog walking support last week. So much gratitude for everyone who sent sweet gifts or notes of kindness and encouragements via text or snail mail. To friends who sent treats from really far away or just up the street. For those who cooked us nutritious and delicious meals, and walked our dogs. I have so appreciated seeing people and spending small windows of time together, and hope for more of that soon.

That's all for now, sending you all so much love and healing if needed. Hugs.