Turns out there are a lot of abnormal cells throughout this right breast - a concerning number. More than one person has told me "there's a lot going on in there." Dr. Y confirmed that those cells have a much higher-than-average risk of turning into invasive breast cancer. In fact, there is a very slim chance that there is actually a small invasive cancer, right now, lurking in that breast - because the biopsies were only a small sample, they're not sure. So leaving the breast there makes me a great candidate for Cancer, Round III, which is a battle I'm not keen on fighting. Therefore, the safest, most risk-averse route is to remove the whole shebang. If I do this, barring finding anything invasive, that'd be it for "treatment."
Then yes, there is a lumpectomy + radiation + hormonal therapy option. And actually, I could do tamoxifen for hormone therapy again . . . good news? Yes and no. I felt like crap on tamoxifen and it really interfered with my quality of life. But you can take it if you're pre-menopausal. We discussed the aromatase inhibitors - the class of drugs I mentioned before that I'd need to be post-menopausal to take. The doc is not keen on shutting down my ovaries, either with drugs or by removing them - he's never been a fan of this for me - there are huge quality of life implications, and then also big-time bone-density concerns for someone who's only 42 and already has osteoporosis. So if I did the lumpectomies, it'd be 5 more years of tamoxifen.
Net-net, and I'm keeping this simple: when pushed to the wall, he recommends mastectomy. And a double, while we're there. He will, of course, support any decision I make, but he thinks that even though it's major surgery, with emotional baggage attached and risks associated, my quality of life soon afterwards and in the long run will actually be significantly better than if I go the lumpectomy + rads + hormone route.
There's more thinking, talking and research to do, but I have to say, I tend to agree.
So ended another surreal afternoon in Suite 9A. Despite the bad news, Dr. Y reminded me of why I adore him. I am so, so thankful he hasn't retired yet, so he can be my sherpa through Round II. Normally a gentleman, he admitted that when he heard the news of the new cancer, his response was "oh shit." He sat, as usual, unhurried, and hashed out all the possibilities with us. He acknowledged that this is a crummy set of choices, but also reminded me that if I have more questions, at any point, he's here for me. This is why I chose him, 10 years ago. He might run a bit late, but he's worth the wait. He saved my life once, and I'm gonna trust him to do it again.