Surgery Day Had Come 

At our very first consultation with Dr Heslop, we knew that in sometime during the near future surgery was going to be a must. What I’ve failed to share with you thus far is that mom was given the heart breaking news that she would need a mastectomy. A mastectomy is the removal of the entire breast.

It does not take much to realise that a woman’s breasts are part and parcel of her definition of femininity. It doesn’t matter if it’s awkward looking, big or small – it’s part of who we are. It took a lot of getting used to and as a female it wasn’t easy for me to tell my mother “what’s boobs and hair if it means you get to be with me”, but it was the truth.. I’d rather have her alive and well, without boobs and bald than lose her to this dread disease.

It is only with the grace of God that on mom’s 7th treatment, a routine exam reveled to Dr Heslop that my mother had a complete response to the chemotherapy and that a mastectomy was too much… she would be able to get away with a lumpectomy. Cue the violins because this was music to our ears. If hearing the news of this could make us so overjoyed – I anxiously await the day she’s told she’s cancer free!

After her 9th treatment, chemo was stopped…the drastic side effects can only be attributed to the notion that perhaps there’s no longer rapid growing cancer. And after 2 weeks, a PET/CT scan revealed just that.

Now what was the need for the surgery then… Here’s the thing which I learnt only when mom was diagnosed, chemotherapy kills rapidly growing cancer cells.. it does not kill pre cancer. Nor will a PET scan reveal the location of pre cancer.
Therefore a mammogram was done and we met with the surgeon.. Dr Bisetty, a specialist surgeon at the Westville hospital.

One would think having a complete response to treatment would mean surgery would be easier, with not that much to “clean” up so to speak. However, given that mom’s diagnosis was at such an early stage and coupled with her complete response to treatment – his job just got ridiculously difficult.. to quote him, “I’m going in blind”.
To guide the surgeon, a wide localization was needed. In simple terms, a radiologist going by what the the mammogram, ultra sound and MRI of the breasts revealed, uses a hookwire as a guiding tool to the abnormality which cannot be felt by a doctor. This acts as a marker during surgery and enables the surgeon to remove the correct area of breast tissue. The hookwire is inserted to guide the removal of both benign (non-cancerous) and malignant (cancerous) abnormalities.  The wire is called a hookwire because there is a tiny hook at the end, which keeps it in position. Breast hookwire localisation is done using local anaesthetic to numb the breast in the area where the hookwire is to be inserted.
Straight after this procedure at Lake, Smith and partners on Tuesday morning, mom was taken back to Westville hospital where she was taken in for surgery.  In surgery Dr Bisetty  had a pathologist that would tell him if the cells that he had taken out were cancerous and if he had clear margins. Margins refer to the edge or border of the tissue removed in cancer surgery. The margin is described as negative or clean when the pathologist finds no cancer cells at the edge of the tissue, suggesting that all of the cancer has been removed. The margin is described as positive or involved when the pathologist finds cancer cells at the edge of the tissue, suggesting that all of the cancer has not been removed. To be told margins aren’t clear was the worst case scenario and the idea of a mastectomy would need to be revisited. As he as a surgeon cannot remove chucks of the breast from different areas. However, mom was in the clear and there was nothing to worry about. We are so thrilled about this!

Post surgery

It’s the 2nd day since her surgery… She has been discharged from hospital and is back home today. Unfortunately she is in pain and discomfort, which is to be expected, but since then she’s been handling it.

P.s. I’m proud of you mom!!!


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