Wednesday 2 March 2022

Breast Cancer - healing from surgery and the pathology report

This post follows my initial post about Sewing a gown for breast cancer surgery
and my previous post talking about my stay in hospital

Please note that this is my personal medical story. There are details of medical procedures. I am not a medical doctor. 


I am now just over four weeks post-surgery and things are going well. I have been able to see an improvement almost every day in the wound healing and the things I can do. When I came home from hospital I was only able to walk outside for about five minutes and that was very slowly. I have gradually increased my distance and my speed, making sure to listen to my body and not do too much. I am now walking up to 30 minutes at a time and I'm definitely getting closer to my old speed. As my pace increases, so does the tightness in my tummy, so I'm taking smaller steps than I used to. I'm very happy to be out and about again and I feel like I've turned a corner in healing since increasing my walking.

Out and about three weeks post-DIEP surgery. I only had the dog for the photo as any pulling on the lead is not good for healing.

I am able to lift my arms above my head now and have been encouraged to do a wider range of arm and shoulder exercises to help with movement and to reduce the chances of lymphoedema, which is arm swelling from having lymph nodes removed. That means I can wash my hair and hang out washing! I'm not allowed to lift anything more than 2kg though so I have to ask someone to bring the laundry basket in and out. Cooking simple things is getting easier too, although some things, like the 3L bottle of milk, are also too heavy. I've even done a little bit of sewing in short stints. Things are definitely looking up!

Sleeping is getting more comfortable. In the past few days I've stopped using the pillow under my knees and just have my normal pillow for my head. Stretching full length is uncomfortably tight in the tummy, but I can lie on my side (the non-reconstructed side) quite comfortably, or on my back with my knees bent. Being able to change position has helped relieve the back aches from always sleeping on my back initially.


Wound Healing

A week after leaving hospital I went back to have my dressings changed. The large dressings and plastic tape were removed from the scars and Fixamol tape was placed over the abdominal scar. No dressings were put on the breast or underarm scars. I was told to use an oil on the scars, including over the top of the porous Fixamol tape and massage the scars twice a day to help healing. I am using Bio Oil for that. After another week I was able to remove the Fixamol tape and didn't need more dressings. The twice daily massaging needs to be kept up for several months I think. Showering with the Fixamol tape in place was fine and after it was removed I had permission to go in a pool or the ocean.

To give an idea of the surgery, this 40 second video from Johns Hopkins University explains very clearly what I had done. 


The pictures below show how my abdominal wound is healing. It also shows the belly button, which I have received many comments on after my earlier post! As I mentioned, after the wedge-shaped piece of skin and fat is removed, the skin is stretched tightly together and stitched. A new hole is cut for the belly button and stitched around the original indent. 

After the surgery I noticed a mole directly above my belly button that I couldn't remember being there before. After checking my 'before surgery' photos I was quite amazed to see the same mole much higher up on my tummy (see arrows)! Fascinatingly I have seen photos of a lady with a stomach tattoo, who ended up with part of the tattoo on the skin that was transferred to her nipple area. I've heard of another lady who's appendix scar partially appeared on her breast. These things can apparently be 'corrected' during a second 'revision' surgery if they are a concern. Revision surgery can also fix puckering of the scars, can add nipples, do a breast lift on the natural breast etc.



You can see that the healing and swelling has improved a lot in just four weeks. The tummy area is still very hard and stretched. Pressing on it is like pressing on a drum. There is very little give. I tried on a close-fitting pair of zip-up pants and there was no way I could suck myself in to do them up, even though my tummy looks smaller than it did before the surgery. Clearly there is still plenty of swelling to go down. Since surgery I have lost 1.5kg. You can see on the side of my tummy (on the left in the photos) a faint curved line. This is a reaction to the drainage tubes that were taped to my skin during surgery. Initially they were red, blistered and itchy like a jellyfish sting. They have now faded, but I'm surprised at how long they are taking to disappear.

Another strange and unexpected result of the surgery is that, as well as the top part of the scar being pulled down, the lower part is pulled up, although to a lesser extent. This has meant that my hair line is now higher than previously!! Not such a desired outcome, but I guess some laser hair removal could be an option down the track. 

Overall, I am very pleased with the outcome so far. The reconstructed breast is getting softer and more comfortable. It is somewhat perkier than the other one, but with a bra on they look the same. I haven't taken anything for pain since being in hospital, which I find amazing considering the size of the scars and seriousness of the surgery. I came out of the shower this morning feeling quite pleased with my appearance and sought the opinion of my partner. After a quick appraisal he declared that my torso looked like a smiley face with googly eyes. Hmmm, not quite what I was hoping for!


Four weeks post surgery about to have a gentle dip in the ocean (no swimming allowed). The new breast is my left one.

The Pathology Report

Last week, three and a half weeks after surgery, I had an appointment with the breast surgeon to receive the results of the pathology that had been done on the tumour and lymph nodes. I was very anxious prior to the appointment and had tried not to get my hopes up that chemo wouldn't be needed after having only two lymph nodes removed.

There was good news and bad news. The good news was that the tumour had been completely removed and there was no cancer found in the lymph nodes or the blood vessels, meaning that there was no evidence of the cancer spreading.  The not so good news was that the cancer was large. It consisted of a cluster of tumours, too many to count, spanning an area 9cm across. The largest of these tumours was 5.8cm. I was told that if a tumour is larger than 5cm, then radiotherapy is required. The surgeon said I would also need chemotherapy that would throw me into chemically-induced menopause which would be 'miserable'. Once the chemo and radiation are finished I will need hormone blocking therapy for five years.

This was quite a shock. Somehow, even after all I've been through so far, this was the point at which it hit me that I really have cancer. I had a bit of a meltdown as I tried to process the news. During the three month wait from diagnosis to surgery I could feel the cancer growing. Initially it was not noticeable, but prior to surgery, I could feel a large, hard area in the breast. Could I have avoided further treatment if I'd had the surgery sooner? I'll probably never know.

So, the next step is appointments with both the medical oncologist (chemo) and the radiation oncologist. They will have the final say on what is the best treatment in my case. Obviously the decision is ultimately mine, but I will go with their recommendations. For the past few days I have been reading about the possible treatments as well as genetic testing, which may help determine whether or not I need treatment, although at a large financial cost. I'm feeling better about it all and I feel my resilience returning ready for the next step.

Next I will talk about my appointments with the oncologists.

3 comments:

Bronwyn said...

You look amazing. That video is great, and it shows the magnitude of the surgery. I’m sure you are going to be one of the most formidable questioners that the oncologists have ever met. All the best for the appointments.

Megan O said...

Thank you Bronwyn. You are right about the number of questions, I hope they are ready for me!

Suresh Sivacolundhu said...

So proud of you Meg! You really are one tough chick! 😘😘😘

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