We saw her surgeon this morning to get confirmation of what they found from the tissue they removed during the operation and also to check how Sarah's healing.

The wounds (I'm sure there's a better word) are healing nicely.

The cancer is officially stage 2 because of the spread into the lymph nodes. Confirmed as grade 3. There are four stages, lower is better. Although grade 3 is the fastest growing. The tumour was 28mm and the DCIS 45mm in length.

Of the 12 lymph nodes that were removed 3 had cancer and there was

of cancer cells in the blood. Which although sounding scary is apparently common (I almost wrote normal but this obviously isn't normal is it?). Two sentinel nodes were removed the other one didn't have cancer so the two other cancerous nodes were further down the chain from the cancerous sentinel node. Ever the optimist possibly but this sounds good to me as it clearly hasn't spread far.

The reason St. George's missed the lymph node cancer in their biopsy is because Sarah's sentinel lymph nodes are unusually high up under her arm.

The official name for her type of cancer is metaplastic squamosa as the cancer cells mutate into other forms, ie not breast cells. I'd strongly advise you not to Google these terms as this terminology applies to other cancers.

The Professor stated that the 10 year survival for this type/stage is 85%. Which is less that we've heard to date because of the histology they've obtained from the tissue they've now removed.

The positive news is that the margins of both the breast tissue and cells removed containing the lymph node was clear. In other words, and to quote him "we've removed all of the cancer". Putting this in context they could have discovered cancer at the edges of what they had removed which would have been worse because they would have needed to go back and remove more. I'll let your imagination fill in the blanks.

One consequence of what they've found is that Sarah will in addition to t
he chemo have radiotherapy. Combining the positive Pet-CT and this news really should mean these treatments are just insurance to kill off any rouge cells that have escaped into the lymphatic or blood systems. Again his words. Interestingly it's apparently common to have cancerous cells floating around in your blood supply - your immune systems deals with them like any other invader. So even if you looked and found them it wouldn't necessarily be bad news.

The next major step is a pre-chemo meeting with her Oncologist who the Professor says is a first class expert in this type of cancer. That meeting is on Monday 17th October and then the chemo starts on the 18th. We're not sure when the radiotherapy happens but he mentioned today it's after the chemo sessions not during them.

Still no news on the HERS2 result which would offer an extra treatment. We should get that at another follow up appointment next Thursday.

I really believe we're in the best hands possible. Although we can look at this as desperately unlucky it really could have been so much worse. The cancer could have spread further and we might not have such great doctors available to us.

Rob.