Diagnosis & Treatment

In mid May 2011, I did a breast self-exam and felt a small, hard lump in my right breast. I have dense breast tissue and a history of benign cysts. I wasn't all that concerned but knew I needed to see my doctor right away for a diagnostic mammogram.

Initial Diagnosis
I had my diagnostic mammogram and biopsy at the end of May and received my diagnosis on June 2, 2011. The initial diagnosis was invasive ductal carcinoma (IDC) at Stage 1. The tumor was recorded at 0.7 cm (very small). An MRI was ordered to get a better view of both breasts. I had a suspicious lump in my left breast and underwent a second MRI-assisted biopsy. Thankfully, the lump in my left breast was benign.
My lymph nodes were examined by ultrasound and MRI and looked clear. I was scheduled to have a lumpectomy in mid-July to be followed by six weeks of radiation.

Surgery and Updated Diagnosis
I went in for my lumpectomy and sentinel node biopsy on July 13. My tumor was removed and measured. It turns out that it was actually 1.6 cm and not 0.7 cm as originally thought. The biggest shock was that I actually had a tumor in one of my lymph nodes that showed up during the sentinenl node biopsy. The tumor was 9 mm. Having lymph node involvement moved me from Stage I to Stage II.

Official Pathologic Staging
My official pathologic staging is: pT1c pN1a pMX

This means:
pT1c - tumor is less than 2 cm in size
pN1a - cancer as spread to 1-3 lymph nodes under the arm with at least one area of cancer greater than 2 mm
pMX - Presence of distant spread (metastatic) cancer cannot be assessed.

Tumor Pathology - ER/PR positive, HER2 negative
My cancer is estrogen and progesterone receptive meaning it needs hormones to help it grow and spread. Luckily for me, breast cancer that is hormone receptive is generally easier to treat. On the flip side, I am now in instant menopause and cannot use hormonal therapy to alleviate menopausal symptoms. But I will take menopause over cancer any day.

My tumor was HER2 negative. HER2 is a protein found in 1 of 5 breast cancers. It signals a more aggressive form of breast cancer, one which may also be resistent to hormone therapy. My tumor was HER2 negative meaning my cancer is less aggressive and possibly slower growing.

Chemotherapy
Because my cancer had spread to one lymph node, I elected to do six rounds of chemotherapy on the advice of my oncologist. I could have skipped chemo and just had six weeks of radiation. But when my oncologist showed me my chances of recurrence within the next 10 years and I saw 40% chance without chemo and 12% with chemo - it was an easy decision.

I started chemotherapy on August 24 and finished on December 7. I took two drugs intravenously every three weeks: Taxotere and Cytoxan.

My chemo sessions were on Wednesdays and were usually a 6+ hour long day. I would arrive at the infusion clinic at 8:30 AM, check in and have my blood drawn for lab work. Once the lab results came back OK (usually around 9:30), my chemo drugs were ordered from the pharmacy. I was generally hooked up to my IV by 10:30 AM and done by 3:00 PM.

08/24/2011 - Round 1
09/14/2011 - Round 2
10/05/2011 - Round 3
10/26/2011 - Round 4
11/16/2011 - Round 5
12/07/2011 - Round 6

Side Effects From Chemo
The worst side effect for me was massive bloating and water retention. I usually felt fine after my chemo session on Wednesday and just went home to rest afterwards. I went to work on Thursday but by Friday afternoon, I was extremely tired and horribly uncomfortable from the bloating. I was never nauseous but I was very tired and achy. The weekend after my chemo session was typically my time to "crash and burn." I would stay in bed or lay on the couch all weekend. I didn't have the energy to do anything except rest. By Monday morning, I was feeling well enough to go back to work.

Radiation
I had 33 sessions - Monday through Friday. Radiation was a lot easier than chemo because I really did not have any side effects. I was told that radiation would cause me to become cumulatively tired. I really did not see a change in my energy level until about the last week.

I had plenty of energy during the day but was totally ready for bed by 8:30 PM. I listened to my body and got lots of rest. I also used an organic skin balm called Magic Skin Balm by Brigit True Organics which saved my skin. I did not have any blistering or peeling. My skin did turn pink and then a very dark tan. My skin continues to fade back to its normal color.

01/10/12 - Set up appointment
01/19/12 - First radiation session
03/05/12 - Last radiation session

Hysterectomy
Women diagnosed with estrogen-receptive breast cancer like mine usually have their ovaries removed to help lessen the chance for recurrence. Prior to my diagnosis, I was dealing with the unpleasantness of a large uterine fibroid. My doctors all agreed that the best course of action was to perform a complete hysterectomy which meant they would take everything - ovaries, tubes, uterus and cervix. My surgery was performed on April 24, 2012.

I could have put this surgery off for several months but decided to just get it over with. I figured that I would be fully recuperated from surgery by my one year "cancer-versary" on June 2, 2012. There was just something about getting over all the hurdles by that one year mark that really motivated me.

Tamoxifen
My oncologist is recommending tamoxifen over an aromatase inhibitor. When she listed the side effects of both, the side effects of tamoxifen sounded a little more doable -- the lesser of two evils. I will start taking tamoxifen when I have recovered enough from my hysterectomy and start moving/walking/exercising because tamoxifen increases the risk of blood clots. I have decided to start taking it on June 2 (just because I like order in the universe! haha!)

1 comment:

  1. You've been through a lot. Tamoxifen or not, I admire your courageousness. You speak as if this are all just a temporary thing. It makes reading your blog light, yet one realizes that this is not a light matter. Enjoy life to the fullest! God Bless!

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