That first weekend was the worst. I couldn't sleep and when I did, I had nightmares. I had no appetite. All I did was google breast cancer statistics and survival. Except I knew nothing about my breast cancer so I didn't know what I was even looking for. Over the next few weeks, I would get more of an education in the science of breast cancer than I ever thought I'd have.
If my breast cancer had a Match.com profile, it might list some of these stats:
1) It's estimated to be about 2-2.5 cm.
2.) It is a grade 3 tumor. On a scale of 1-3, 3 is the most aggressive.Grade 1 cancer cells look closer to normal cells, grade 3 cells are what they call "poorly differentiated".
3) Grade is not to be confused with stage. Your stage of cancer is not officially known until surgery is done and they are able to see if the lymph nodes are involved, and if so, how many.
4) My tumor is 100% estrogen receptor positive. This means that out of 100 cancer cells, all of them have estrogen receptors. It is also 80% progesterone receptor positive. Hormone receptor positive tumors tend to have better prognosis, be slower growing than hormone negative tumors, and have a variety of oral hormone treatments available to stop the receptors from using estrogen as fuel. Every medical professional that sees these stats on my biopsy report has gotten really giddy. This must be a good sign.
5)My tumor is HER2 negative. HER2 is Human Epidermal Growth Factor Receptor 2. When this protein is over expressed it leads to the tumor being HER2 positive and makes it a more aggressive cancer. Lucky for people who are HER2 positive, there is a drug called Herceptin which works well on this kind of cancer. But thankfully, I don't have to worry about it because like I said, it was negative.
6) The left breast is a mess. In addition to the tumor that myself, and by now, countless others have felt, there is all kinds of other happenings going on in there, in the same area as the tumor, that were picked up on the MRI. It could be that it's more ductal carcinoma in situ, which is early stage cancer that hasn't yet become invasive. Or it's a completely different kind of cancer. Or it's a bunch of benign happenings. They won't know until they go in and do surgery.
7) At my first surgery consult, radiology looked at my MRI from Hershey and thought they saw a slightly swollen lymph node. They thought it was probably just reactionary to my breast biopsy, but decided to biopsy it to be sure. It has come back negative. This brings me hope. It's pretty close to where the tumor is and I'd like to think that if cancer hasn't gotten him, then it hasn't gotten to his buddies either. I have to be realistic though, because there are about 30-40 lymph nodes under the arm, and just because one is clean doesn't mean they all are.
I've been to Pinnacle, Hopkins, and Hershey for consults and have settled on Hershey. My breast surgeon at Hershey, Dr. Kass, is highly recommended and really impressed me at our first meeting. She thought my plan for a bilateral mastectomy was a good one. Because my lymph nodes do not show any clinical signs of having cancer in them, they will do a sentinel node biopsy where they inject a dye into my nipple (AHHHHH) and as it spreads throughout the breast, they see which lymph node it goes to first. They remove that one, test it for cancer, and if it's negative, they assume the cancer hasn't reached the others. If it's positive, they keep removing more. In the surgery, they will remove the tissue of both of my breasts, sparing the skin. They will then put tissue expanders in which they will gradually fill with saline over the course of the next few months. Once my treatment is over, I will have silicone implants put in and I can guarantee they will look better than my current situation. So there's that to be excited about.
As far as treatment, I will not know until after my surgery. If they detect positive lymph nodes I will have chemotherapy followed by hormone therapy for 5 years at least. If my lymph nodes are negative they will send away the tumor and do the Oncotype test on it. That tests 21 genes and figures out what my rate of recurrence will be. If it's on the low side, hormone therapy would be all I need and chemo wouldn't be of much benefit. But if it's intermediate to high, I will definitely go with chemo. I want to hit this with everything they got. I keep saying give me the trifecta-surgery, chemo, and radiation! I'll do it all, if it means I have a bigger chance of this being the only time breast cancer ever sets up shop in my body.
So I think you're pretty up to date by now. I'm just waiting to hear from Hershey when my surgery will be. This is the worst part, the waiting. They made sure to let me know that breast cancer is not a medical emergency as it has probably been growing in my body for 8-10 years. What's a few more weeks, right? I'm going to go throw up now.
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