In the last couple weeks, I have a LOT of tests: 2 biopsies, 3 blood tests, 3 MRIs and 1 PET/CT scan, and that doesn't even count the mammogram, sonogram and various physical exams I've had.
All of these tests have served to give my docs - and me - more info on exactly what we're dealing with, so they can determine my course of treatment.
I have a "large irregular mass" in my right breast. The biopsy showed that the mass consists of both ductal carcinoma in situ (DCIS) and invasive ductal carcinoma. DCIS alone is considered stage 0 cancer and does not spread. Invasive ductal carcinoma is the one to be concerned about since that is the kind that spreads.
So, has it spread? The sonogram did show that I have a swollen lymph node, but I had a separate biopsy of that lymph node that came back "inconclusive." My breast surgeon, Dr. Rosenbaum Smith, said hopefully it's swollen because the lymph node is doing its job and trying to keep the cancer out. My oncologist, Dr. Sara, did a physical exam and he said that the swollen lymph node did not feel like a "typical cancerous lymph node" to him. So, in my mind, there is a little war going on in my lymph node... the cancer is trying to spread, but the lymph node is fighting valiently to keep it out. Come on, lymph node!!!
Luckily, my PET/CT scan, which scans the whole body, did not show any signs of cancer anywhere else in my body. Woohoo! It did pick up a little spot on my liver, but the docs say that it does NOT look like cancer and is most likely a hemangioma, which is kind of like a birthmark on my liver. Who knew you could have birthmarks on the inside of your body? Just to be sure though, I had an MRI on my abdomen yesterday.
Anyway, since there are signs that the cancer is at least trying to spread to my lymph nodes, my course of treatment will consist of chemotherapy first to stop the cancer in its tracks. This will take 4-6 months, and then 4-6 weeks after that (to get my strength back), I will have a mastectomy. Turns out they can do the reconstruction in the same surgery now, so that is a plus. After surgery, I will need radiation, and I will probably also need a hormone treatment (just a pill) after that.
Dr. Sara says that cancer is "very moody" and it can act 10 different ways in 10 different patients. Luckily, there are a couple characteristics to my cancer that will make it easier to treat.
- It is estrogen receptor positive. This means that it feeds off of hormones in my body. This is a good thing, since they can give me anti-estrogen drugs to combat this. Usually these kinds of cancers are found in older women, so it's a bit unusual for someone my age to have it.
- It is Her-2 positive. This is also a good thing because it means they can give me Herceptin, a drug that has proven very effective against these kinds of cancers. There was even a Lifetime TV movie about the discovery of this drug, called Living Proof starring Harry Connick, Jr. (no I have not seen it).
Also, Dr. Sara said that even though my mass is quite large, it has not spread much, if at all, which tells him that it seems to be a type of cancer that likes to stay where it is. It's kind of a homebody, if you will. At first, I was worried about the size of the mass (large must equal bad, right?) but he said that he's had patients with lumps the size of peas that have already spread everywhere. So it turns out size DOESN'T matter.
So, this is basically what we are dealing with. Now that we know, I am anxious to get the treatment started! Chemotherapy starts Friday... stay tuned!