Another Doctor's Appointment
Today, Bo and I met another member of my recently assembled medical team, the radiation oncologist. Dr. G. was quite a treat to meet, and even though she won't be my regular radiation oncologist (he was out of the office this week), she reviewed my history and discussed the proposed treatment with me. There are still several missing pieces of the puzzle with my situation, so even though chemo has begun, some of the proposed treatment is subject to change based on test results. In that regard, she didn't tell me anything I hadn't heard before, but I will summarize the main points below.
What we do know:
I have a clinical diagnosis of Stage IIB breast cancer - this is still considered early stages of breast cancer. It means my tumor is between 2 -5 centimeters with metastatic involvement of ipsilateral (same side as the breast cancer) axillary lymph nodes (moveable) and no distant metastasis. In my initial biopsy, only one swollen lymph node was found, and it did turn out to be cancerous.
The pathology staging of the cancer can only be done after surgery when the lymph nodes are removed and a biopsy completed, but the CT/PET scan did not indicate lymph node involvement, so I am hopeful that it didn't spread beyond that one that showed up in the initial biopsy. (and yes, one of my questions is - if it showed up in the biopsy with cancer, why didn't it show up in the CT/PET scan? Donna, the nurse practicioner told me on Monday that the lymph node is so small, the fine needle aspiration that was performed during the biopsy may have removed all of the cancer cells.... That question is still on my list for the doctor though.)
The tumor is estrogen receptor positive, which means it is more like normal breast tissue, and that, I am told, is a good thing. I believe this means it should be more responsive to treatment. It would be even better if it were progesterone receptor positive also, and it isn't, but one out of two isn't bad.
What we don't know and are waiting to find out:
The initial pathology results showed the tumor was HER2/NEU negative, but the oncologist requested a second, more accurate test, called a FISH test, to confirm this finding. We want the initial findings confirmed because HER2/NEU negative means it is a less agressive form of cancer. I ask for this test result everytime I am on the phone with someone who has access to my records, but so far, the results are still pending.
Due to my family history (both my grandmother and mother were also diagnosed with breast cancer at the age of 40), there is a strong likelihood that I am genetically predisposed to breast cancer. They are currently doing the genetic testing to determine if this is the case. So, why does that matter now that I actually have it? Well, if I do have the gene, the most aggressive form of treatment for me would include, in addition to a mastectomy on the right side where the cancer is, a prophylactic removal of the left breast. It would also include prophylactic removal of my ovaries. I have a ton of questions on that, so more to come. They told me it would take a couple of weeks to get those results back.
The ultrasound and biopsy of the "area of suspicion" in the left breast that showed up in last week's MRI is scheduled for this coming Monday. I am confident that the results will be favorable and that we are just dealing with the one tumor on the right side, but we will know for sure by the middle of next week.
Dr. G. discussed the radiation process with us. It is generally done four weeks after surgical recovery. I will need to go five days a week for 6 to 6 1/2 weeks. The side effects are pretty much limited to fatigue. In the past, radiation was performed on women who had four or more lymph nodes involved, but two very large clinical studies showed a benefit to post-mastectomy radiation in women with any lymph node involvement. I am all for that then!
It has now been almost a week since my initial chemo treatment, and I am happy to report that I still feel pretty darn good and mostly "normal". I actually went to my first ever yoga class tonight. My instructor, Joseph, is 51 and claims to have the flexibility of his 18 year old daughter. By some of the moves he was doing, I believe him. It was supposed to be a beginner's class - at least that is what the chalkboard said. I felt like I kept up pretty well, but I kept waiting for relaxation mode to kick in. All that stretching and bending and breathing was hard work! After class, Joseph confessed that he customizes the class to his audience, and tonight, all of his advanced students showed up! I will probably be feeling it in the morning!
What we do know:
I have a clinical diagnosis of Stage IIB breast cancer - this is still considered early stages of breast cancer. It means my tumor is between 2 -5 centimeters with metastatic involvement of ipsilateral (same side as the breast cancer) axillary lymph nodes (moveable) and no distant metastasis. In my initial biopsy, only one swollen lymph node was found, and it did turn out to be cancerous.
The pathology staging of the cancer can only be done after surgery when the lymph nodes are removed and a biopsy completed, but the CT/PET scan did not indicate lymph node involvement, so I am hopeful that it didn't spread beyond that one that showed up in the initial biopsy. (and yes, one of my questions is - if it showed up in the biopsy with cancer, why didn't it show up in the CT/PET scan? Donna, the nurse practicioner told me on Monday that the lymph node is so small, the fine needle aspiration that was performed during the biopsy may have removed all of the cancer cells.... That question is still on my list for the doctor though.)
The tumor is estrogen receptor positive, which means it is more like normal breast tissue, and that, I am told, is a good thing. I believe this means it should be more responsive to treatment. It would be even better if it were progesterone receptor positive also, and it isn't, but one out of two isn't bad.
What we don't know and are waiting to find out:
The initial pathology results showed the tumor was HER2/NEU negative, but the oncologist requested a second, more accurate test, called a FISH test, to confirm this finding. We want the initial findings confirmed because HER2/NEU negative means it is a less agressive form of cancer. I ask for this test result everytime I am on the phone with someone who has access to my records, but so far, the results are still pending.
Due to my family history (both my grandmother and mother were also diagnosed with breast cancer at the age of 40), there is a strong likelihood that I am genetically predisposed to breast cancer. They are currently doing the genetic testing to determine if this is the case. So, why does that matter now that I actually have it? Well, if I do have the gene, the most aggressive form of treatment for me would include, in addition to a mastectomy on the right side where the cancer is, a prophylactic removal of the left breast. It would also include prophylactic removal of my ovaries. I have a ton of questions on that, so more to come. They told me it would take a couple of weeks to get those results back.
The ultrasound and biopsy of the "area of suspicion" in the left breast that showed up in last week's MRI is scheduled for this coming Monday. I am confident that the results will be favorable and that we are just dealing with the one tumor on the right side, but we will know for sure by the middle of next week.
Dr. G. discussed the radiation process with us. It is generally done four weeks after surgical recovery. I will need to go five days a week for 6 to 6 1/2 weeks. The side effects are pretty much limited to fatigue. In the past, radiation was performed on women who had four or more lymph nodes involved, but two very large clinical studies showed a benefit to post-mastectomy radiation in women with any lymph node involvement. I am all for that then!
It has now been almost a week since my initial chemo treatment, and I am happy to report that I still feel pretty darn good and mostly "normal". I actually went to my first ever yoga class tonight. My instructor, Joseph, is 51 and claims to have the flexibility of his 18 year old daughter. By some of the moves he was doing, I believe him. It was supposed to be a beginner's class - at least that is what the chalkboard said. I felt like I kept up pretty well, but I kept waiting for relaxation mode to kick in. All that stretching and bending and breathing was hard work! After class, Joseph confessed that he customizes the class to his audience, and tonight, all of his advanced students showed up! I will probably be feeling it in the morning!
posted by Mary @ 8:43 PM
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