How It All Began...

Well it all started on Friday, October 14, 2011.  There was an area on my right breast that felt a bit odd.  Since I'd lost about 60 pounds in the previous 11 months, I initially assumed it was just a natural change in my body.  Being that I had just turned 39 and my mom had gone through a breast cancer diagnosis last April, I thought it would be a good idea to see my doctor about it.  I wasn't concerned since other than my mom's recent diagnosis, we have no family history of breast cancer.  Besides, given her age at diagnosis, hers likely had no genetic component.  So I made an appointment for the following Thursday. 

As it turned out, my daughter Mandi had an appointment for Tuesday of the next week and while with her, I asked the doctor to take a peek at my lump.  She felt it and said "it feels soft and squishy, which is good" but recommended I get a mammogram to be sure.  I still wasn't terribly concerned and made the appointment for a mammogram and ultrasound on Monday October 24th. 

This is where it starts to get real.  While having my mammogram (which I thought was a piece of cake by the way), the tech left the room, came back, and said the radiologist wanted more pictures.  Okay...hmmm.  Next I went in for the ultrasound.  Again the ultrasound tech did her thing, left the room, came back and said "the radiologist wants more measurements".  Ok...what's going on.  I asked her and of course she wasn't allowed to comment and said the radiologist would be in shortly to discuss it with me.  Now I was nervous.  I KNEW they saw something.  So the radiologist came in and said they wanted to get a closer look and have me in for a biopsy.  I asked him based on his experience what did he think.  He said "I'm very concerned".   

I left the appointment concerned but still thinking it may be suspicious but the odds were in my favor that it was nothing.  I went home and did what every potential cancer patient does-but should NOT do-and went straight to the internet.  Big mistake...HUGE!  I was terrified by what I read and of course focused on the worst case scenarios.  My biopsy was scheduled for Thursday, October 27th. 

I was very emotional heading into that appointment and when they said my husband Jeff couldn't come back with me, I burst into tears.  Suddenly I didn't want to be alone.  The nurses were very kind and reassuring and we went forward.  I was scheduled to see a different radiologist this time for an ultrasound guided core biopsy.  This is where, using ultrasound, they shoot a needle into the tumor sight four different times and extract samples. It was actually a lot less painful than it sounds. When the radiologist came into the room, the first thing she said to me was "I'm pretty certain it's cancer".  So, there you have it.  She still did not have specifics but based on the looks of the tumor, she had enough experience to know what she saw.  I asked if it was Ductal Carcinoma In Situ (which is what my mom had) and she said no.  That made me nervous at first because my mom's was stage 0, highly treatable, and non-invasive.  They performed the biopsy and Jeff and I met with the nurse to schedule an appointment with a surgeon.  They were going to proceed as if it were cancer, but still needed the biopsy results to confirm the actual type and specifics of the tumor. 

I spent the next few days telling our family and friends, crying, researching, and trying to come to terms with our new reality.  The worst part of the experience was the five days between being told by the radiologist that it was most certainly cancer, and when I actually got the pathology results.  By the time I was called with the results, I was elated by the "real" diagnosis.  I don't think the nurse who called knew what to do with me.  I was literally excited!  I was told I had Invasive Ductal Carcinoma.  My tumor was roughly 1.8 cm big, progesterone and estrogen positive, and HER2 negative.  This was very good news.  What it meant was my tumor wasn't very big (under 2cm is good), it was hormone receptive (which means it will respond well to hormone therapies), and it wasn't an extremely aggressive form.  Invasive Ductal Carcinoma is the most common form of invasive breast cancer.  Roughly 85% of women diagnosed have this type and the prognosis is very good.  The next step for me was a pre-op meeting with a surgeon and deciding whether I wanted to have a lumpectomy (where they remove the tumor and some surrounding tissue), or a mastectomy (where they remove the entire breast).  That was a much tougher decision for me than I thought. 

My initial reaction was to "chop them off!".  But, that creates it's own set of issues.  Recovery and reconstruction can take many months and can be very traumatic.  I was told that there was no difference in long term recurrence rates between women who had a lumpectomy with radiation, and women who had a mastectomy without radiation.  It was a tough choice.  I didn't want to spend the rest of my life waiting for a recurrence, but I also knew I would most likely do that anyway.  It took me a little while to make the decision and decided to wait to see what, if anything, the MRI revealed.

Thankfully, my MRI showed no additional signs of disease in either breast and no evidence of the cancer in my lymph nodes.  This was fantastic news!  I felt confident that I was at a stage 1 with a fantastic prognosis.  My surgery was scheduled for November 21st and I decided to go forward with a lumpectomy and sentinel node biopsy (using radiation they track which lymph node receives blood flow from the tumor first). My plan for after surgery treatment would be assessed once the tumor and node(s) were removed but it was looking like chemo, radiation, and hormone therapy.  I was okay with that-just tell me I'll survive!


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