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Initially diagnosed June 4, 2009 Invasive Ductal Carcinoma Stage II,Grade II tumor size: 2-3 cm node positive ER/PR postive HER2 Neu - negative Current Diagnosis: Metastatic Invasive Ductal Carcinoma Grade 3 Mets: Scalp/skin, Liver, Spine, Bone ER/PR + HER2/NEU -

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Friday, June 5, 2009

Diagnosed with Invasive Ductal Carcinoma

Back in August 2008 I noticed a palpable lump in my right breast. I went into the gynecologist to have it checked out. They referred me for mammograms and ultrasounds. They advised me that the lump I felt was most likely a benign cyst and told me not to worry about it. However, they noticed several unusual looking spots on my left breast, and referred me to a breast surgeon to have these biopsied.

I went in a few weeks later and had the two cysts on my left breast biopsied using fine needle aspiration. The liquids were checked and both came back as benign.

The lump on my left breast was still there and continued to grow over the following months. It became rather large (you could feel about an inch or an inch and half of hard mass there). It bothered me some due the size and location, as it rubbed against my bra line. It wasn't that bad, so initially I wasn't too worried about it. Then I developed another small lump on my left breast in a different location, so I thought it might be a good idea to go get it checked out and get them both drained.

In order to do this, I had to go in and get another set of mammograms/ultrasounds. I decided to go to another doctor this time for the aspiration though. The last one was terrible! She was very unprofessional and had a bad bedside manner, so I asked my GYN to recommend another one. She referred me to Dr. Mary Brian.

I made an appointment with Dr. Brian on Wednesday June 3, 2009. It was supposed to be a consultation only, but after looking at the x-ray films, she decided to go ahead and drain the cysts that day. They drained the newer smaller cyst first with no problems. Then when they went to drain the larger original cyst, they found it could not be drained. It was a solid mass rather than a fluid filled cyst. She decided to take 3 biopsies of the tissue using core needle biopsy. The biopsy was not much fun, but they used a local anesthetic so it wasn't very painful during the procedure. After the procedure there was a lot of bleeding, so they had to tape me up. I have a bandage over it now that I can't remove until Monday where they made the incision. There is a little discomfort there, but it's tolerable.

The results from the core biopsy came back the next day around 2pm. The results confirmed that it was malignant and that I had a moderately invasive ductal carcinoma. There was also some cancer cells seen in the lymphatic vessels. They are not yet sure if it has actually reached the lymph nodes.

She went over the treatment course she recommended that same afternoon. It involves first doing some further tests to determine if the cancer has spread to other parts of my body (CT Scan/Whole Body Scan, MRI). She also wants me to do a test to see what the chances are of it recurring after treatment (Genetic testing for BRC1 gene). These should be completed in the next few weeks.

After that, I have to decide based on all the results, which option I would like to go with to remove the cancer. I have to either choose lumpectomy + radiation (where they take out just the lump area and a small margin of good cells around it) or unilateral or bilateral masectomy (where they take off one or both breasts) and possible radiation.

Lumpectomy is less invasive, but if you have a high risk of the cancer coming back, may not be the best option. Masectomy would lower my chances of it reoccuring in that breast or in bilateral, either breast, but is a more serious surgery that would require more healing time and reconstruction afterwards.

While they are in there doing either the lumpectomy or the massectomy, they are going to remove my sentinel lymph node. They will send this to a pathologist and have them look for cancer. The results of this will tell them if it has entered my lymphatic system. If it has, they will need to remove some of my lymph nodes in a separate surgery. They will also insert a port in my chest area while they are in there. The port will be used for direct access to my blood vessels for the chemo therapy.

Once the cancer is removed, by either method, they are recommending chemotherapy. This is the thing I'm really dreading the most. I've seen so many people go through this and they just look miserable. I hate to lose my hair and all that as well. I talked to some women on a breast cancer chat the other day though, and they gave me some options on where to get free wigs and some pretty funny stories of their mishaps with their wigs etc. So it made me feel a little better about this, but still really dreading it. They claim it is necessary due to the invasiveness of the cancer I have. Even if they dont find anything on the scans, there may possibly be cancer cells floating around in other parts of my body that haven't formed into tumors that could cause my cancer to return in the future.

The whole thing sounds pretty scarey initially, but after reading through all the facts and information, it appears that, although it is going to be is a not so fun experience, I have little to no risk of dying from this form and stage. I just have to do the things they tell me to do, deal with the pain, nausea, embarrassment and other side effects of it.

Before I start all this, I decided it would be a good idea to get a second opinion on the diagnosis and treatment plan. I wasn't sure how to go about it, so I contacted the local chapter of the American Cancer Society last night. They gave me some steps to take to do this. They also told me it is very normal for someone to request a second opinion when it comes to treatment this invasive, and that my doctor should not be insulted if I mention it. I hope this is true. I like this doctor so far and dont want her to think otherwise. I just feel like I need to be sure that I really do have this and that the treatment plan she chose is completely necessary. The first step was to call our health insurance provider and make sure that they would cover a second opinion. I had Jesse do that this morning.

When Jesse called to confirm coverage for the second opinion, they assured him it would be covered. They also transferred him to Cancer Resource Services. That is a benefit his employer offers to assist people going through cancer treatment. They are going to find me a doctor to consult with for my second opinion and should be calling me back to answer any questions and give me details. They also can provide a consult with an oncologist if I'd like to do that. I'd like for them to retest the core sample at another lab and provide me with their interpretation of the results (diagnosis) as well as what they'd recommend as a treatment plan so I can compare them.

If anything is different, I guess I will ask them why they recommend this or that or think the diagnosis is different so I can do some research and decide who I believe is right. If both come up the same, it will help to know that two doctors agree that this is what I have and what I need to do.

I believe I'm still somewhat in shock over all this. Two days ago, I was going in for a consultation to get a harmless cyst or two drained. Today, I have breast cancer and am facing surgery, radiation and chemotherapy. It's amazing how your life can change so suddenly in just a couple of days...


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