I’ve learned a lot in the past 3 weeks. Not only do I have dense and busy breasts, but after 5 hours at Dana Farber yesterday I also learned they’re “lumpy”. At first I really thought they were complimenting me… now not so much. I also learned that I definitely have breast cancer. A naive part of me thought they might say I was misdiagnosed then I’d have to apologize to everyone for making you say “touch your boobs” and sending me gifts. But deep down I knew that wouldn’t be the case. I also learned that a diagnosis isn’t as straight forward as yup you have cancer, here’s how you treat it, and we’re done. It’s complicated and there are many pieces to the puzzles. And the doctors try to piece them together and formulate the best treatment recommendation based on you, your diagnosis and your preferences. I learned, most importantly, that this cancer picked the wrong bitch to mess with. I’m coming for you, cancer.
I’m not sure those are the lessons the doctors were hoping I walked away with so I’ll get down to the legit information they relayed to me. I learned more about my diagnosis and treatment options but that I need further testing in order to complete the puzzle we’re piecing together in order to make a final determination on both.
As a part of a program at Dana Farber for young women (age 44 and under) with breast cancer called Young and Strong, I was also offered genetic testing and fertility preservation options. I don’t know much about either yet but they’re just two of the services offered through the program. Others include support groups, education programs, etc. So as a part of these services I’ll meet with a genetic counselor to determine if genetic testing is the right option for me based on the likelihood of having a genetic mutation (family history will help determine that). I’ll also meet with an oncofertility specialist to discuss preservation options. Chemotherapy has the potential side effects of damaging reproductive parts or causing premature menopause. I don’t know much about either of these and whether or not I’ll participate in them but it was something I learned more about on my journey and wanted to share. Stay tuned for more.
So onto the diagnosis. Like I said, it isn’t a straight forward “yup, you gots the cancer” type of a thing. There are so many different aspects to a diagnosis and as I mentioned in my “what is breast cancer” post, this guide is really helpful to understanding it all:
So my diagnosis…. drumroll please! The good news is my left breast biopsy came back benign. However, they want to do a little more poking around before making a final diagnosis there. The, what we’ll call, not awesome news is I have invasive ductal carcinoma in my right breast – basically breast cancer that started in a duct and has left the original site. The grade of a cancer refers to how different the cancer cells are from the normal cells, rated on a scale of 1-3. My cancer is a 2-3 meaning they definitely don’t look normal and are growing at an intermediate to high rate. Put that in the not so awesome category. The good news is that it’s still early – it’s at least stage 1, possibly stage 2. Stages refer to how large the tumor(s) is and how much it has spread. The additional testing will help determine the actual stage but for now we know it’s at least stage 1. Stay tuned for more on that.
I know a couple of other pieces of information as well. They test for hormone receptors – both estrogen and progesterone receptors. I tested positive for both which means the cells “listen” to signals from hormones and they respond to hormonal therapy. I also tested positive for HER2. HER2 positive means the gene is abnormal and causes the cells to grow and divide more rapidly. This is in the “not awesome” pile as well but my doctor yesterday said something really reassuring. She said if she had to pick the most significant breast cancer advancement in the past decade it’s the research and treatment options for HER2 positive cancer. There are targeted therapies now that HER2 patients respond really well to. And Dana Farber is on the cutting edge of cancer research and treatment in general, so I know I’m in good hands. Overall, there is some good news in the shit pile of not awesome news and I feel more confident than ever that I’m going to kick this cancer’s ass.
So, I mentioned there are more pieces to this puzzle that require additional testing – which means another mammogram, ultrasound and MRI on Monday (reference my first post for how fun this all will be to repeat). They need to confirm the size of my tumor(s), check my lymph nodes and re-check the left breast. All of that, like I said, will confirm a final diagnosis and treatment plan. I want to emphasize that I make it sound like a nightmare, it really isn’t. It’s completely tolerable. I just want to be honest that it can be uncomfortable but I want to stress how important it all is to get it done. They’re being thorough and as much as I joke about getting pulled around by my boobs, I couldn’t be more appreciative they’re double checking my dense, busy, lumpy breasts.
The treatment plan is not confirmed yet so I won’t go into too much detail around options but there are two types of treatments. Local treatments target the specific area and that includes surgery and radiation. Surgery options are a lumpectomy (removal of the cancer) or mastectomy (total removal of the breast with reconstructive surgery). For this I have a surgical oncologist to oversee my treatment plan. There are also systemic treatments, which are drugs that spread throughout the body to go after any cancer cells wherever they may be. This includes hormonal therapies, chemotherapy and targeted therapies. To oversee this course of treatment I have a medical oncologist. Again, the further testing will help determine a plan and sequencing but I will have a combination of most, maybe all, of these options.
That’s a lot of info. I’ll stop for now. I have one recommendation for anyone going through this and that’s bring a notebook. My doctor asked me if I’m an engineer because I was so organized, took thorough notes and asked questions. It’s only because I’m a nerd, feel inadequate if I don’t know everything and also don’t listen well if I’m not writing. So touch your boobs and bring a notebook. I’m getting so bossy these days, I know. But just do it.
I’m tired and my brain is spinning but I’m so confident and prepared to take this on. The doctors at Dana Farber are really amazing and made me feel at ease. I’ve also gotten so much love and support. I am overwhelmed by it in the best way possible. To summarize, cancer makes you popular. I’ll leave you now with words of wisdom from my insightful big brother… time to kick cancer in the dick. So cancer, I’m coming for you.