The struggle is real

There is no doubt I have a long, tedious road ahead of me... but the good thing is, it's a hopeful one.

Breast cancer update...

I finally visited the breast clinic on 4/21 and was given formal recommendations & options for treatment. I met three new doctors and I will break down what each of them said (in a nutshell, of course... I spent about an hour with each of them).

Surgical oncologist: This doctor recommended a lumpectomy and said that it would be a simple outpatient operation. The sentinel lymph node from under my left arm will also be tested (just like I went through with melanoma on the right side). Recovery time is only about a week and I shouldn't notice any significant physical changes/disfigurement.

Radiation oncologist: Approximately 2 weeks following surgery, this doctor recommends 6 weeks (30 doses) of radiation. This means another (longer) stay in $eattle. Be careful what you wish for, people!!!

Medical oncologist: After radiation, this doctor will start me on Tamoxifen -- a daily pill that blocks estrogen for hormone-receptor positive breast cancers (like mine). I will be on this drug for 5-10 years. If I wish to have another baby, they will actually allow me to stop taking it and then restart after the baby is born or done breastfeeding (if I'm able). We cannot attempt this until I've been taking Tamoxifen for two years... but we were prepared to be told it was completely off the table, so this is a major win in our book.

OF COURSE there is a BUT.

I have to meet with my genetic counselor again to undergo a panel of genetic testing -- including BRCA aka the Angelina Jolie gene mutation -- before we can confidently proceed with the above plan. If I am BRCA positive, which is highly unlikely given that there is NO breast or ovarian cancer in my family to speak of, than a new treatment plan may be formulated. I meet with genetics on Thursday 4/30 and the results will probably take about a month (it's an extensive panel).

So... it's unlikely I'll have any further updates or actual treatment for breast cancer until the end of May. My doctors have assured me that it's a slow growing, small, totally treatable cancer and it's okay if we take this time to make a well-informed decision. It's weird because I can feel it and I just want it out now!

Sarcoma update:

Meanwhile, I'm having surgery on my leg tomorrow. I check in at 5:45am for an 8am procedure. I'll be in the hospital overnight and my unbelievably supportive & fabulous husband will be with me every step of the way... as always. #shoutout

I'll let you know how it goes!

New scans

New imaging to report on...

Breast MRI 4/9:
The mass is actually 11mm (1.1cm), but no lymphadenopathy or multifocal/multicentric disease is present.  In other words... it's slightly bigger, but it doesn't appear to have spread to the lymph system and there is only one tumor.

Chest CT (to check on my lungs) & leg MRI 4/14:
No changes since prior scans in Dec 2014. Yay!

The latest...

Had my pre-op visit with my sarcoma surgeon on 4/14. No changes! I am still having surgery on 4/24. The breast "issue" will be dealt with separately and I still won't have a treatment plan until I visit the breast clinic on 4/21. My first appointment will be an all day event.

Basically, as soon as I beat sarcoma... I will be tackling breast cancer. Stay tuned...

Immunohistochemical results

Here are some additional details, copied & pasted from my path report...

---

Invasive ductal carcinoma with the following immunohistochemical features:
1. Positive for estrogen and progesterone receptor expression (Allred 8 and 7 of 8 respectively).
2. Negative for HER2 protein overexpression by immunohistochemical technique (1+).
3. Ki67 proliferative index: Approximately 5% of nuclei strongly positive.
4. Immunohistochemistry for D2-40 highlights angiolymphatic spaces with no neoplasm identified, supporting an interpretation of no angiolymphatic space invasion identified.

Breast cancer

I am just going to be matter-of-fact here...

Got the call this morning. It's invasive ductal carcinoma, grade 1 (low grade or well differentiated)... less than 1cm... slow growing... and highly curable.

I have a breast MRI on Friday the 10th and I will have an orientation of sorts at the SCCA breast cancer clinic on the 21st. I have no details about my treatment plan at this time.

My sarcoma surgery is in 2.5 weeks and I also have no idea how this new hurdle is going to mesh. I don't know if they can be combined into one procedure... or if one will take precedence over the other... I have a lot to learn & absorb over the next few weeks. More later...

Core needle biopsy

SCCA agreed with my local hospital... the lesion is suspicious... however, they downgraded it to a BI-RADS 4! That is slightly encouraging.

I went up to Seattle yesterday and had an ultrasound-guided core needle biopsy and post-biopsy mammogram. The biopsy site is only mildly tender. Not the worst procedure I've gone through. No shower for 24 hours and steri-strips can come off in 5 days.

I should have results by early next week. I am preparing for the worst, but hoping for the best! Waiting is the hardest part. I hate where my mind takes me... staying positive and hopeful can be really hard.