It’s Wednesday, Sep. 25, 2013. I am at my doctor’s office because a few days ago, I found a disturbingly large, oddly shaped mass in my right breast, near my arm pit. I am a little bit anxious walking into the appointment, but not enough that I asked anyone to come with me. I really think it will be dismissed. I’m 39, I have no family history. I go to my annual exams religiously. I have already had a baseline mammogram at age 37. I am definitely not prepared for what would follow. During the ultrasound, I see the image on the screen, and I immediately know this thing isn’t going to go away quietly.
I go into my doctor’s office where I know she’s now seen the radiology report. She does her own exam, then proceeds to tell me that it’s going to have to come out regardless. Even still, I’m naive in this moment. My first thought is this the absolute worst possible time for me to miss even a couple hours at work to fit in this appointment. Literally. Line up all 52 weeks of the year and ask me to pick out THE worst possible week. I am in that week. So being out for a surgery just doesn’t work for me right now.
Then I realize how this already challenging week is about to become much more difficult when my doctor insists that before I leave her office, I must provide her the name of the surgeon. After I ask if this is serious and she replies, “It’s concerning,” the next couple hours are nothing but a flashing, foggy slide show. Called Brent, freaked out, decided on a surgeon, set an appointment for the next morning, got lost finding the elevator to leave the doctor’s office, found my car, tried to read crappy handwriting on the radiology report (which by the way my doctor did not review with me), googled every key word on the radiology report on my phone while sitting in my car. Highly suspicious of adenocarcinoma of the right breast. Called my family, drove home, more phone calls, deal with work that I now realize is not going to be done by me. Everyone kept telling me that we still don’t know for sure. But, in my heart, I know. I have breast cancer.
The next day, we go to meet with my surgeon. He does additional ultrasounds and a core biopsy. We then go to his office and he tells me that he does suspect it will be cancerous. He will know for sure the next day and will call me. He does call, and on Friday, Sep. 27, he confirms what I was already prepared to hear. I have breast cancer. My tumor is approximately 2.4 centimeters, grade 3 and stage 2. At this point, there is no concern with my lymph nodes, but we’ll know for certain after my sentinel node test.
What follows is a series of tests and doctors appointments. I meet my nurse navigator and my oncologist. My initial biopsy didn’t have enough breast tissue to determine the most important trait of my tumor, so a lot of decisions cannot be made until that is known. What we do know is that I will be doing chemo first, surgery later. Based on my age and the size of the tumor, there is no escaping chemo. There was a lot of waiting between Sep. 25 and Oct. 21. That’s the day I had surgery where my surgeon installed my power port, performed the sentinel node test and did another biopsy so we can find out my hormone receptor status. Immediately following the surgery, we learn that my lymph nodes appear to be clear, but we need to wait until the pathology report to know for sure. A few days later, I learn that one was negative and the other has a 1.25mm cancer. While this is very small and considered a micrometastases, I of course wish it was negative also.
On Halloween, I met with my oncologist for the second time, and we now finally have the information that we’ve needed. I have a sub-type of breast cancer called Triple Negative. This means that the tumor does not have receptors for estrogen, progesterone or a protein called HER2. It is an aggressive type of cancer and because it does not have any of those three receptors, there is no additional treatment beyond chemo and surgery. Because of these factors, it has a high rate of recurrence in the first 2-5 years, and when it does recur, it tends to metastasize to other organs. It does tend to be highly responsive to chemo, which is a positive. And, if you make it past five years without a recurrence, the rate of recurrence is lower than those with positive hormone receptor status.
I am scheduled to begin my chemo treatment on November 21. I will have four rounds of Adriamycin and Cytoxan on a dose dense regimen, which means I will have it every other week. After each treatment, I will have a shot of Neulasta to stimulate white blood cells. After those eight weeks, I will begin a weekly regimen of Taxol for 12 weeks. If all goes as planned, I will be done with chemo on April 3, 2014.
Following chemo, I will have surgery, and we aren’t 100% sure yet what type of surgery I will have. It will depend on my response to the chemo.
Despite all of this overwhelming news, I realize I am so lucky. I have an amazing husband and family who have stepped up in more ways than imaginable, amazing friends, amazing work family and so much support. Each and every one of them represent one of the many arrows I plan to launch at my cancer.