Showing posts with label biopsy. Show all posts
Showing posts with label biopsy. Show all posts

Tuesday, January 26, 2016

NO WHAMMIES!!!

Nope. None. Nada. 

We've got NO whammies here, ma'am!

               *dances silly jig*

I got the call earlier today.  A nurse from the Betty Ford Breast Cancer Center called to check up on how my night of iced boobs went following the afternoon of 13 biopsies.  The conversation went something like this:

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I have some questions to ask before we get to your pathology.  So how did last night go when you got home?

Pathology? You have the pathology?


Oh, yes, but there's a checklist here, we'll get to that.

*Me. Instantly thinking it must be bad news.*


So how did last night go?

Fine. All fine. I haven't taken pain pills since this morning.


Do you have bruising?

Not much.  It's fine.


Fever?

No.


Well, okay, good, just let us know [FOR THE LOVE OF GOD WOMAN TELL ME THE PATHOLOGY] if there are any changes or if you have any questions.

Of course, so you have the pathology?


Yes, let's see ... [YOU'RE KILLING ME, SMALLS!]

Okay, both areas biopsied have the same diagnosis.

*Me. Positive that she just told me that the biopsies have the same diagnosis as my tumor because OF COURSE THAT'S WHAT I'M GOING TO THINK HEARING THOSE WORDS!*


The same?


Yes blah blah blah benign blah blah blah blah

Wait, back up ... benign?!


Yes, no further cancer was shown.

*Silence as a wave of relief is crashing over me*


Kimberly?

*I finally get out*  I'm here.  Just a second.
Why do I always cry at GOOD news?!


Of course, dear.  Now blah blah blah blah blah medical terms blah call us if you have questions.


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And then I was back under control. 

None of the 13 biopsies yesterday showed any cancer cells!  Can I get a "Yay!!!!" - because I'm fairly certain all of my neighbors know I was flippin' happy for a while minute there.

So this means my surgery Friday will be a lumpectomy to remove the main tumor and removal of several sentinel lymph nodes to check those for cancer as well.  I will still have chemotherapy and radiation but the cancer has not spread to the rest of my left breast or to my right.  My next big hope is that the lymph nodes continue to be clear.

But for now - NO WHAMMIES! 

Sunday, January 24, 2016

For the Love of the Surreal Life

I'm trying so hard.

Ever since the unfortunately named Dr. Pennes walked into the ultrasound room and uttered, "You have a little bit of cancer," I've been steadfastly and happily planting myself in a surreal version of life.  It just hasn't seemed real.

               Little bit of ...

Didn't that use to be the name of a candy bar?  Right.  Bit O'Honey.  Instead of honey I've got a Bit O'Cancer. 

Just a bit ... but, well, yes, it's just a bit but see it's an ANGRY bit.  An angry bit of grade 3 triple negative, you see.  That's a bit of aggressive, that is ... just a bit of aggressive cancer.  Nothing to worry about.  Just a  ....

 .... what's that?  Oh ... yes, well, there are also a couple of "suspicious" areas on the outer sides of, well, of both breasts but ... MRIs can lie, don't you know.  Yes, they can show things that aren't actually cancer so don't you worry ... let's just stick a few more needles in and check, shall we?

Just a couple of needles


Here, get on your stomach again and, well, wait, we need to put another IV in so we can send that icy, stinging contrast through, the better to see the suspicious bits, you know.  Now hover and aim well, there you go, right into those two holes because that's the most comfortable thing in the world, isn't it.  Now hold still.

No, really ... you must NOT move.  We'll just roll you into the MRI tube and take a quick picture and, now don't move, roll you out and insert the needles, don't move, now roll you back into the tube for more images to make certain the needles are well placed and now roll you ... don't move ... out again and
                *BAM*           
                           take the biopsies.

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At least that is how I'm imagining it will be come tomorrow.  And, as you can probably tell, I'm writing this while Downton Abbey is playing in the background.  Just picture Mrs. Patmore and/or Mrs. Hughes saying the above and you'll see.

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And now surgery of some kind is on Friday, and I won't know what kind of surgery I'm having until Tuesday or Wednesday.  Is the cancer still believed to be an angry little dot on the upper inside of one breast?  Or will I find out it has spread throughout the breast or, perhaps, is represented in both. 

Or further.  Will it be found in my lymph nodes?

The surreal nature of this mayhem is finally cracking for me. 

And I don't like it one bit.

One angry little bit.







Monday, January 18, 2016

A Plan. Of sorts.

I find myself wondering what to share here.  Do I share all?  Do I stay a bit vague on the details and only cover the main events?  Surgery, etc.?  There are benefits to both but, in the end, if someone stumbles upon this blog who is just beginning to fight breast cancer, I guess I'd rather them have my whole experience instead of a diluted version. 

So, here we are then.

After my initial diagnosis of breast cancer last week, I was referred to the Breast Cancer Multispecialty Team (MST) for treatment.  Frankly, I knew going into the appointments that my cancer is aggressive.  The pathology report for my biopsies finally posted early this morning and, so, I read it before going to the MST session.  If you're going through this right now, you'll have to decide for yourself whether or not you want to read reports before meeting with your doctors.  You know better than anyone else whether you'll benefit from it or be harmed. 

Don't listen to anyone else; make your own decision.

For me, if there is a chance it will be bad news, I'd like to read it, digest it, and perhaps get sick from it in private than sitting in front of another human being.  But that's me.

So I knew that my cancer is aggressive.  I joke that since I excel at so many things (Ha!), I should have expected my cancer to excel as well.  Now, I know my joking is a coping mechanism.  And I'll continue to joke for as long as possible.  Forgive me if it offends you.  But I really don't give a damn.

Because my cancer is aggressive, I'm on a priority list for surgery.  So my surgery will likely be within the next 2-3 weeks.  The grading of my cancer is a 3 on a scale of 1 to 3 with 1 being slightly abnormal and 3 being  ... really fucked up.  The pathology also tests whether the cancer is responsive to estrogen or progesterone.  If it is positive for that, then there are medications that have proven effective for helping fight against any reoccurrence.  Mine is negative for both.  Mine is also negative for a protein called HER2.  So my cancer is a triple negative invasive ductal carcinoma. 

Alas - this apparently is quite different than being a triple crown winner.  But, in a way, it is just another tool for the doctors to use to determine the best treatment. 

Which brings me to the plan:

This week, I'll be getting a chest x-ray, which is a fairly standard pre-operative test.  I'll also see my regular primary care doctor for pre-operative approval. 

Next week, I'll be getting at least two more biopsies.  I mentioned my pathology report above.  I also got the results of the lovely hang-loose breast MRI.  Along with measuring my tumor - it is anywhere between 11 and 15 mm depending on the test you read: the MRI has it at 13 mm - the MRI showed a questionable area immediately above my tumor that may be DCIS - ductal carcinoma in situs - basically, cells that would be invasive cancer IF they broke out of the duct.  It is sometimes called Stage 0 cancer.  The MRI also showed two small questionable areas on the bottom outside of both breasts. 

So, next Monday, I will be getting each of those two small areas biopsied.  If they come back negative for cancer - remember that MRIs can show things that look like cancer but are not - then I will be receiving a lumpectomy of my left breast, i.e., the surgeon will remove the tumor and a few lymph nodes (to double check those).  Before that surgery, the doctor wants a biopsy of that area above my tumor in order to determine exactly how much tissue needs to be removed.

If, however, those first two biopsies next week come back positive for cancer, I will be having a double mastectomy, the removal of both of my breasts.  Again, this would be due to the aggressiveness of my cancer so please, if you're just beginning to deal with your own, remember that everyone is different and many things go into the decision of how best to treat breast cancer.  All I can really say about this possibility is this: 

        If I'm to lose the ones I have, I expect the new ones to be SPECTACULAR. 

The actual surgery will likely be sometime during the first two weeks of February.  Up to two weeks of recovery is expected for a lumpectomy - and it would be outpatient surgery.  I'm not sure right now about the mastectomy recovery - I'll cross that bridge if it comes.

Roughly four weeks after the surgery, I'll be starting chemotherapy.  I'll have a port installed so that the drugs can be put directly into a larger artery and I'll receive it every other week.  The good news is that my oncologist strongly urges women getting this chemo to continue to work.  She does not expect me to have nausea or other issues that would impede me from doing so.  The bad news, or at least odd and surreal news, is that I WILL be bald.  Early on in the chemotherapy, my hair will fall out over a day or two - it happens quickly apparently - and I will then struggle not to call myself Gollum. 

Seriously.  Short, bald creature with large eyes.  Just call me Sméagol. 


Yep.

 My chemotherapy will last four to five months. 

And about two weeks after the last dose, I'll likely begin up to six weeks of radiation.  The radiation would take place at daily 15 minute appointments.  It is meant to make sure no stray cells of cancer remain and greatly lessens the chance of reoccurrence.

Regardless of what type of surgery I receive, the end result after chemotherapy and radiation will be this: 

My chance of reoccurrence will be between 4-6%.  When you consider that the chance of any woman in the U.S. developing breast cancer in her life is 12%, those odds sound pretty good. 

So, that's the plan.  I might be forgetting some specifics but, hey, it's been quite a day. 

Do me a favor if you've read this far.  Trust that I am strong.  Trust that I'll be fine.

I really am quite a bitch when I need to be.   

Make me laugh if you can.  It really is the best medicine.  Cause, hey, I'll be a hot mess of bald and boob jokes for most of 2016. 

In short, trust that I've got this.





Monday, January 11, 2016

Just A Little Bit ...

... of cancer.

I've sat here staring at the white page for a while now.  I'm not sure what to write.

But those were the words that turned everything surreal.

"Just a little bit of cancer." 
Less than a week out from my boring, smoosh 'em session, a nurse from Spectrum called to let me know that my mammogram showed some asymmetric tissue and they wanted me to come in for further images.  The next afternoon. 

No problem.  I know multiple people who have had to do the same. So, the next day, I again donned the stylish wrap half-gown (in plum this time) and allowed another stranger (extremely nice) to position my body and breast, and then I held my breath, and repeated the process several times.  The staff at the Betty Ford Breast Center in Grand Rapids are incredible.  And they don't send you home after taking a few images.  They have you wait while a doctor examines them in case more are needed.

More were needed.  So they took more.  And I waited.

The doctor requested ultrasounds of both breasts.  And, no, I didn't have to set up a new appointment and return again.  They did the ultrasounds while I was still there.  And the doctor reviewed them immediately as well.

I just wasn't expecting the results.  "Just a little bit of cancer." 

I had watched the screen as the technician tried to find the tiny spec showing up on the mammogram of my right breast.  She never did.  The report officially says my right breast is "unremarkable." 

                           Oh, if I had a nickel ....

She had then moved to my left breast.  My words a few seconds after she began, "Well ... that's a bit different."  Even I could see the black hole (at least that is what it looked like to me).  It's only 11 mm across.  Tiny, really.  Of course, it seemed massive on the screen. 

"Just a little bit of cancer."

So surreal.

It still is.

I'm not so much frightened as I am annoyed.  The doctor ordered a biopsy then went on to explain that the cancer is small - hence, "a little bit" - and immensely treatable.  I worried aloud about my Ireland trip in September (again, surreal), and he replied that, barring any unforeseen complications, he believes this will be in my "rearview mirror" by that time. 

Good. 

Okay. 

Right. 

Now what.

Oh, biopsy, right.  Let's schedule that.  Tomorrow morning? Let's do it.

So I returned to the Center Thursday morning where five core biopsies were taken from "the mass" and two from a suspicious looking lymph node under my left arm. 

Again, the people at Betty Ford are incredible.  I didn't feel a thing.  Actually, I found myself staring at the ceiling where some designer had installed a light panel that looks like a blue sky complete with a tree branch covered in blossoms.  Meanwhile, the doctor, nurse, and ultrasound technician all prepared me for the biopsies. 

"Does anyone here watch The Walking Dead?"  -- my all important question.

The answer was yes. 

                                "I'm just going to look at the flowers." 

     [Psst. Don't click that link unless you know what I'm talking about already 'cause SPOILERS.]

Chuckling from the watcher.

The area was numbed and then the doctor used ultrasound to guide her to the exact locations.  I heard several clicks as a hollowed needle took samples from the area but felt nothing.  Yay, Novocaine!

Then the waiting game began.  They had hoped that the results of the biopsies would be received in time to call me on Friday. 

They weren't. 

Hey, do you know what makes a winter storm weekend even longer?  Waiting for confirmation that you have breast cancer.

Just a little bit of breast cancer.

This afternoon, I finally received the call confirming it.  As in ... about an hour ago.  The good news is that the testing on my lymph node was negative! Yay!  The bad news is that I have cancer. 

Just a bit. 

Again, even with the diagnosis, I'm not scared; I'm annoyed.  And that's a good thing.  As they've told me, this is small, it is early, and extremely treatable.  And, it is small, it is early, and extremely treatable because I did not put off my mammogram any longer than I did.  I am so lucky. 

I am blessed by living in Grand Rapids with such easy access to the excellent nurses, doctors, and specialists at the Betty Ford Breast Center and Spectrum.  I am blessed to be catching this so early.  I am blessed to have excellent insurance.  I am blessed to be surrounded by incredibly supportive friends and coworkers.  And I am blessed to have family who are willing to drop anything if they are needed. 

So I am annoyed with just a little bit of cancer.  But I am blessed immeasurably more and look forward to the day I see this annoyance in my rearview mirror.