Baseline Scans and The Path Report

When you are diagnosed with the cancer, you wait for everything.  I swear the waiting is worse than the diagnosis.  Because I am waiting to know how bad it is.


I told my mom the other day, how am I supposed to fight when I don't know who my opponent is?  Its true though - how can I mentally prepare if I don't know what I'm up against.

This is why the treatment team (further to be known as TT) needs to order so many tests and scans.  They want to know their opponent too.  The tests and scans tell the TT where the cancer is in my body (outside of the boob) and how it behaves.

The first test was the biopsy, which I mentioned in my previous post.  I realized I didn't say what the biopsy said.  The biopsy is like the personality report of your cancer.  It tells the TT more than anything else.  I can't tell you what kind of efforts I made trying to get a copy of the damn thing.  I'm smart enough to understand the results and wanted to see them with my own eyes.  But anyway, my cancer's personality is kind of like the me I always wanted to be.  Aggressive and girly.  I will explain.

My Cancer is Invasive Ductal Carcinoma (IDC). It is ER/PR+ and HER2 -.  Here is the break down of what that means:

• Invasive - this means it is growing outside of the ducts and is more aggressive than other types.
• Ductal - of the ducts.  The ducts are where the milk is carried in the boob.
• Carcinoma - this just means cancer - stupid fucking cancer
• ER - Estrogen receptive - this means that my cancer is fed by hormones, specifically estrogen.  It also means my cancer's cells attract estrogen because there are a lot of estrogen receptors on my cancer cells.  Likes keys and locks.  Estrogen is the key that fits in my cancer cells lock (thats what she said).
• This is rare for someone young like me.  
• This is a good thing, because there are more treatment options for cancers that are hormone +
• These treatments, however, basically put me in menopause 
• PR - Progesterone receptive - same thing as estrogen - my cancer is also fed by another hormone, progesterone and has lots of progesterone receptors.
• HER2- - HER2 is a gene that is expressed in some breast cancers.  It characteristically more aggressive.  Mine is negative, which is good because it is not aggressive, but bad that it limits one of the treatment options. 
• Histopathology Grade 3 X 3 - just a grading scale for 3 different categories.  The cancer is graded from 1 to 3 of how normal it looks.  3 being less normal.  I got a 3 for all 3 categories.  My cancer is fun and eclectic!

There is another personality trait that is significant and that is whether or not I carry a a mutated version of the breast cancer gene called BRAC.  If you have mutations, you are more likely to get breast cancer.  And this would mean that I would be more likely to get it in my other boob.  Not many people have it (maybe 5%), but because I am young (average age of breast cancer patient is 63), and because I didn't have a strong family history, we are seeing if I am mutated (ha ha).  I had to see a genetic counselor for this.  The test was basically me buying a $3500 bottle of scope and swishing it around and spitting it in a tube.  Thinking about the effect the news of me being + for the mutation would have on my family, my cousins, aunts...well, I got kind of sad.  I had this done 6 Apr and still don't know the results.  If I am positive, the TT will most likely recommend a mastectomy.  BOOOOOOOOOOOOOOO!

Most people wonder what Stage I am.  Staging is kind of like finding out how serious it is.  There are 4 stages, with Stage IV being the worst.  Staging can't be done until we know 1) Size of the tumor 2) if the cancer has entered my lymph nodes and 3) if the cancer is anywhere else in my body.

At this point, I only know the size - which is about 2.6cm.  Someone said to me, wow that seems tiny.  I kind of got upset.  So I said you might change your mind if it was in your boob.  I guess it is small, one inch is 2.54cm, but according to my oncologist, the average size is 2.3cm.  Based on size alone, I am at least a stage II.

Anywho - we have to do more tests to find out if the cancer is in my lymph nodes or somewhere else in my body.  Having cancer in your lymph nodes is bad because it means it is most likely circulating (or could circulate) in your blood stream.  If it is in your nodes, its probably elsewhere.  Which is no bueno.

I have already had a few tests to see if the cancer was in my lymph nodes.  I had an ULTRASOUND of my lymph nodes on 6 Apr (Ultrasound like they use to find babies, luckily there were no babies in my armpits - although when I made this comment during my original ultrasound, the radiologist said we could be millionaires if we did find a baby).  The radiologist said my lymph nodes looked normal, but that normal looking lymph nodes on ultrasound could still be cancerous like 40% of the time.  Not sure why I had this done then.

Next I had an MRI of my chest on 12 Apr.  This thing blew.  I hate MRIs.  First, they have to remove all of my body jewelry.  Nose ring - no biggie.  Belly button ring - WTF?  I've had this thing in for like 15 years or something.  I don't know if it comes out.  Well damn if I didn't have the best tech ever that got it out and later helped me put it back in.  Anywho - next, they shoot you up with dye.  I don't do well with needles or blood or veins or....here I go, I'm getting woozy just thinking about it.  I pretty much almost passed out.  And this MRI was super fun, because I laid on my stomach with my boobs hanging out of this rectangular hole.  HA HA - good times while the tech manipulated my boobs.  HA HA - fun fun.  Then, headfirst into this tube and it was regular schmegular MRI - loud clanks and buzzes and all - for about a half hour.  I could at least see out of this machine.  All of that to say that this one came back normal.  I still haven't see this report with my own eyes, but I will trust my surgeon.  He says that this means my chest wall and lymph nodes as well as my other boob look normal.  I was a little worried about this one, so this was good news.

The final test to do to check the nodes will be done during surgery.  I will talk about that later.

To check if the cancer was somewhere else in my body, I had a Bone Scan and CT Scan on 13 Apr.

The bone scan is used to see if the cancer is in my bones.  I thought the whole thing was interesting.  They shot me up with radioactive stuff and then made me wait around a couple of hours for the radioactive stuff to get into my bones.  They asked me to drink a lot of water while I waited.  I didn't feel different after they shot me up.  But I thought about the Japanese.  Then after a couple of hours I laid on this table (face up this time - thank goodness) and they wrapped me up like a burrito and then sandwiched me between 2 picture taking plates and sent me through a tube.  Then I came out of the tube slowly like a pizza oven.  It took about 20 minutes.  When I started to come out of the tube I saw my skeleton on the screen (with a fat body outline - sigh).  It was awesome.  I didn't see cancer and I don't think my tech did either.  I asked, but she couldn't say.   Anywho - this test came back normal.  I still haven't seen this report with my own eyes but I trust my oncologist.

The CT (CAT) scan is used to see if I have cancer in my chest, abdomen or pelvis.  It was at the end of the day and I was just happy to get it over with. This one I laid on this table and got shot through this very short tube several times.  Towards the end, they had to shoot me up with dye.  This dye I DID feel.  They told me I would feel hot and then like I peed my pants.  Yep.  They didn't lie.  It didn't last long though, but I truly thought I peed my pants.  This test came back almost normal. They found a "questionable spot" on my liver.  The doctor was not concerned, but wanted to rule out cancer in my liver so that there are no surprises.  So I have to go back for an MRI of my liver 19 Apr.  I did confirm that I DO NOT have to be shot up again.  Yay!  This sucks, but I really just think its liver damage from all of those beers I drank in high school and college.  I didn't mess around.  We will see.  If there is cancer in my liver, this is really really really bad news.  This will automatically put me at stage IV.

I think that is all of the tests I've had so far.  I see the fertility doctor next week, so I am sure there will be testing there too.

In case I don't post anymore for a bit, I am scheduled for surgery - a lumpectomy - 22 Apr.  More to say about that later.

Thank you everyone for the kindness, support and understanding.  I totally think its funny that you all know me well enough to call me out on my isolating.  But, understand that sometimes that is the best way I know how to deal.  AND that sometimes, I am just tired - emotionally, psychologically and physically tired.

I LOVE YOU GUYS!