MEDICAL UPDATE: 1
Diagnosis:
Invasive Lobular Carcinoma: Cancer cells started in a lobula of the right breast and they have now invaded the fatty breast tissue. Size is ~2cm; the size of a peanut (shelled).
LCIS (lobular carcinoma in situ): Not cancer. This is also present.
PR & ER Positive: I am estrogen positive and progesterone positive. This is good.
HER2 negative: HER2 cancer is fast growing. I do not have this. This is good.
KI-67 biomarker: This looks at the biology of the cancer. My score is 9%. Anything above 20% means chemo. No chemo for me!
Grade: This is a microscopic view of the features of the cancer. It is called the Nottingham scale (1-3). My grade is 2. This means slow growth, but cells have become irregular.
Stage: Early stage/stage 1: Possibly stage 2, but slow growing, treatable. Not present in lymph nodes. This is good.
Plan:
Meeting with specialized breast surgeon, Dr. Ose. Scheduled for Jan 30 (video visit).
Genetic testing (lab draw completed 1/17/23). If genetic testing is negative, this is good. I have family history of other types of cancer, so if it’s positive, the plan will change. Will cross that bridge if need be but for now, assuming genetic testing will be negative. Possibility of kids and other family members getting a referral letter for genetic testing. Not sure on timing of this. First round of results should be within 10 days; remainder of results can take 2-3 weeks. Initial results (breast cancer genetic testing) should be completed prior to surgeon consult.
Surgery is normally done 2-3 weeks after the surgeon consult. I am hoping to push this to early March, and this should not be a problem. Lumpectomy under general anesthesia takes ~2 hour, same day/outpatient. Will remove cancerous mass plus some surrounding tissue AND will remove a few lymph nodes under my right arm for testing. Two incisions 3” long. Could be microscopic cancer cells in the lymph nodes so will test for this. Surgery recovery is several days but can travel within 1-2 days.
Medical Oncologist will be on-going for 5 years. Regular (3-6 month) appointments and not sure about screening and testing. Unsure when I choose an oncologist but probably after surgery.
Radiation begins 4 weeks post surgery. Daily, Monday thru Friday for 4-6 weeks. I will meet with a specialized radiation oncologist before and during treatment. Radiation itself only lasts about 1 minute. Side effects can be skin irritation and fatigue, usually starting a few weeks after radiation begins and may continue after radiation is finished. Will be checking into radiation in Montana (insurance issue).
Hormone blocking therapy will begin 2 weeks after radiation is done. This will continue for 5 years. Meds are called aromatase inhibitors (AI). Brand names Astrozol & Nastrozol. Another one is sometimes used, called XMS Stain but this is expensive and not needed in my case (not really any better outcomes). It will take my body a few months to adjust to the hormone blocking therapy, but we will return to menopause symptoms again like hot flashes, joint pain and fatigue. Bad news: side effect. Good news: my cancer responds well to this treatment and will hopefully prevent recurrence.
Prayer requests:
- That the genetic testing comes back NEGATIVE for other indicators of future cancer.
- That the surgeon will allow me to wait until March for surgery.
