Breast Cancer 101
It’s been a tough couple of weeks since I was diagnosed with breast cancer. In that time, I have shed tears, asked questions, experienced a myriad of emotions and generally have been overwhelmed. It has also been an amazing time of learning about this cancer so that we can be active participants and advocates when we meet with the medical team at North York General Hospital next week to discuss my treatment plan.
So here is an executive summary of what I have learned so far. Warning: the information below may contain technical information that puts readers to sleep!
Breast cancer starts in the cells of the breast. Normally, healthy breast cells grow, divide and die in an orderly way. Cancer cells are wayward and mischievous. They multiply in a uncontrolled fashion and create a lump or tumour, or damage healthy tissue.
There are many types of breast cancer. These include:
- Ductal carcinoma in situ (in situ is good; it means that the cancer is contained within the milk ducts and has not spread)
- Lobular carcinoma in situ (this just means that there are changes to the cells in the breast. Most women who have this condition never develop progressive cancer disease)
- Invasive ductal breast cancer (invasive is not good. It means that the cancer cells have spread from the milk ducts to the surrounding breast tissue). This is the most common type of breast cancer and the one I have been diagnosed with.
- Invasive lobular breast cancer (this means that the cancer cells have developed in the lobules and spread to the surrounding breast tissue)
- Then there are less common breast cancers called inflammatory breast cancer and Paget disease of the nipple. They sound just plain scary.
The most common cancer treatments are surgery, radiation therapy, chemotherapy, hormonal therapy and biological therapy. The treatment depends on many factors including the type of cancer as well as the stage of the cancer (the size of the tumour and how much it has spread) and the grade of the cancer (how the cancer cells look and behave).
The treatment also depends on the hormone receptor status which is whether the cancer cells have receptors for the hormones estrogen and progesterone. Ideally you want the hormone receptor test to be negative because it simplifies the treatment. Unfortunately, my biopsy results came back estrogen positive.
The other test that is done is something called HER2/neu status. HER2 is a protein that promotes cancer growth. Ideally you want this test to come back negative. Unfortunately, my biopsy showed that I am HER2 positive.
This week, I had two additional tests: a full CT scan and a bone scan. I am hoping that these tests will show that my cancer has not spread beyond the one or two lymph nodes in my under arm. If it has, I am in deep trouble. The plan is for me to meet my new oncologist on Friday next week to get the results of my CT scan and bone scan and to finalize a treatment plan. Unfortunately, based on preliminary discussions, it appears that this will include chemo, surgery and radiation.
In the meantime, I have an appointment on Thursday to inject markers (in the form of titanium clips) in the area of the tumour and affected lymph node. The reason for this is that if the chemo works so well that the doctors can no longer find the cancer, they need a marker to show them where the tumour was. I just find this the funniest thing ever! I guess after Thursday, I will be a bionic woman!
Also the medical team has “strongly recommended” and “highly suggest” that I see a psychiatrist who specializes in oncology. I don’t know if they do this for all their patients who are going through breast cancer, or figure I need one based on the fact that I am a “complex case” who is going through “more stuff than any person should go through”. I am keeping an open mind and will go to at least one appointment scheduled in January.
All in all it has been an eventful week. Next week is important as the oncologist shares the results of my CT scan and bone scan and discusses the treatment plan. My knowledge of breast cancer has grown, as has my vocabulary. In situ? Receptor status? Ductal carcinoma? HER2? lobular? Biological therapy? What?!
Thank you so much for your emails, phone calls and facebook messages. I am so grateful for your love and support. I am only able to read a couple of messages at a time – – they make me laugh, they make me cry, they make me feel incredibly special. You are my true heroes and I love you all very much.