The Story

Many of you may not know that I was diagnosed with breast cancer on September 3rd. Nearly one month later, after a lot of research, doctors appointments and soul searching I am moving forward with a lumpectomy on Thursday, October 7th. If all goes according to plan the lumpectomy will be followed by partial/localized radiation.

I have a  2.7 cm lump in my left breast (as measured on MRI) that is currently classified as stage one ductal invasive carcinoma, estrogen and progesterone receptive and HER2 negative. It's a low grade, slow growing cancer. It's growth is fueled by hormones. I'm told these are all "good" things in the world of breast cancer.

Unlike many other health conditions where the doctors tell you what type of treatment you need, I was presented with choices. Choices are good. But choices make decision making hard.

I was presented with the options of lumpectomy with radiation or bi-lateral mastectomy (removal of both breasts followed by breast reconstruction). Through all the anticipation of hearing if my second biopsy was cancer (the first one was inconclusive), I didn't think mastectomy would be on the table for some reason. But I guess these two options are standard choices offered to women in my situation. I'm told I'm lucky to have to these choices, because if my cancer was more aggressive, or I was positive for the breast cancer, BRCA gene test, or if I was above a stage 2, lumpectomy may not even be an option. Though mastectomy seems quite radical, there are very valid reasons to choose this option. Age, reducing the risk of recurrence and the benefit of avoiding radiation are the biggest factors. Apparently it's not typical for a woman my age, 36, to have breast cancer. It's most common in women 50 and older.  So I have a longer span of time in which another breast cancer could occur. 

Two mammograms, 3 ultra sounds, 2 core biopsies, 2 genetic tests, an MRI, 5 doctors and 9 doctor's appointments later I finally concluded that lumpectomy was the right choice for me. Throughout the research process Brad and I learned all about radiation (partial and full), plastic surgery, and medical oncology (the overall treatment plan pre and post surgery). Though I won't get into all the details here, there a countless variables to be considered. Ultimately the mastectomy option seemed too extreme for me personally. So I am taking it one step at a time and going forward with the less aggressive approach.

What is the next step? Surgery on October 7th to remove the lump.  During the surgery they also test my lymph nodes to see if the cancer has spread (my MRI showed no signs of the cancer spreading but they still test because the MRI doesn't always pick up small groups cells). Surgery will be followed up by a doctor's appointment on October 13th where we will learn the results of the pathology of the tumor, additional details on the lymph nodes, if I am a candidate for partial radiation and next steps.

You're probably wondering why the name of this Blog is The Fight Against Fred....Gloria vs Fred.  We named the tumor.  Well actually Brad named it.  Fred sounds a little better than saying "my tumor"....because every time I hear or see the word "tumor" I hear it in my head as "too-mah" in an Arnold Schwartzenegger voice.  Fred is our way of bringing some humor into the tumor situation.  Our official position on Fred is that he as a speed bump in our lives rather than a road block.  And I fully intend to kick Fred's butt along with any of his friends!  So Fred....your days are numbered.

I know this is a lot of information, especially for those of you who Brad or I haven't the opportunity to call and talk to personally. So I'll take a moment to answer some frequently asked questions.

FAQ's:

How was the tumor detected? My doctor felt a lump during my annual gynecology exam. So ladies, do your self breast exams....because had I done mine I would have felt this lump long before it was discovered.
Does breast cancer run in your family?  I have an aunt who had breast cancer and was treated with lumpectomy, radiation and chemo and never had another recurrence.  However, my cancer is not genetically related. 
How long does the surgery take? 1.5 hours and I get to go home the same day.
What does the surgery consist of? Removing the tumor and doing a full pathology. The surgery also involves removing some of the nearby lymph nodes to see if the cancer has spread (my MRI showed no signs of cancer in the lymph nodes, but they still have to check anyway).
How long is the recovery from surgery? About a week and involves pain that can typically be managed by over the counter tylenol. Brad technically gets to be my slave for the week. ;) I'm told I will feel like I can do more than I should. So it sounds like I'll be watching a lot of TV and reading trying to avoid overdoing it and boredom.
Why is radiation needed? Once the lump is removed during the surgery radiation is necessary to kill any stray cancer cells that may have broken off from the tumor.

What is partial or localized radiation? It's a procedure where a balloon is inflated inside the breast where the tumor previously resided. The balloon is attached to a tube that is outside the breast and a series of cables hooks up to administer radiation to just the impacted area. The treatment is administered 2 times per day for 5 consecutive days. Side effect is fatigue.

What is full radiation? This radiates the entire breast and is done once a day 5 days a week (M-F) for 7 weeks. Side effects are a sunburn effect on the skin and fatigue.

Will chemotherapy be needed? Possibly. It depends on the results of lymph nodes. If the cancer has spread, then chemo will be required.

What long term treatment is involved? I will be taking a hormone reducing drug called Tamoxifen for 5 years to help reduce the risk of recurrence. There is a genetic test to ensure I am receptive to the Tamoxifen therapy and I took the test and am receptive.
Where can you get more information about cancer? http://www.breastcancer.org/ or American Cancer Society

The past month has been a whirlwind of activity as you can imagine and we have not had the opportunity to personally reach out all our friends and family members. But Brad and I will plan to provide updates via this blog as way of keeping everyone in the loop on how things are going. If you have any questions don't hesitate to reach out to us.  Or you can leave a comment here on the blog and we will respond.  We appreciate the love and support from all our friends and family.  Thank you!

Gloria and Brad