A Little Bit of Science...

I was diagnosed with a type of cancer called invasive ductal carcinoma (IDC). It is the most common type of breast cancer. When I had the biopsy they tested the cancer for types of receptors which helps to target treatment. I have a type called estrogen receptor negative, progesterone receptor negative, HER2 receptor positive. This means that my cancer will not respond to hormone treatment, but will respond to therapies targeted towards the HER2 receptor.  

I initially felt my lump in October. I put off getting it checked until last December. To be honest, I decided to get the ultrasound done because we were thinking of getting less expensive insurance with less coverage in January. Why not get the ultrasound while my expensive insurance covered it, right? The ultrasound was done on 12/31. The radiologist doing it said it looked like a galactocele, or a cyst filled with breast milk which can happen after breastfeeding. I felt reassured. But the radiologist still recommended a biopsy because of my family history (more on this later). On 1/9 I had the biopsy. On 1/10 I got the call that changed my life. The next week I went in for repeat ultrasounds and mammograms of both breasts. A week later I met with a surgical oncologist. She explained that my ultrasounds and mammograms did not show any other suspicious lesions. She was hopeful that we caught this early. We spoke about the options of lumpectomy (just taking out the cancer and surrounding tissue as well as lymph nodes) vs mastectomy (taking the whole breast). Given that my cancer was still small, she recommended lumpectomy for me so that I can recover fast and start chemo. At that second, I was like, “wait what?! I thought you said this cancer was caught early! Why do I still need chemo?!” She went onto explaining that I have an aggressive type of cancer that is “invasive.” Even with early detection and small size, the chance of recurrence and metastasis is high without chemo. Now, I’m a physician, but I haven’t done anything related to cancer treatment since med school. I knew there was a slight chance I would need chemo but, REALLY? Is this for REAL? I broke down. I bawled and cried like Landon when we take away his yogurt snacks from him.

After I stopped sobbing, we talked more and we decided on the lumpectomy. This will allow me to heal sooner and start chemo sooner. I could consider mastectomy in the future if my genetic testing comes up with anything suspicious (more on this later). I had my surgery on 1/31. It was an outpatient surgery so I was able to go home a few hours after the surgery. The anesthesia hit me harder than the surgery itself. I was lightheaded and dizzy for a good 2 days after surgery and stayed in bed most of the time. But after that, aside from pain and numbness in my axilla (which is very weird because it felt like my arm pit was fat but not there at the same time) I felt fine. On 2/4 I went back to work. A lot of people thought I was crazy for going back to work so soon, but for me, it made sense. Work was a distraction for me, a place where I wasn’t a patient. Heck, my brain still works, so why shouldn’t I continue to work?

After my surgery I got good news. My tumor was only 1.2 cm which is small. My surgeon got good margins, which means that the tissue around the tumor that she got out were cancer-free. She took out 3 lymph nodes in my right axilla and they were all negative for cancer cells. This meant that my cancer had not spread. I was classified as stage 1A, which in the world of cancers, is the best case scenario. Unfortunately, I still need chemo. Argh!

On 1/18 I met with my oncologist. He explained everything to me regarding my staging and he recommended a regimen of chemotherapy called TCHP which stands for Taxotere + Carboplatin + Herceptin + Perjeta. The first 2 are chemotherapy agents. The last 2 are antibodies against the HER2 receptor. This is a very aggressive regimen. Even though my cancer is early and has not spread, he still recommended this regimen because my cancer is aggressive and has high risk of recurrence and metastasis. This is the same regimen someone with metastatic cancer would get. I was shocked. Why do I have to get such an aggressive regimen with so many side effects? Aren’t there any benefits to me finding this early? I ended up talking to a few other oncologists who my MD friends recommended. They also recommended TCHP. There are other regimens that are less aggressive but that means higher risk of recurrence or metastasis. In the end, I decided I couldn’t take any chances, especially now that I’m a mom. Landon needs me.  Dan needs me (so he says!). I’ll do anything for them.