Cancer Diagnosis Details
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Ruth
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Ruth
From Ruth:
Cancer Details (HR+/HER2- with DCIS, and possible lymph node involvement)
The cancer is stage 1, with one small tumor in my left breast. The cancer is ER* positive, PR* positive, and HER2* negative. There is also an extensive area of calcifications that were also found to be cancerous, though they are non-invasive DCIS* (often referred to as stage 0 cancer). Finally, there's one abnormal lymph node that the cancer may have spread to (this would mean that the cancer has progressed and is higher than stage 1). Unfortunately, due to the lymph node's proximity to major arteries, doctors feel it is too risky to biopsy it to test for cancer.
Treatment (Mastectomy & Hormone Treatment)
The cancer team we've spoken to (a surgeon, oncologist, and radiologist) has agreed that I need a full mastectomy* of my left breast, largely because of the spread of the DCIS.
When my surgeon performs the mastectomy and removes the tumor, the tumor will be tested to assess risk of regression. Nearby lymph nodes will also be removed and tested to assess if the cancer has spread there. Depending on those results, my oncologist may recommend radiation or chemotherapy post-surgery. Either way, everyone is recommending endocrine/hormone therapy*, which could last 5-10 years.
Each of these treatments come with their own substantial recovery, side effects, and decisions. Surgery can take about 4 weeks to physically recover from, assuming no radiation or chemo are needed. The endocrine therapy will bring on early menopausal symptoms for an extended time. Pregnancy during treatment is not allowed – meaning I have to make a decision about fertility treatment now.
Care
Cancer Details (HR+/HER2- with DCIS, and possible lymph node involvement)
The cancer is stage 1, with one small tumor in my left breast. The cancer is ER* positive, PR* positive, and HER2* negative. There is also an extensive area of calcifications that were also found to be cancerous, though they are non-invasive DCIS* (often referred to as stage 0 cancer). Finally, there's one abnormal lymph node that the cancer may have spread to (this would mean that the cancer has progressed and is higher than stage 1). Unfortunately, due to the lymph node's proximity to major arteries, doctors feel it is too risky to biopsy it to test for cancer.
Treatment (Mastectomy & Hormone Treatment)
The cancer team we've spoken to (a surgeon, oncologist, and radiologist) has agreed that I need a full mastectomy* of my left breast, largely because of the spread of the DCIS.
When my surgeon performs the mastectomy and removes the tumor, the tumor will be tested to assess risk of regression. Nearby lymph nodes will also be removed and tested to assess if the cancer has spread there. Depending on those results, my oncologist may recommend radiation or chemotherapy post-surgery. Either way, everyone is recommending endocrine/hormone therapy*, which could last 5-10 years.
Each of these treatments come with their own substantial recovery, side effects, and decisions. Surgery can take about 4 weeks to physically recover from, assuming no radiation or chemo are needed. The endocrine therapy will bring on early menopausal symptoms for an extended time. Pregnancy during treatment is not allowed – meaning I have to make a decision about fertility treatment now.
Care
My surgery is scheduled for Friday September 26th. I have decided not to go with reconstruction. I have many overlapping communities available to help care for me, both in Somerville and elsewhere. Bandmates have driven me to faraway appointments; housemates are covering some unforeseen expenses; friends are accompanying me to doctor's visits. David is moving into an opening room in my co-op for the fall to help with the acute treatment and recovery. I am grateful to family members who have already made my care a priority – namely, Stephen for consulting about breast reconstruction*, Uncle Calvin for consulting on the nature of the cancer, Laura for coming out to visit, and Travis for taking on a heavier parenting load while she was away.
I found the lump on my breast randomly, which is fortunate since I'm 34 and testing doesn't become routine until 40. If you don't already have scheduled mammograms or ultrasounds, here is a resource with a helpful video on conducting self breast exams, which should be done monthly.
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Glossary
ER - Estrogen Receptor. Cancer that is ER positive is responsive to estrogen hormone therapy.
PR - Progesterone Receptor. Cancer that is PR positive is responsive to progesterone hormone therapy.
HER2 - Human epidermal growth factor receptor 2. Cancer that is HER2 positive is known to be more aggressive
DCIS - Ductal Carcinoma In-Situ. Often referred to as stage 0 cancer, it is a very early stage, non-invasive, cancer contained within the milk ducts and lobules within the breast. Can turn into invasive cancer if left in place.
MRI - Magnetic Resonance Imaging. Medical imaging technology used in this case to scan for abnormalities in the breast.
Mastectomy - Surgical removal of all tissue of one breast (a unilateral mastectomy) or both breasts (a bilateral mastectomy).
Endocrine therapy - A type of hormone therapy used to suppress estrogen to suppress tumor growth.
Breast reconstruction – Restoring a breast that has been removed. This can be implant or tissue-based and is performed by a plastic surgeon.
BRCA – Stands for BReast CAncer gene. There are two, BRCA1 and BRCA 2. People who inherit harmful changes (mutations) to these genes are at a higher risk of certain diseases like breast and ovarian cancer.
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