A Long Day

I didn't sleep well last night so forgive me if this post isn't terribly coherent- it was a long day and I am really tired.

Before I jump into some details I just want to express my deepest gratitude to all of you who have expressed your love and support. It means a great deal to me to know that you are all behind me forming a web of support that stretches across the whole country. The fact that some of you offered to get on a plane to come help me blows my mind! As I said to a couple close friends of mine over the weekend, "I love everybody!"

As I mentioned last night, today we met with my treatment team at SCCA: medical oncologist, surgical oncologist, and radiation oncologist. We were there for five hours with a one hour break. It was long and we are awash in information. I'm going to try to keep this relatively short because a) I want to go to sleep and b) I don't want to put you into a medical-ese induced coma.

So to start, the good news is that as it currently appears my long term prognosis is quite good. The bad news is that the next 6 months to a year is going to suck. All things considered, I'll take a crappy year in return for a positive prognosis.

The Medical Details...

If you get your kicks looking at medical terms here are the details (if you don't, just try not to let your eyes glaze over too much):

• Cancer type: invasive ductal carcinoma (about 80% of all breast cancers fall into this category)
• Cancer grade: Grade 3, unfortunately this is the most aggressive grade of cancer
  
• Cancer stage: as yet unknown (more on this later)
• Other info: ER, PR & HER2 negative (also known as a triple negative)
• Ki67 Rate (cell proliferation rate): 85, this is really high (scale 1-100) and means my cancer is aggressive and can grow quickly

What It All Means...

Basically I have an aggressive form of cancer but it should be very treatable. It appears that I found the cancer early and given the aggressive nature, that is, as Martha says, A Very Good Thing. I do say "appears" because all the data is not yet in. I still need to have an MRI and an ultrasound of my lymph nodes before they can determine my cancer stage. The physical exams today did not turn up any additional lumps or bumps but the imaging will help determine if there are any additional masses in my breast or if the cancer has spread to additional locations (left breast or lymph nodes). SCCA is trying to squeeze me in for an MRI and ultrasound tomorrow but if that doesn't work out it will definitely be Thursday or Friday. If they find anything odd with the imaging they'll do a needle core biopsy right away. Fingers crossed that that is unnecessary! Once this last bit of information is known the doctors will assign a stage to my cancer.

Moving Ahead...

While decisions are final until all the information is gathered, in terms of treatment, I think will be taking a slightly different approach to things. Instead of having surgery and then chemotherapy, I am opting to have pre-op chemotherapy followed by surgery. I'm also going to have genetic testing done to see if I have any of the three breast cancer mutation markers (they can currently test for) as that might also influence my approach to surgery (the how much to remove question). This will be done this fall while I'm having chemotherapy.

I was going to explain all the how's and why's and what's of my treatment tonight but I find I am fading fast... I need to prop my eyeballs open at this point. Instead, I think I'll say good night for now and get back to explaining tomorrow.

For now, suffice to say that I left my consult with a very positive impression. I feel I am in extremely good hands medically and emotionally I know I have all of you cheering me on... What more could a girl want?

If you want a bit more explanation of the gobbley-gook in the medical details section, here are a couple links:

Seattle Cancer Care Alliance - Breast Cancer Facts
Word List via BreastCancer.org - a mini dictionary
Diagnosis Explanations via BreastCancer.org

Good night!