What They DON'T Tell You About Breast Cancer/Chemo Part 1

Surgical Site of My Chemo Port
Image Mine, @luanne

So I decided to squeeze in another post about stuff cause I don't know how I'll feel after the next infusion & it could be a long while 'fore I'm up to it.

When you are diagnosed with not only cancer, but breast cancer, you instantly become part of a very special club. I call it the Pink Brigade &/or Warriors. They welcome you with a smile, open arms & a soft sorry on their lips. Some are in remission, or NED as they now call it (No Evidence of Disease): some are in their 2nd or 3rd battle & some are even closing in on the end of their fight.

Warriors in all stages are everywhere! Tonight the cashier @ the grocery store was one & gave me a huge huge. She's been NED for 10 years.

Although tremendous advances have been made in fighting cancer & winning, death is still a very real factor. We accept it, & when we get really scared our sisters in the pink brigade are the ones we mostly easily can talk to about it.

(Since the beginning of this year, I have been taking an informal count of people I've become aware of who have passed from cancer in this year. It includes all kinds of cancer. As of tonight, the count is at 18).

There are so many things they don't tell you about. Everything from the difference in mammogram types to all the possible short term & long term side effects one can have for chemo.

While the general public are very familiar with breast cancer, what is not commonly known is all the different types.

Ductal Carcinoma (me) is one of the most common types along with Lobular Carcinoma. With both of these there's invasive (me again) & non invasive.

When a questionable lump is found-most often via mammogram, (I actually found mine) the next step is a diagnostic mammogram with ultrasound. If that still proves to be inconclusive, the next step is biopsy.

(As a general rule, about 80% of all lumps turn out to be benign).

The biopsy, albeit very nerve wracking for me, was also interesting. There's nothing quite like being wide awake with a numb body part as a fairly extensive needle is pushed into your skin & lump not just once but 3 or 4 times. Yes that is correct. THREE OR FOUR. The needle is hollow & takes what is called a core. It makes a drilling sound or, as was the case with me a large snap because the drill wasn't getting an adequate 4th sample so they changed to another piece of equipment. All of this is not only displayed on an ultrasound right next to my left shoulder, but that "drilling" was going on just a smidge to the right of the center of my cleavage. Refer to pic below.

Pixabay Image, approx. location of my lump in my right breast.

It takes about a week before biopsy results are back & even then they're just preliminary. They basically tell you what cancer you have, but further testing is needed to find out what stage.

Meanwhile, at least for me, I was extremely stressed out; my anxiety off the charts.

Once your preliminary type of cancer is determined, they then conduct further testing not only to determine stage, but grade & if it's horomone driven and/or protein driven.

Ok here's where it gets a little complicated. The stage of cancer basically is how far it's spread or not spread. Grade is how rapidly it grows- in other words how fast the cancer cells multiply.

I am stage 2a & my grade cancer is 3. The stage of my cancer was based on the size of my lump which was 2.2 cm. (.866 of an inch) Anything below 2 cm is considered stage 1. I'm just barely over into stage 2, hence the 2a.

Grades of cancer run a scale of 1 to 3. The higher the grade number, the more aggressive the cancer is. Mine was technically estimated between 2 to 3 but for treatment purposes my plan goes with a 3 for better outcones.

Next comes whether the cancer is horomone and/or protein driven. Breast cancers can be estrogen driven, progesterone driven or both. There is also a type of protein called HER2 that can also stimulate cancer cell growth.

My cancer is very very week estrogen positive (1.8% almost made the 1% crowd haha!) & strong HER2+. Because my cancer is so weak estrogen but strong HER2, my treatment plan focuses on fighting the HER2 protein.

HER2 protein occurs in everyone's genes, however it's majorly amped up in some cancer patients & can cause the cancer to grow & spread at an even quicker pace. Until about 5 to 6 years ago, the success & life longevity rates for HER2+ cancers was pretty bad. Science has made tremendous leaps & bounds tho, & now there are new treatments for HER2+s with a high success rate.

The most common of HER2+ treatments is a drug called Herceptin. I receive it with my infusions & then will continue to receive it alone monthly even after my chemo's done. I will be on it for 1 year.

When a breast cancer warrior is positive for both horomones & HER2, it's called triple positive. When they are negative for all 3, it's referred to as triple negative. Triple negative is considered to be one of the hardest to treat because successful treatment plans can be very elusive.

Once the Drs have a complete cancer diagnoses, it is then determined what surgery, or surgeries, are needed as well as chemo and/or radiation.

In my case, I was to have a lumpectomy-removal of my lump- along with the standard sentinel node procedure. With respect to breast cancer the lymph nodes in the arm pit are one of the first places the cancer spreads too. In order to determine metastasis (spreading of cancer), radioactive dye is injected in 4 different shots in the nipple of the affected breast. Once all 4 shots are given, the patient then has to massage the nipple & breast for 15 minutes or so to help work the dye into the system.

(They do numb you up but you still feel the dye when it's injected which is like the burn you get when getting a flu shot, & because we're oh so special we get it 4 times!)

The radioactive dye works it way to your lymph nodes so that the surgeon can see with special tools. This way they don't have to go digging around in your armpit trying to find node #1. (They're pretty small). In my procedure nodes 1, 2, & 3 were taken to be tested for metastasis all of which came back clear.

Some warriors only wind up with a cppl nodes removed. Others with several to many if the cancer has spread.

The "great" thing about node removal-and I'm being sarcastic here, is that for some it can lead to what's called lymphedema. This can happen regardless of whether one node is removed or 20. All it takes is for the lymph nodes in a given area to be disturbed.

Lymphedema is swelling in an arm or leg caused by a lymphatic system blockage. It can be treated but there is no cure & it can be pretty darn painful. With respect to breast cancer warriors, lymphedema can affect the arm and/or the breast on the same side of the body as where the node procedure was performed.

In my case I seem to have developed lymphedema on the right side of my right breast & underneath the breast as well. I haven't been officially diagnosed yet, but will be talking to my oncologist about it this week.

After my surgery, I was given 4 weeks to heal before starting chemo. This actually wound up being 5 due to a lower abdominal wound I have that was a complication from the hysterectomy I had end of Nov. The surgeon had to see me before I could start chemo. The wound was actually healing pretty well lately but my chemo seems to have reversed/slowed down the healing process cause it was down to 1.3cm deep & now 2 weeks later it's 2 cm deep. Cancer- the gift that just keeps on giving! 😕

Ok. I think I've covered quite a bit tonight. I will do my best to get back on here to go further into chemo, part 2, before I must surrender Thursday to my next chemo treatment.

Stay tuned!