Diagnosis

January 5, 2008 - I found a lump on the left side of my chest. It was like a small marble near the surface of the skin. I didn't think it was breast related at all. I thought maybe it was a cyst or growth or something, but not cancer. Still, I thought I better get it checked out.

January 8, 2008 - I had an appointment with my doctor to follow up on physical therapy I was receiving for my back related to a car accident. While I was there I mentioned the lump. He did a breast exam, didn't seem worried, but referred me for a mammogram.

January 9, 2008 - I had my first mammogram. The radiologist said the lump looked "suspicious" and followed up with an ultrasound the same day. It was determined to be a 1.5 cm suspicious mass. I could clearly see it on the ultrasound. It was a black jagged blob, surrounded by fog (edema/fluid, swelling). She said it needed to be biopsied. I started to worry. What if it's cancer??

January 10, 2008 - I had a needle core biopsy. It hurt and I was sore for the weekend. The cute pink ice packs really helped. I kept thinking that it was worth it to know what we were dealing with.

January 14, 2008 - Monday moring as usual. We got the kids off to school, Austin headed out for work and I was getting ready for a meeting later in the morning. I was sitting at the diningroom table, going over a client file. The phone rang. It was my doctor. He asked if I could please come in to the office later that morning. I asked if he had received the biopsy report. He said he had received it but wanted to talk to me about it later in person. I asked him to please just tell me... He said it was "an invasive ductal cancer". SHIT! Cancer????!!!! I was in shock. I called Austin. I told him he needed to come home. I said it was cancer. He turned around and came home. He walked in the door and just held me as I broke down. We both cried. Cancer? No way. How could this be happening to us? I kept thinking, wasn't it enough to have a special needs child? How am I going to deal with cancer? What will happen if I die? I thought I was going to die soon. My mind was racing. We calmed down a little, went to see the doctor. He went over the pathology report with us and prayed with us. We all cried. He recommended a surgeon and oncologist. The cancer journey began.

Pathology Report: Left Breast 11 0'clock, core biopsy Invasive Ductal Carcinoma, with the following features: Modified Bloom-Richardson grade III of III (tubule formation score 3, nuclear pleomorhism score 3, mitotic rate score 3).

January 15, 2008 - Austin and I met with the surgeon. My mom joined us too. We covered a lot of information. The surgeon's nurse gave me a copy of Dr. Susan Love's Breast Book, which would prove to be an excellent source of information. We talked about scheduling the lymph node biopsy and putting a port in. I was in new territory. There was so much I didn't understand and felt like I was asking stupid questions.

January 25, 2008 - First appointment with the oncologist. He said my tumor is Type IIa, Grade 3 and triple negative, which is the most aggressive kind. He recommended doing chemotherapy first, then surgery. This is known as neoadjuvent chemotherapy. He also ordered an MRI.

January 29, 2008 - PET Scan. They scanned my whole body to see if the cancer was in my bones or had spread.

January 30, 2008 - PET Scan looks good.

January 31, 2008 - Breast MRI. The tumor measured out at 4 cm. It had increased from 1.5 cm. I could tell it had grown, it was so close to the surface of the skin. It felt like an egg under my skin. I am sure it felt bigger because it was surrounded by fluid and seemed swollen, but it had also grown.

February 5, 2008 - Pre-op appointment with the surgeon. [When discussing the surgical treatment of your breast cancer with you, your surgeon will discuss whether or not your breast cancer is invasive. Breast cancers can be confined within the lining of the endothelial cells along the breast duct (in-situ cancers); or it can start to spread beyond the breast duct (invasive cancers). This is important because the blood vessels and lymph vessels that potentially spread the cancer beyond the breast run along this area. If the cancer has spread beyond the lining of the breast duct, and is picked up by the blood vessels or lymph vessels, then it can potentially spread elsewhere in the body, or “metastasize.” Lymph vessels are small channels that drain all the tissues of the body. Lymph vessels drain excess fluid back into your circulation. As lymph fluid drains back into your circulation, it goes through lymph nodes. Lymph nodes are collections of lymph tissue that have a high concentration of white blood cells, the cells in your body that fight infection and cancer. The lymph vessels of the breast drain into the lymph nodes in the axilla (underneath the arm), and sometimes into the lymph nodes along the sternum, (or breastbone), and above the clavicle (collarbone).]

February 7, 2008 - Surgery for sentinel node biopsy and port-a-cath placement. [A sentinel lymph node biopsy is a new technique. This was developed as a test to determine if breast cancer has spread to the lymph ducts or lymph nodes in the axilla without having to do a traditional axillary lymph node dissection. Experience has shown that the lymph ducts of the breast usually drain to one lymph node first, before draining through the rest of the lymph nodes underneath the arm. That first lymph node is called the sentinel lymph node. That is the lymph node that helps sound the warning that the cancer has spread. Lymph node mapping helps identify that lymph node, and a sentinel lymph node biopsy removes only that lymph node. The sentinel lymph node is identified in one of two ways, either by a weak radioactive dye (technetium-labeled sulfur colloid) that can be measured by a hand held probe, or by a blue dye (isosulfan blue) that stains the lymph tissue a bright blue so it can be seen. Most breast cancer surgeons use a combination of both dyes.] [The oncologist may recommend that you have a port or "port-a-cath" inserted in your upper chest wall (the space between your collarbone and your breast) to make chemotherapy easier, safer and more comfortable. The port is about the size of a quarter, only thicker, and will show only as a bump underneath the skin. There are several benefits to having a port: No need to find a vein every time you receive chemo. A special needle fits right into the port, so all you feel is the stick. The medication goes right into the main blood supply entering the heart, so it can be sent quickly and efficiently to all parts of the body. Blood for blood tests can also be taken from the port.]

February 8, 2008 - Lymph nodes are negative!! This is great news.