Wednesday, November 28, 2012
Treatment - What I Know Today
My doctor has initially recommended a combination of chemotherapy and radiation treatment. The exact treatment will be determined after I have surgery. An Oncotype DX test is done on the tumor. This test quantifies the likelihood of recurrence in estrogen receptor positive, early-stage breast cancer patients and assesses the likely benefit of certain types of chemotherapy. Radiation would follow after chemotherapy and I would go 5 days per week for 5 weeks.
Surgery Details
Surgery is scheduled for January 3rd, 2013. I will be home resting for 6 weeks.
I've elected to have a lumpectomy. This is a breast conserving procedure. The lump and a surrounding amount of good tissue (margin) is removed. The goal is to remove all of the cancer but conserve as much good tissue as possible.
There will also be a sentinel node biopsy of the lymph nodes. A dye is injected into the lump and then they track which lymph nodes it drains to. Those are the first nodes to biopsy. If they are clear of cancer cells, that is all that happens with the lymph nodes. If there are cancer cells, then they will biopsy the axillary nodes to check for further spreading.
Additionally, I have decided to have a hysterectomy (uterus removal) and an oophorectomy (ovary removal). I have a history of ovarian cysts that are very painful and there wouldn't be anything my doctors could do about these while I am going through treatment. Stopping them from developing was done by taking oral birth control. But the pill contains estrogen, so I have had to stop taking them. Removing the ovaries eliminates the primary source of estrogen in my body thus reducing the availability of food for any cancer cells bouncing around.
I've elected to have a lumpectomy. This is a breast conserving procedure. The lump and a surrounding amount of good tissue (margin) is removed. The goal is to remove all of the cancer but conserve as much good tissue as possible.
There will also be a sentinel node biopsy of the lymph nodes. A dye is injected into the lump and then they track which lymph nodes it drains to. Those are the first nodes to biopsy. If they are clear of cancer cells, that is all that happens with the lymph nodes. If there are cancer cells, then they will biopsy the axillary nodes to check for further spreading.
Additionally, I have decided to have a hysterectomy (uterus removal) and an oophorectomy (ovary removal). I have a history of ovarian cysts that are very painful and there wouldn't be anything my doctors could do about these while I am going through treatment. Stopping them from developing was done by taking oral birth control. But the pill contains estrogen, so I have had to stop taking them. Removing the ovaries eliminates the primary source of estrogen in my body thus reducing the availability of food for any cancer cells bouncing around.
Pathology
These are the details of my breast cancer.
- Invasive ductal carcinoma (starts in a milk duct and invades the surrounding breast tissue)
- Stage 1A (caught early)
- Grade 2 (size is between 1.1 and 2cm - mine is 1.9cm)
- Estrogen receptor positive 90% (feeds off estrogen)
- Progesterone receptor positive 40% (feeds off progesterone)
- HER2/neu negative (Human Epidermal Growth Factor Receptor 2 negative means slow growing)
- BRCA1 mutation negative (hereditary breast cancer)
- BRCA2 mutation negative (hereditary breast cancer)
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