Monday, May 2, 2011
Sunday, May 1, 2011
What's Missing
From the last post is the emotive content - from the time I found the lump, I've been terrified, off and on. When I was told it was probably malignant, and I called my sister to tell her, I couldn't speak. I've had to tell so many people by now (though I'm waiting to tell my parents until the results from tomorrow's biopsies come back, and I know what's going on) and it *is* getting easier, but it's not easy. It's never easy.
I weep off and on; I wake up some mornings weeping. I fear mutilation. I fear the loss. The effects of the drugs on my pretty pink cerebellum. I can't give blood again. I am going to miss this summer; I am going to miss Scotland. I'm not going to be able to do anything for a while, and I have so very much to do.
And it hurts.... not just emotionally, but physically - my left breast, flank, and arm ache; throb; sting. I thought cancer wasn't supposed to hurt, I thought it was supposed to be slower. It's all happening so fast.
I have so much to do before the 11th, when surgery is scheduled. There's so much I want to do, there's so much I have to do - loose ends to tie up and projects to finish, packages to send. Shall I at least set my house in order? Which reminds me that not only is there the house to set in order, but there's extensive damage from an ice dam over the winter that needs to be dealt with.
If tomorrow's biopsies come back negative, I get to keep my breast - if not, then I'll need a mastectomy. Sentinel lymph nodes will be taken during surgery. It's big scary potatoes. If I'm very lucky, I get to keep my breast and go through a minimum of nine months or so of hell. It's all happening so fast.
Also seeing my mom through breast cancer 4 years ago, and knowing what the road is like... hard lines, hard lines. I'm guessing I'm Stage 2a already, based on tumor size, and only if everything else is clear.
I will make it through, I've really no doubt on that - I'd really like to make it through with as much of my breast intact as possible. And please don't talk about reconstruction - I don't want a useless plastic Barbie boob. It's not just vanity, it's that my breasts are a huge erogenous zone.. it'd be like someone telling you they were going to take away a third of your penis glans, but they could rebuild so it looked ok.....sorta.
Not really the same as the original, it doesn't *work*. And this is visible...
So, send the energy out for me, please... it's still going to be a good nine months of hell (and house construction as well.. fml), if not longer, but I would like this small (and let's face it, it is *small*- never been a *big* girl) concession. I want to keep my breasts. They're mine. I made them.
And if needs must, I'll survive.
What I do NOT want from anyone is any blame. O, and any one calling this a "gift" or "opportunity for growth" or reminding me of all the valuable things I'll take out of the experience or *anything* similar in tone or feeling* - I can still break your fingers, just remember that.
That would be a lovely opportunity for growth... really, think of it as a *gift*.
*I heard all of these sorts of things when mom had cancer, and in similar situations... and while it may be meant well, it's just adding insult to injury. I know I'm going to hear some of them, but I'm doing my best on pre-emptive warnings. And I'm sure there will be good mixed with the crap - there always is- but it's still crap. On the whole, I'd rather be in Philadelphia.
It's really going to suck, I'll be ok, but it's going to suck big time. It already does.
I weep off and on; I wake up some mornings weeping. I fear mutilation. I fear the loss. The effects of the drugs on my pretty pink cerebellum. I can't give blood again. I am going to miss this summer; I am going to miss Scotland. I'm not going to be able to do anything for a while, and I have so very much to do.
And it hurts.... not just emotionally, but physically - my left breast, flank, and arm ache; throb; sting. I thought cancer wasn't supposed to hurt, I thought it was supposed to be slower. It's all happening so fast.
I have so much to do before the 11th, when surgery is scheduled. There's so much I want to do, there's so much I have to do - loose ends to tie up and projects to finish, packages to send. Shall I at least set my house in order? Which reminds me that not only is there the house to set in order, but there's extensive damage from an ice dam over the winter that needs to be dealt with.
If tomorrow's biopsies come back negative, I get to keep my breast - if not, then I'll need a mastectomy. Sentinel lymph nodes will be taken during surgery. It's big scary potatoes. If I'm very lucky, I get to keep my breast and go through a minimum of nine months or so of hell. It's all happening so fast.
Also seeing my mom through breast cancer 4 years ago, and knowing what the road is like... hard lines, hard lines. I'm guessing I'm Stage 2a already, based on tumor size, and only if everything else is clear.
I will make it through, I've really no doubt on that - I'd really like to make it through with as much of my breast intact as possible. And please don't talk about reconstruction - I don't want a useless plastic Barbie boob. It's not just vanity, it's that my breasts are a huge erogenous zone.. it'd be like someone telling you they were going to take away a third of your penis glans, but they could rebuild so it looked ok.....sorta.
Not really the same as the original, it doesn't *work*. And this is visible...
So, send the energy out for me, please... it's still going to be a good nine months of hell (and house construction as well.. fml), if not longer, but I would like this small (and let's face it, it is *small*- never been a *big* girl) concession. I want to keep my breasts. They're mine. I made them.
And if needs must, I'll survive.
What I do NOT want from anyone is any blame. O, and any one calling this a "gift" or "opportunity for growth" or reminding me of all the valuable things I'll take out of the experience or *anything* similar in tone or feeling* - I can still break your fingers, just remember that.
That would be a lovely opportunity for growth... really, think of it as a *gift*.
*I heard all of these sorts of things when mom had cancer, and in similar situations... and while it may be meant well, it's just adding insult to injury. I know I'm going to hear some of them, but I'm doing my best on pre-emptive warnings. And I'm sure there will be good mixed with the crap - there always is- but it's still crap. On the whole, I'd rather be in Philadelphia.
It's really going to suck, I'll be ok, but it's going to suck big time. It already does.
Saturday, April 30, 2011
start at the beginning
Four years ago, in the spring of 2007, my mother was diagnosed with breast cancer, a form known as Inflammatory Breast Cancer (IBC). What followed was a grueling time for all of us close to her, and most especially for her and her partner - first waiting for test results, and then the enduring of intense chemotherapy, then surgery, then radiation, and recovery. My mother did recover, thankfully - it was a hard hard road to walk, but she made it through.
Left breast ultrasound was performed demonstrating an approximately 19 x 15 x 20 mm hypoechoic trilobed malignant appearing mass at 9:30 to 10:00, 1 cm from the nipple. The coarse chunky calcification seen in association with this mass on the mammogram can also be seen byultrasound. The mass appears to be somewhat lobulated and macronodular. It is highly concerning and likely represents an invasive breast cancer. The remainder of the left breast was evaluated and is overall unremarkable. Left axillary lymph nodes are identified and have a normal internal architecture by ultrasound. Heterogeneous and amorphous calcifications noted superior to the palpable mass on the mammogram could be identified with ultrasound. These are randomly scattered and located at about 11:00, 3 cm out from the nipple. They are associated with minimally dilated ducts which are embedded in dense echogenic fibroglandular tissue by sonogram. These calcifications and the appearance of the surrounding parenchyma would be more consistent benign fibrocystic changes than DCIS.
Impression left breast: BI-RADS category 5, highly suggestive of malignancy.
Recommendation left breast: As discussed with the patient after reviewing the imaging findings, she will undergo ultrasound-guided core biopsy with clip placement later this afternoon. The biopsy will be reported separately.
Right breast ultrasound findings: Given the highly suspicious findings in the left breast, a right breast ultrasound was also performed demonstrating dense parenchyma throughout and scattered subcentimeter cysts and fibrocystic nodules, none of which is viewed with concern. There are no suspicious solid masses in the right breast. The right axilla has a normal appearance."
Three days later, Wednesday the 27th, the biopsy results came back. I have invasive ductal cancer with lobular features. The tumor is both ER positive (60%) and PR positive(40%), with cell nuclei rating of 2. Given the visible rate of growth, the proximity of the tumor to the nipple, and that mastectomy (single and bilateral) has already been mentioned repeatedly, I expect rather radical and unwanted body modification in my near future.
On Saturday, April 16, 2011, an obvious palpable lump suddenly appeared in my left breast - I'd swear it hadn't been there the night before. It was large (I guesstimated just over 2 cm) felt hot and heavy at first, though not painful; rounded but with an almost webbed texture - and I was terrified.
First thing Monday morning, I called and got an appointment at my primary care clinic, was examined there, and was informed that, given my presenting symptoms, it was most likely a cyst that would resolve itself, and was referred to the local breast care center for mammogram and ultrasound.
My appointment was for Friday the 22nd at 10:30. By that point, the lump was decidedly uncomfortable... achy and prickly feeling, all of which supported the possibility of a cyst. Soon after the mammogram was completed, I was told that the mass was highly suspicious; the ultrasound confirmed that it was not a cyst, but a highly irregular tumor consisting of two joined sections, one deeper in the tissue with the other easily palpable mass blooming forth from the lower mass. The radiologist informed me that he was 'leaning heavily" towards the mass being malignant and advised performing a needle biopsy, which was done that same afternoon.
I left at 4:30 - this is the report:
I left at 4:30 - this is the report:
"Left breast findings: A triangle marker was placed over the newly palpable lump at about 9 oclock. Standard views are augmented with spot compression magnification images of the area of palpable concern demonstrating an area of vague architectural distortion without a discrete definable mass. The architectural distortion is located at the site of a solitary coarse chunky calcification which has been present for several years. The architectural distortion is seen to better advantage on the spot magnified images. Additionally, there are some new slightly amorphous and slightly heterogeneous calcifications projecting over the area of architectural distortion on the CC view. These are located about 3 to 4 cm above the palpable mass on the ML view. On the prior mammogram, there are some scattered calcifications in this region. The calcifications have somewhat increased in number since the 2009 exam. There is no rod or branching morphology however. The remainder of the left breast is unremarkable. No mammographically evident enlarged axillary lymph nodes are seen. There is no evidence of skin thickening or retraction overlying the palpable lump.
Left breast ultrasound was performed demonstrating an approximately 19 x 15 x 20 mm hypoechoic trilobed malignant appearing mass at 9:30 to 10:00, 1 cm from the nipple. The coarse chunky calcification seen in association with this mass on the mammogram can also be seen byultrasound. The mass appears to be somewhat lobulated and macronodular. It is highly concerning and likely represents an invasive breast cancer. The remainder of the left breast was evaluated and is overall unremarkable. Left axillary lymph nodes are identified and have a normal internal architecture by ultrasound. Heterogeneous and amorphous calcifications noted superior to the palpable mass on the mammogram could be identified with ultrasound. These are randomly scattered and located at about 11:00, 3 cm out from the nipple. They are associated with minimally dilated ducts which are embedded in dense echogenic fibroglandular tissue by sonogram. These calcifications and the appearance of the surrounding parenchyma would be more consistent benign fibrocystic changes than DCIS.
Impression left breast: BI-RADS category 5, highly suggestive of malignancy.
Recommendation left breast: As discussed with the patient after reviewing the imaging findings, she will undergo ultrasound-guided core biopsy with clip placement later this afternoon. The biopsy will be reported separately.
Right breast ultrasound findings: Given the highly suspicious findings in the left breast, a right breast ultrasound was also performed demonstrating dense parenchyma throughout and scattered subcentimeter cysts and fibrocystic nodules, none of which is viewed with concern. There are no suspicious solid masses in the right breast. The right axilla has a normal appearance."
Three days later, Wednesday the 27th, the biopsy results came back. I have invasive ductal cancer with lobular features. The tumor is both ER positive (60%) and PR positive(40%), with cell nuclei rating of 2. Given the visible rate of growth, the proximity of the tumor to the nipple, and that mastectomy (single and bilateral) has already been mentioned repeatedly, I expect rather radical and unwanted body modification in my near future.
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