More news, and more waiting…

Today I had my first meeting with my Surgeon, Dr Johnson, where I learned a lot more about cancer, began to lay out a treatment plan, and discussed additional tests needed before we can proceed forward. First, a little on what we learned about the cancer in Ralph, based on the pathology report and last week’s MRI:

1. The cancer cells are estrogen and progesterone hormone receptor negative – this isn’t great news, but also isn’t surprising. In short, it means my cancer will need chemo to zap it vs relying on hormone-based treatments
2. The cancer cells may or may not be HER2-positive. The initial lab results were inconclusive, so more work is being done this week on the cells.
3. My tumor is about the size and shape of an extra-large egg, and is a grade III tumor  on a 3 point scale. This is not the same as staging – a grade III means the cancer cells don’t look like normal cells and tissue and the cells tend to grow rapidly and spread faster than tumors with a lower grade (I or II).
4. Several of my lymph nodes were noted as “abnormal” in my MRI, meaning there is a risk that the cancer has started to spread beyond my breast.
5. In short, the above info means that Chemo needs to happen, and that it should happen BEFORE surgery, so that it can try to shrink the cancer and limit what needs to be removed during surgery (keeping lymph nodes as long as they are cancer free is a good thing!)

There are still more tests needed to determine the exact next steps, including staging of the cancer.

• After I met with Dr Johnson today, I had a biopsy done of the most abnormal looking lymph node in my armpit. Fortunately, Dr Shearer was free today, so he conducted the biopsy (always nice to have a familiar face when you’re pulling your boob out for an ultrasound and biopsy). Results should be back tomorrow, but given the MRI, it seems likely that the lab will find cancer in the lymph node cells.
• If the lymph node that was biopsied has cancerous cells, I’ll get a PET scan to see if the cancer has spread beyond my breast area which will inform treatment plan, including chemo

Tomorrow I see the genetic counselor where we’ll discuss my BRCA-1 mutation and implications – honestly not sure what to expect but hoping she’ll have some guidance on how to think about the increased risk of Ovarian cancer due to the BRCA-1 mutation, what actions should be considered, and how that might fit into the rest of my treatment plan.

After that, hopefully next week but no later than August 20th, I’ll meet with Dr Tsai, my Medical Oncologist to figure out the Chemo plan. So, its back to waiting a bit before moving forward.

Unfortunately, this blog post wasn’t very funny. It honestly wasn’t a very funny day. And because of the additional tests, my vacation week is going to be spent in town at appointments and not at the cabin.

Fortunately, I managed to tap out this update so I’m counting that as today’s win.