The positives of negatives

Late last week I got the pathology results of my lymph node biopsy as well as an update on the pathology of Ralph’s tumor. Overall, its fairly good news.

The lymph node that was tested (the one that is most swollen of the bunch in my armpit right near my right breast) came back as Negative for cancer. This is AWESOME and is the best indication that the cancer hasn’t spread. Lymph nodes function as the “snails” of your body – they’re there to clean out all the gunk – which is why they tend to get swollen when you have a winter cold, because they’re working overtime cleaning out the virus/bacteria causing the cold. In cases of cancer, it tends to spread to the lymph nodes first because of how the “plumbing” in your body works. Earlier this month, the lymph nodes near my right breast all appeared swollen during my ultra sound and MRI, so they wanted to test them to see if the cancer had spread there. With a negative result (yay!) they are fairly confident that the cancer hasn’t spread, and instead the lymph nodes are swollen in reaction to the tumor and attempting to clean out the inflammation that the tumor is causing. I’ll likely get a PET scan in the next week to confirm the results, but so far its looking pretty good that the cancer hasn’t spread beyond my breast.

The other results back late last week was the HER2 response of my tumor cells. Reminder: HER2 is a receptor that some breast cancer cells respond to, and these tumors get treated with special medication that takes advantage of the HER2 response. My tumor is HER2 negative, so along with the progesterone and estrogen status I heard last week, this makes my tumor “triple-negative” which occurs in 10-20% of all instances of breast cancer. The downside of this result is there aren’t “specialty” treatments to target the tumor. The upside is that triple-negative breast cancers are highly researched in an effort to develop new specialty treatments (there’s likely a clinical trial in my future!) and triple-negative breast cancers are also the most responsive to chemotherapy.

So, with these results, my high-level treatment plan remains the same: chemo first, then surgery, and then likely radiation. All of the pathology details will be helpful for my medical oncologist, Dr Tsai, in determining the best cocktail of drugs to attack the cancer during chemo, so I’m sure I’ll have more details from her when we meet in the next week. Finally, the MRI detected another small lump in Ralph, so tomorrow I’ll have an MRI guided biopsy of that lump, and all the same lab testing will be repeated if that biopsy is positive for cancer. Since the radiologist will be in the room for the MRI, I don’t think I’ll be singing TSwift this time around.

Unfortunately, I still have more tests before we can move into “action” mode to kick this cancer’s heinie.

Fortunately, looks like the cancer has stayed put in Ralph, and hasn’t spread, making for much easier cancer butt-kicking!