Wednesday, September 5, 2012

Elderly Woman

According to my oncologist, I have an "elderly woman's tumor." She started off quizzing me on family history and said that I have a very unusual case. Usually when a young woman gets breast cancer it's a more aggressive form than the kind I have. At this point we are still gathering more information about my cancer but she feels very confident that it is really treatable. One of the tests we have pending is HER2. HER2-positive breast cancer contains a protein called human epidermal growth factor receptor 2, which promotes the growth of cancer cells. If this test is positive I would have to have chemotherapy, with a drug called Herceptin. This is being done on the biopsy sample they have already taken and should be back any day. She doesn't expect it to be positive as normally estrogen sensitive cancer, like mine, is not also HER2 positive. We want it to be negative to decrease the chance that I will need chemotherapy. 

Additionally, since my cancer is estrogen sensitive, they would like to use hormone therapy to treat it. The good thing about this, is that it's a highly treatable kind of cancer and potentially would mean that I don't have to have any chemotherapy. But, I will have to be on for 5 years. It will cause temporary loss of ovarian function but within 2 years of being done they should resume functioning.  

She also recommended doing a BRCA test. I took this from the Mayo Clinic website. 

"The BRCA gene test is a blood test that uses DNA analysis to identify harmful changes (mutations) in either one of the two breast cancer susceptibility genes — BRCA1 and BRCA2. Women who have inherited mutations in these genes face a much higher risk of developing breast cancer and ovarian cancer compared with the general population."

The hope is that this will also come back negative. If it's positive, my risk of ovarian cancer is 60%-90% as the genes are related. It would also increase my risk of the cancer re-occurring in the other breast. 

Aside from waiting for both of those tests, she wants me to have a CT and Bone Scan done. This will tell them if the cancer has spread to another part of my body. Again, hopefully these tests will be negative. 

The last negative test we are hoping for, is clean lymph nodes at the time of surgery. If they are clean then I should not have to have chemotherapy. If the cancer has made it to my lymph nodes chemotherapy may be required. Both doctors I met with today don't believe it has spread to my lymph nodes, although they can't be sure until the surgery. Everyone I have met with has checked my lymph nodes and they could also be seen on the mammogram and appear normal. 

Next we met with a second surgeon. He started our conversation with letting me know that there is nothing that I did to cause this cancer. They don't understand why I have but it's not my fault. There was some sort of Oncology rounds that happened today and my case was presented. Apparently I was the talk of the town this morning. I was known only as A.M. but of course he knew it was me. He explained the three surgical options available to me. 

  • 1) Lumpectomy with radiation
  • 2) Mastectomy for the tumor side only
  • 3) Bi-lateral mastectomy
He said that any of these options are fine, and that there is no "wrong" choice. Now the ball is in my court. I have decided against a lumpectomy as I do not want to have radiation therapy. Next up I need to schedule an appointment with a plastic surgeon to get more information regarding reconstruction. I was able to schedule my CT and Bone scan for Tuesday.

In summary, there are 5 tests we need to come back negative to have the best possible scenario. 
  1. HER2
  2. BRCA
  3. CT Scan
  4. Bone Scan
  5. Lymph nodes at time of surgery
If all of these come back negative I will NOT need chemo. Please pray that this is the case.

1 Thessalonians 5:16 "Be joyful always, pray continually; give thanks in all circumstances, for this is God's will for you in Christ Jesus."


  1. I love the titles of your posts. I always feel I should start a blog but 1) I can't spell 2) My grammar is TERRIBLE 3) I like to use lots of !!!! and CAPITOL letters randomly and 4) I could never come up with as creative of titles as you (See what I mean about the grammar). Thanks for keeping us in the loop. Thinking of you always.

  2. Sometimes the titles really are the hardest part. In NO way am I the best writer but I try....that has to count for something. :)

  3. I'm loving your positivity.

    Big decision for you regarding the surgery.

    I will pray for big fat negatives for you.

  4. Everything is moving so fast. My thoughts and prayers are with you. Here's to five negative scores in a row!!

  5. Fingers and toes crossed for the best possible outcome for you. You seem so brave about it all. A dear friend of mine was just diagnosed with non-small cell lung cancer and the outlook is equally as challenging. It's not curable but treatable. You have a really good attitude about this. Sending good thoughts your way.

  6. Alanna. my niece, Sarah, told me about your diagnosis. I am so sorry that you have to go through this at such a young age. I went through breast cancer when I was in my 30's and I am now a healthy 50 year old. I too was told that I would probably not need chemo, but it turned out that I did. That was a big blow, but I knew that I had to do everything I could to rid my body of cancer.
    I found a support group was helpful; the women there had a lot of current information and inside perspectives. We laughed and cried together there.
    Also, I am glad you are getting a CT and a bone scan, is the CT a PET CT? If not, you may want to ask about that.
    I will be reading your blog to keep up with what is happening. If you ever want to talk please give me a call. I know I am not your age, but I am a survivor who knows the experiences of many survivors.
    Good luck to you,
    Libby Castro


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