my Breast Cancer blog

2004, age 34 — this is my story

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Raw October — Day 24 (Recurrence Will Not Happen)

Raw Octoberraising breast cancer awareness — one fact, figure, feeling, and photograph at a time.

What a difference a year can make. Last November, I nearly lost my mind after a bogus MRI revealed a possible malignancy. Yesterday, I learned that I pretty much have a zero chance of breast cancer recurrence.

My doctor says she knows this because of my type of disease — my tumor was ER/PR negative and HER2 positive, which happens to be aggressive, but only for the first 5 years. After 5 years (I’m at almost 8 years), there’s pretty much no risk of recurrence either locally or to distant organs. That’s not to say another cancer won’t ever pop up, but the one I had should not ever, ever, ever return. I will not, therefore, be a woman who says 20 years down the road that her cancer came back.

I should find great peace and comfort in this news, said my doctor. I do, I assured her. I really, really, really do, and while I kept my composure in her office as this gift of information swirled in my brain, tears fill eyes as I adjust to my newfound relief.

More good news — no more annual MRI. It’s not the standard of care for someone with my risk, and that makes it just not necessary. No more annual blood draw, either. It’s also not the standard of care, and the results tell my doctor nothing about my cancer-related health. My future line-up, then, is one annual follow-up with this doctor (she’s my medical oncologist), one annual follow-up with my radiation oncologist, and one annual mammogram.

Sounds good to me.

All of it.

Today, I Got a Call

Regarding the the unofficial good news I’d received about my MRI results on Tuesday, I wrote:

(But you know what? There’s a teeny tiny part of my brain thinking that someone might call and say, “nevermind, there is something wrong,” and, in the spirit of being totally honest, I must admit this.)

Well, someone did call today, a someone who gave me the official good news that my MRI was normal, that the wonky results that showed up the first time around were, in fact, due to hormonal fluctuations.

OK, I feel better now.

(Next up on the imaging front is a routine mammogram in June, then another routine MRI in November.)

Live and Learn, MRI Style

So, here is what you should know about MRI:

  • Your MRI will pick up everything. Great if you have certain types of breast cancer, because they will likely be detected, and this could save your life. Bummer if it’s not cancer, because you’ll be forced to chase it down like it is cancer in order to confirm that it’s not, and this could take a really long time, and even if it doesn’t take a really long time, it will seem like forever, and you will worry and fret and panic until you find answers.
  • Your MRI should be scheduled for a day that is between something like seven and 15 days after the onset of your period. This is very important. Should you schedule off this track, your MRI (remember, it will pick up everything) will zero in on all sorts of hormonal tissue changes, and this could lead a concerned radiologist to indicate in test results that “malignancy is considered.”

Get where I’m headed here?

In a nutshell, I caution you to (a) realize MRI is a very sensitive screening tool, and (b) make sure you are scheduled properly when you plan to use this very sensitive screening tool. If (a) and (b) converge, you might have a stressful time on your hands, like I just did.

Why for my past five MRIs no one has ever asked about my cycles when scheduling me, I will never know. And WOW, how lucky I’ve been for all those five times to not have happen to me what happened last Thursday. You see, my period started the day after my last-week MRI, and it looks like this just skewed everything. Yesterday’s MRI, though, implemented properly, apparently showed that the worrisome issues had resolved.

<sigh>

No.

<big sigh>

You just can’t imaging how relieved I am, given the fact that seven years ago TODAY, I had a biopsy for a lump I’d found in my left breast. The next day, the day before Thanksgiving, a doctor called me to say, “unfortunately, cancer cells were found.” That just can’t happen twice, with such precise timing.

It just can’t.

And it didn’t.

Now is when I get to declare that I am the happiest girl I know!

(But you know what? There’s a teeny tiny part of my brain thinking that someone might call and say, “nevermind, there is something wrong,” and, in the spirit of being totally honest, I must admit this.)

MRI Monday

The re-do MRI is over, and I fully expect I will get a call in the next day or so from a medical someone who will declare it normal. I really do believe this, even though there were machine technical difficulties this morning requiring a start and stop and start again, an interruption to fix one boob that might have been receiving too much pressure in the apparatus in which it hung, and marks on my body from said pressure that I never noticed after my past five experiences in the tube. Surely, none of that will matter, because my sense, really and truly, is that this whole scare that’s been going on is just a fluke, a false alarm, bad monthly “cycle” timing, something other than the “malignancy considered” wording that appeared on the first MRI.

I’m sure I’m right. I just need someone to confirm it for me.

Waiting.

 

Surgeon Says

Today, I met with a breast surgeon to review what’s happened over the past almost-week. To recap:

  • there was the annual MRI.
  • then the MRI report featuring the awful words “malignancy considered.”
  • then three days of pure worry (and lots of well wishes and prayers).
  • then an ultrasound that prompted docs to utter the happy word, “benign.”
  • then another couple of days of pondering it all.
  • then this afternoon’s consultation with the guy who operates on women with breast cancer.

First of all, who knew the gowns had gotten so lovely in the past seven years. Wow, check out my beautiful blue poncho-style paper cover-up, complete with hanging-open sides that are just perfect for peering in at boobs and muffin tops. It didn’t really matter, though, how substantial that pretty paper is because in a matter of minutes, I was on the exam table, boobs fully naked and prime for examination. And here’s what I learned about the troublesome twosome:

They feel fine. No lumps, bumps, masses, or tumors. No thickening or dimpling or other changes in the skin. Maybe a little nipple redness (we’ll monitor that). No swollen lymph nodes. No infection. No inflammation. No apparent cause for concern.

The game plan: The surgeon will review my MRI and ultrasound Monday morning at a weekly “breast conference,” where all sorts of doctors converge and weigh in on cases. While he’s at the meeting, I’ll be getting a re-do MRI, and he says if it looks better than the first, we’ll sum up that I am A-OK, and I will check back with him in January. If it looks the same as the first, we’ll call it a mystery and continue digging by way of MRI-guided biopsy. No matter what, I’ll watch the nipple (not, like, every two minutes, though, the surgeon said), and I’ll report any continued or worsening redness.

I learned so much from the surgeon today, like if I ever get cancer in my right breast, it won’t be a spread of the cancer I had in the left breast, because cancer doesn’t spread from one breast to the other. It would be another new cancer, and the chances of that happening are something like .5% per year.

I also learned that MRI catches more than 95 percent of invasive breast cancers (there are others, but these are the types that present as lumps). Awesome, right? Of course it is, but the bummer side to the story is that MRI picks up everything else, too. And what the heck does one do about that? Chase it all down, that’s what, just like I’m doing right now, to see if the iffy stuff turned up by that loud and annoying tube is cancer-related in any way, shape, or form. No fun, I admit, but it’s a necessary evil — unless of course, the boobs go away, which is totally an option, and thanks so much to everyone for sharing opinions on whether or not I should just chop the breasts right off (well, the surgeon would do it, not me). Still thinking on that one, but I’ll keep you posted.

Today was a good day. No pure worry, but still plenty of well wishes and prayers, and news that is more hopeful than not.

Oh, and to make the day even better, the skin biopsy I had last week came back normal. I didn’t see that coming at all, but what a treat!

Mastectomy — Do It? Or Too Drastic?

I’ve had breast cancer. I’ve had a lumpectomy (tumor was taken, but breast was not). I’ve had chemo, radiation, and more drug therapy. I’ve survived for seven years. You’d think I’d be fine for the long haul. But last Thursday — a suspicious MRI, a report that read “malignancy considered,” and a three-day wait for today’s follow-up ultrasound made me crazy with worry and panic. The ultrasound docs say “benign” to everything they saw this morning, but for safety sake, I’ll have a re-do MRI in two weeks. And this Wednesday, I’ll meet with a surgeon, just so he can check me out and review what’s taken place over the past few days. When I see him, I think I’ll ask him a big question: Should I just cut off the damn boobs?

My initial reaction is that it’s too drastic. I mean, if I were faced with breast cancer again, I’d definitely do it. But without the bad news, do I take prophylactic measures? Do I endure major surgery and the whopper decisions regarding reconstruction?

But what if I continue to have scares like the one from which I’m still reeling? When does it become worth it to just cut the risk right off my body. Why wait for cancer to strike again?

Still, what if cancer isn’t in the cards for me at all anymore, and I go and chop off some of my womanhood?

Heavy stuff, right?

Former Fox News Anchor and conservative E.D. Hill removed her breasts based on family history alone.

What would you do, you know, if you were me?

(Please answer the poll, then leave a comment if you care to share your views.)
(And click on “view results” to see how the responses are stacking up.)

Benign

Docs have talked, and the call at this time is “benign.” No need for biopsy right now. Follow-up MRI at end of month, and, if it shows concerns, we’ll take it from there. <sigh>.

Ultrasound Not Alarming

Initial news is good: no mass, tumor, lump — ultrasound showed a bunch of dense and enhanced tissue + a lot of shadows. What does that mean? Not sure, so ultrasound doc will follow up with doc who read MRI, and she will compare with my previous MRIs to determine what exactly has changed and if there is anything to biopsy. If not, a repeat MRI will probably be scheduled. Surgeon will also be looped into the mystery. So, while I did not get a definite “everything is fine,” I am at peace knowing there was nothing alarming discovered!

Suspended State

“I’m sure you’ll be in a suspended state until you know.”

Suspended state.

That’s it.

Exactly.

Credit for these words, which are so fitting for my situation, goes to Anna. She’s my boss, a faraway friend, someone I’ve never even seen in person — that is so strange, isn’t it? The virtual world makes it possible for me to work at home in Florida with a staff of others who fill a New York City office building. I am so lucky. (Not to have never seen Anna, of course, just to have the great gift of working in my house so I can be a professional and a mom.)

So, if you have not read the posts that come before this one, I am waiting. waiting. waiting. for an ultrasound (hopefully on Monday) that will give a second look at a “new conglomerate of small enhancing foci in the retroareolar region” of my right breast (not the one where I’ve already had breast cancer) and a non-mass-like something in the posterior of the same breast. Malignancy and infectious/inflammatory etiologies are considered, says the MRI report.

The MRI I had on Thursday was just a routine follow-up — a test that was supposed to reveal I am still cancer-free.

Maybe I am still cancer-free. Maybe I’m not. The ultrasound, and probably a biopsy, will flesh it all out. While I wait for that second look, though, I’m sorta just going through the motions and hanging in a balance. I’m up and down, and, well, this is what I feel:

Yes, a suspended state, Anna. I don’t know whether to feel panic or peace, nervous or calm, worry or hope. It’s crazy.

There is still plenty of happy in my world, though. I mean, how can I not count my blessings with a boy who is willing to dance his little heart out at the Gator basketball game last night just to get on TV (and in the newspaper).

All in all, I am fine. I know deep down that if cancer is back, I will just fight it again. And if it is not back, I will be the happiest girl I know.

MRI No. 5

I had my fifth post-cancer MRI today. I get one every year, right at this time. It’s just a routine thing, a method of peeking at the insides of my breasts to determine if cancer is coming back or not. I don’t know what today’s results will reveal — gotta wait for my oncologist to call — but I do know it was a pretty good visit. I can’t always say that, because I usually wait so long to have my turn in the tube that I’m steaming mad by the time I slip into my awesome blue gown.

Today, though, no one made me wait, no one made me pay, I got my MRI in the new part of the hospital (first time there), and besides one minor blood spill when the needle came out of my arm, everything went well. The best part of the morning was meeting a woman newly diagnosed with breast cancer, telling her it’s been almost 7 years since my story started (see, there IS hope!), and leading her to my blog, where she can hopefully see that what lies ahead isn’t always horrible.

And to the newly-diagnosed woman — if you are reading, welcome to my blog. It’s really long (that’s a good thing — it means I’ve been surviving for a good amount of time), but I hope you’ll find what you seek, and if you don’t, please just leave me a comment or send me an e-mail (address is on the card I gave you), and I will happily answer any of your questions or lead you to someone who can. Best wishes to you!

Beautifully Benign

matze_ott, Flickr

matze_ott, Flickr

Five years ago, on November 24, I was diagnosed with breast cancer. And today, on another November 24, I learned that my recent MRI, showing some suspicious little nodules, is nothing to worry about. The news comes from my surgeon, who offered me a second opinion. The first opinion, by the way, was that I probably had nothing to worry about, but now it’s official:

“Your MRI is fine, the small spots represent fibrocystic disease, a benign condition.”

Whew!


MRI Shows Low-Risk Changes

Crap.

I was hoping for an e-mail from my oncologist that went something like this:

“Your MRI results are back, and everything is great!”

But this is what I got:

“Your MRI report is attached; My take is that there are some low risk changes and that we should keep doing what we have been, the mammogram alternating with the MRI.  Let me know if you want to talk.”

We talked. And my doctor said he thinks we are fine to just keep monitoring — even though the report said things like: There has been interval development of few small, less than 3 mm enhancing foci located more posteriorly within the right breast which demonstrate Type II enhancement curves. No space-occupying lesions are identified. No other concerning enhancing lesions are identified.

You see, tests like MRI are very sensitive, and they pick up all sorts of things. It’s all probably benign, it could be fibrous stuff, or hormonal stuff, who knows.

The “who knows” part is what scares me. Maybe it shouldn’t. The radiologists involved are apparently very cautious, and if they were worried, they would have recommended further action. Still, I’m going to have my surgeon and some others take a look at the report on Monday.

Some good news — everything on the left side is good, and that’s where the cancer was five years ago. It’s the right side that is causing trouble now.

More as the mystery unfolds.

Either I’m Fine or I’m Sick

Another MRI.
Quick this time around.
Answered some questions.
Filled out some forms.

Blue gown and underwear.
IV in arm.
Beeping and screeching.
Kelly Clarkson in my ears.

8 minutes on my back.
20 on my belly.
Boobs through holes in table.
Someone snapping pictures.

“Pretty,” she called the pics.
I was still and didn’t move.
The real answer comes tomorrow:
Everything is fine, or maybe it’s not.

Relaxing at home.
Not worried, really.
Either I’m fine, or I’m sick.
I know the drill.

5 years looming on horizon.
Will I make it free and clear?
I think so.
Will let you know.

Mammogram and MRI: Mix ‘Em Up

Check this out: I just read in Family Circle magazine (October 1, 2009) that alternating between mammograms and MRIs every six months is a potentially lifesaving measure for women at high risk for breast cancer. This comes straight from new research out of the University of Texas M.D. Anderson Cancer Center. I find this reassuring because it’s the exact schedule I follow — mammogram, MRI six months later, mammogram six months later, and so on.

More research, from Dartmouth University in Hanover, New Hampshire, found that MRIs can spot tumors not found in mammogram or ultrasound in 20 percent of breast cancers.

I think I’m covered. Whew.