What it’s like to be newly diagnosed

Spoiler alert: it’s not fun!

There was waiting for the initial biopsy results, waiting for the appointment with my new surgeon (love her), and waiting for more results to inform the potential treatments. All I want is to begin the process of getting the boob invaders out. Cut ’em off? Cool. Point some rad radioactive waves at my chest? Bring it on. Poison the bad cells all over my body? Yes, I’m ready. Hair grows back, right? I just don’t know the treatment yet, but I’ll share what I do know so far!

I met with Dr. Dudak on Monday, September 14th. I came armed with a dozen questions and accompanied by my handsome husband, Eric, who is wonderfully supportive and who has been my rock since the “C” word became a reality in our lives.

She is no-nonsense. She is experienced. She knows her stuff. She drew a picture of my boob on the thin paper that covers the examination table, explaining the receptors and making it clear that there is nothing clear-cut about breast cancer treatment. I liken it to a really insane flow chart:

lots of “if’s” and “then’s”

What I know:

The cancer is hormone positive, which the doctor reassured me was a very good thing for the reasons stated in my last post. Yay!

I also found out that I have invasive lobular carcinoma, not ductal. Ductal is THE most common breast cancer, lobular is the second most common, initiating in the milk-producing glands. Dr. said no changes in treatment and prognosis does not change.

She did a thorough clinical examination and confirmed that none of my lymph nodes in my neck or underarms felt enlarged or in any way funky. Double yay. Early stage it is.

The lesions have been classified as “grade 2” which means they are not agressive, but not super slow growing. That’s fine.

The MRI I will have on Friday will show the physiology of what’s going on inside the breast, so that will answer many questions regarding details about the size and shape of the lesions.

I will have a meeting on Wednesday of next week with my full “Oncology Team”. I’m excited about this! I will meet the medical oncologist (the doctor who will oversee chemo if I need it; he will also be the one to prescribe the hormone targeting medication), the radiation oncologist, a plastic surgeon, a psychologist, and a nutritionist.

What I don’t know:

It turns out the HER2 status of the cancer is not very clear from the original test done on the biopsy. Dr. Dudak is ordering a special test called a FISH test that is very sensitive to the HER 2 hormone status. Because I can’t say whether I’m HER2 positive or negative yet, there are many open ended questions surrounding treatment. (update: I got a call from Dr. Dudak telling me it is definitely HER2 NEGATIVE. This is great, great news!)

The nurse took a blood sample from me for a full panel of genetic mutations. Because of my age, this is one of the first things that must be ruled out.

Dr. Dudak also ordered a test called a mammaprint, which does a genomic assay on the lesions. This basically means that the test will give me a score that shows the cancer’s potential future recurrence. A high score will most certainly mean chemotherapy.

So, the question of whether I need surgery and no chemo, or surgery first and then chemo, or chemo first and then surgery (with a touch of radiation for shits and giggles) is still up in the air, but these questions should be answered when I meet with my bewb dream team. Yes, that is what I shall call them henceforth.

Being newly diagnosed is confusing as hell.