May 2009

I have an annual breast ultrasound because of my mother’s cancer history. This year a lump was found in my right breast (I didn’t know it was there). I had two breast biopsies. The first one didn’t work. The second was done with a fine needle, which is inserted in and out of the tumour to collect some cells. The other technique used is a core sample, which is taken by what feels like a staple gun. This returned the result:

15th

Diagnosed with ductal invasive early stage breast cancer in my right breast. Basically there’s ductal and lobular breast cancer and my cancer spread outside the milk duct into surrounding breast tissue, hence the term ductal invasive breast cancer.

22nd

Lumpectomy to remove cancerous tumour and surrounding tissue, and a sentinel node biopsy.

A sentinel node biopsy means surgery to remove the sentinel lymph node or nodes. There can be more than one sentinel node. The sentinel node is the first lymph node that breast cancer cells may spread to outside the breast. In most cases, the sentinel node is in the armpit.

The technique to find the lymph nodes is to inject a blue dye around the breast cancer. The injection is given in the operating theatre just before breast surgery. The surgeon can see and remove the sentinel node because it turns blue when the dye travels to it.

Information taken from National breast and ovarian cancer centre (www.nbocc.org.au/breasthealth/treatment/biopsy.html, accessed July 12th 2009 at 14:20).

25th

Surgery is successful. The margins are clear, meaning the tissue taken from around the cancerous tumour and some of the tissue attached to my chest wall came back negative of cancer. Nine sentinel lymph nodes were removed from my armpit.

Breast cancer diagnosis: 10.5mm grade 2 invasive ductal carcinoma with intermediate nuclear grade ductal carcinoma in-situ (DCIS). One out of nine sentinel nodes showed metastases (i.e. there’s cancer away from the site of original breast cancer). The sentinel node with cancer was 4mm.

My breast cancer is triple positive, meaning it responds to oestrogen receptors, progesterone receptors and the HER2 protein. So, for me there’s a few treatment options:

1. Chemotherapy to mop-up any cancerous cells that haven’t been detected in the rest of my body (let’s call it being safe or just in case).
2. Hormone Therapy to treat my oestrogen and progesterone sensitivity i.e. suppress my oestrogen (progesterone will follow) and send me into early menopause. I’ll be on this treatment (varying kinds of it) for five years.
3. Herceptin drug to zap HER2 proteins.
4. Plus further surgical intervention. I’ve decided to have a double mastectomy, reconstruction next year to further increase my chances of breast cancer not returning.

N.B// Chemotherapy goes first, followed by radiotherapy (I’m not having it because of mastectomy decision), then Hormone Therapy. Surgery not a great idea during chemotherapy due to compromised immunity.

29th

Bone and thoracic CT scans – normal. No evidence of metastasis i.e. the cancer cells don’t appear to have spread from my lymph nodes to other parts of my body.

June 2009

3rd

Genetic testing for BRCA 1, BRCA 2 came back negative (excellent news). There’s a familial, unspecified (meaning don’t really know what it’s called or what it is) cluster for my breast cancer, that I’ve inherited from my mother. Unlike BRCA 1,2 gene mutations, which if you have them means you’re highly likely to develop breast and ovarian cancer (nasty ones at that). In summary: I got breast cancer at 35, and my mother got it at 46. I’ve inherited the tendency to get breast cancer, but it is not BRCA1 or BRCA2.

12th

Portacath put into the left side of my chest, above my breast.

Why portacath?
A portacath is an implanted venous access device for patients who need frequent or continuous administration of chemotherapy. Drugs used for chemotherapy are often toxic, and can damage skin, muscle tissue, and sometimes veins. They often need to be delivered into a large central vein where the drugs are immediately diluted by the blood stream and delivered efficiently to the entire body. Cancer patients also require frequent blood tests to monitor their treatments. For patients with difficult veins, it can be used for withdrawing blood for blood tests.

What is a portacath? A portacath consists of a reservoir (the portal) and a tube (the catheter). The portal is implanted under the skin in the upper chest. It may appear as a bump under the skin in thin patients, less visible in patients with thicker subcutaneous fat. The catheter runs in a tunnel under the skin, going over the collar bone and then enters the large vein in the lower neck (the internal jugular vein). Since it is completely internal swimming and bathing are not a problem. The septum of the portal is made of a special self-sealing silicone rubber. It can be punctured up to one thousand times and therefore can be used for many years.

15th

Echo cardiogram – I have a heart, it beats well and there’s no apparent problems here (good).

26th

Chemotherapy started. My drug regimen is:

• Taxotere
• Carboplatin
• Herceptin

July 2009

6th

Hospitalised for five days with viral/bacterial infection – no neutrophils (white blood cells) to combat bugs.