Cancer Call 12/2

On Friday, 12/2, I got a 5-minute phone call from the nurse at 4:30 who hurriedly explained that based on the biopsy I have stage 3, fast growing breast cancer with metastases in lymph nodes. This breast cancer is "triple negative" and can't be easily treated with hormonal therapy (whatever that means). 

The next steps would be to do an MRI and a CT scan to see if the metastases have spread to any other part of the body. But, alas, it is Friday evening, so she plans to work with scheduling all of these tests sometime next week. 

"Have a great weekend," to be brief and to the point. 

Oh joy, what a delightful surprise to receive a cancer diagnosis at the end of Friday! It's the perfect way to end a long week, isn't it? You can just sleep it off over the weekend and wake up fresh as a daisy on Monday, ready to tackle the next step in your journey. Nothing like a little cancer to add some excitement to your life, am I right?

Good thing that I have a stable psyche and to some degree I was prepared, because of all of my self-diagnostics with Doctor Google. 

And I am off to Doctor Google to figure out what is the "triple negative cancer". This is a less common, fast-growing type of cancer, with a limited number of treatment options that occurs in 12%-15% of the population, with high likelihood of reoccurring... 

Now I will wait for the official explanation with the oncology team in a week, shouldn't just trust some Google search.

Official Biopsy Result

Diagnosis  A. 

LEFT BREAST 1 OCLOCK : INVASIVE CARCINOMA

HISTOLOGIC TYPE: INVASIVE DUCTAL CARCINOMA

GRADE 3/3, AT LEAST 10.0 MM IN LENGTH, INVOLVING MULTIPLE CORES 

Breast Biomarker Report for Invasive Carcinoma (ER/PR/Her2-neu):

Estrogen Receptor (ER) Status Results: Negative

Internal control cells Present and stain as expected

Progesterone Receptor (PgR) Status Results: Negative

HER2 (by immunohistochemistry) Results: Negative (Score 0)

Biopsy 11/29

Biopsy. Breast biopsy is a procedure in which a small sample of breast tissue is removed and examined for the presence of cancer or other abnormalities.

Numbing, long needle guided by ultrasound screen going in, the loud clicking sound when the tissues are cut (very Harry Potter Aragog clicking) -- 5 samples from the breast. I imagined myself on the forest floor of The Forbidden Forest looking for something...

A breast biopsy, you see, is like a treasure hunt where the chest is the chest and the treasure is, well, not treasure at all. Instead, it's a tiny little lump that could be causing quite a lot of trouble. But unlike a treasure hunt where the goal is to find riches, the goal of a breast biopsy is to find peace of mind and hopefully, a clean bill of health.

So now wait and see.

Then the process repeats again for the lymph tissues. Again 5 samples. Lots and lots of sticky tape and ice packs and you are off.

Well, it is not pleasant, but the three medics that performed it in the basement of the clinic were very efficient, kind and considerate. They dutifully chatted away with me about kids, travels and shopping, while my left hand went numb from having to hold it above my head. 

Instead of the scheduled two hours, they managed to get everything done in one.

Self-diagnostic route

After the ultrasound scan and the pictures on the screen of several noticeable black masses, especially in the lymph nodes, and while waiting for results, I did the next best thing -- doctor Google. 

Several hours later, I already self-diagnosed myself with breast cancer, but decided to wait for the official biopsy results and not to panic too early. 

Biopsy results are not quick as they take multiple sample tissues and than the pathologist regrows the cells to figure out if the cells are cancerous, and, if yes, what type.

Ultrasound 11/18

Finally, the day of the appointment  -- familiar basement radiology department 

The procedure itself is relatively painless. During the diagnostic I was told that there are two dark masses --- left breast (known) and lymph nodes (arm pit) and, as predicted, I would need a biopsy... (was telling them all along)

The famous health care protocol kicks in. I can't just schedule a biopsy, as now I have to have a separate appointment with breast specialist within the Lahey clinic, who would then schedule the actual biopsy. There is no other way according to Lahey Clinic.  And, as it is an appointment, there is another week worth of waiting.

At least, here I got lucky -- there was a cancelation that same day 11/18 (4 hours later)

The appointment was a waste of time -- took the vitals, looked at the ultrasound results -- didn't say anything new  -- half a day later, I finally got the biopsy scheduled to the next available on 11/29. 

First Results

As per instructions, I signed up for the Lahey portal and now would get results notifications the same day they became available -- so wouldn't need to wait for the doctor to view them and then reach out to me several days later. 

2 days later, 10/31 the results were in: inconclusive, require follow up diagnostic and ultrasound mammogram as we knew from the get go....

Spent several days writing and calling my primary care doctor to get that additional referral.

Now, in my head, it would make sense to just do a biopsy right-a-way, as the ultrasound is required in order to get the tissues anyway and the lump is there and the only way to figure out if it is benign or not is via biopsy. 

But nothing is that easy or logical -- according to the protocol, I first need to get a regular ultrasound and only after that get another referral to be able to schedule a biopsy.

The first available regular ultrasound appointment was 11/18, because, it seems, there is a shortage of ultrasound technicians.