And We're Off!

So I had my first appointment with a breast cancer surgeon this morning. People are curious about what I found out and how the visit went. Rather than inundating my friends’ Facebook feeds with incomprehensible medical lingo, I figure I will dust off this old blog to share info with those who are concerned/worried/freakishly curious.

The appointment was interesting this morning. We were given a ton of information—most presented in a way that was both kind and informative. We both really, really liked the surgeon, which is odd since Ruanita does not like people as a general rule, and I wasn’t exactly feeling generous in that department this morning either. We learned a lot. We discussed a lot. And yet, miraculously, there is even more we still do not know.
 

Welcome to cancer, huh?
 

So here’s the skinny. We are not sure at this point yet what type or grade of breast cancer I have. The doctor said that my cancer has a “difficult” presentation, to which Ruanita responded, “Fuck yeah, Shannon’s difficult!” But I don’t think that’s quite what the doctor meant. There are certain factors pointing to one type of cancer and certain factors pointing to another—hence the “difficult” description.
 

Here are the positives:

1. The tumor in my breast is only 1.8 cm wide, which is a relatively small tumor.
2. The tumor is a grade 1 tumor, which means that the cancer cells look the most like regular breast cells (grade 3 cells would be the most abnormal, jacked up cells, so grade 1—though grade really doesn’t affect treatment decisions—is a good thing and I’ll take it)
3. The cancer tested both estrogen-receptor positive and progesterone-receptor positive. This sounds bad to get a positive test result, but it is actually a good thing because it means that the cancer can be treated hormonally. One more weapon in our arsenal.
4. The cancer tested HER2-negative. HER2-positive breast cancers tend to be more aggressive than other types of breast cancer. So I will take a negative result here!

Here are the not-so-positives:

1. My cancer presented with redness, swelling, and thickening of the skin of my breast. In a way, this is good because it was these symptoms that forced me to seek out treatment and ultimately led to finding the cancer. However (there’s always a however, I am quickly learning), these symptoms are indicative of a rarer, highly aggressive form of cancer known as inflammatory breast cancer. Inflammatory breast cancer typically is classified as a stage 4 breast cancer.

So this is the conundrum we find ourselves in. All of the positives mentioned above point to a relatively small, easily treatable cancer that would likely be classified as stage 1 breast cancer. However, relatively small, easily treatable stage 1 breast cancers typically do NOT present with redness, swelling and thickening of the breast skin. However (that word again!), if we are dealing with a highly aggressive inflammatory breast cancer, the doctor would expect to see a larger tumor, grade 3 cancer cells, and tests results showing a triple negative (estrogen-receptor negative, progesterone-receptor negative, and HER2-negative.)
 

So…we are all scratching our heads a bit saying, “What the fuuuuuuck….?”
 

Before we are able to plot a course of treatment, we need to figure out what we are dealing with. The doctor did a skin biopsy today to check for cancer cells in the skin of my breast. (I now have two holes in my breast. Good times.) I will get those results on Monday since today is Friday (not feeling the typical TGIF today). If there are cancer cells present in the skin biopsy, we are likely dealing with inflammatory breast cancer. If not….drum roll please…we DO NOT KNOW with certainly whether it is inflammatory breast cancer or not. So, doing the math, the only news I can possibly receive on Monday will be bad news or no news.
 

I am scheduled to have a PET scan and an MRI on Tuesday. These should give the doctor a more definitive idea of what we are dealing with and we can plan accordingly. If we are looking at a stage 1 cancer, the first step will probably be surgery (lumpectomy or mastectomy [single or bilateral] – my choice) followed by radiation treatment (definitely with a lumpectomy and possibly with a mastectomy). If we discover that I have the more aggressive inflammatory breast cancer, I will likely skip surgery for now and start chemotherapy.
 

So that is where we stand right now. Lots of information shared. Very little concrete knowledge accumulated. I either have a best-case scenario cancer—if such a thing exists—or a very rare, highly aggressive cancer. Go big or go home, huh?
 

Oh yeah, and I got a handy-dandy pink ribbon tote bag in which to carry the packet of information I received. I immediately handed it to Ruanita. No way in hell am I toting around a pink ribbon bag!