Results

So here we are May 20th Tuesday- 8:45am. I meet with Dr.Scarth for the first time with his nurse. Has to feel the tumour again. Goes over the results. Which I have no idea what most of it means.Triple Negative? milk ducts, invasive...bla bla bla. I smiled with a brave face and let God guide me through a haze of medical terms. They through alot at you but yet not the full story, because really you are still in shock. I met my Navigator. Kathy Woodhouse, A nurse Case Manager Breast Health Program specially assigned to guide you through the cancer process, especially in the beginning. Very nice lady, She gave me lots of info. I started a binder to keep dates, appointments, and information. She said at this point there will be surgery, MRI, CATSCAN, lymph nodes checked, chemotherapy...but it was all still sort of up in the air, except the tests and surgery. A particular  sheet she gave me was about what was going on with my breast tumour. It was titled "Infiltrating Ductal Carcinoma" an invasive cancer that has grown through a duct wall. It accounts for 60% of all cases. She said that a cancer cell could be very small and not detected on my 2008 mammogram, usually when you get over a certain size they can estimate that it has been about 6 to 8 years in the making. I realized that I wasn't getting the mammogram that day and got the call I think to come back the next day Wednesday. So of course I go home start looking into what TRIPLE NEGATIVE means...

Triple Negative Breat Cancer

So I am at home and started to research, my form of control over the situation. Even though a cancer survivor and friend Almira told me its not a good idea. I kind of agreed after I read about what I had...Below are snippets from the internet. When they do a biaposy they take a sample of your cancer tumor to test it for receptors- they call the results the pathology report.

Receptors:  "to understand triple-negative breast cancer, it’s important to understand receptors, which are proteins found inside and on the surface of cells. These receptor proteins are the “eyes” and “ears” of the cells, receiving messages from substances in the bloodstream and then telling the cells what to do.

• Hormone receptors inside and on the surface of healthy breast cells receive messages from the hormones estrogen and progesterone. The hormones attach to the receptors and provide instructions that help the cells continue to grow and function well. Most, but not all, breast cancer cells also have these hormone receptors. Roughly 2 out of 3 women have breast cancer that tests positive for hormone receptors. 

• A smaller percentage of breast cancers — about 20-30% — have too many HER2 receptors. In normal, healthy breast cells, HER2 receptors receive signals that stimulate their growth. With too many HER2 receptors, however, breast cancer cells grow and divide too quickly. 

Hormonal therapies and HER2-targeted therapies work to interfere with the effects of hormones and HER2 on breast cancer, which can help slow or even stop the growth of breast cancer cells.
About 10-20% of breast cancers test negative for both hormone receptors and HER2 in the lab, which means they are triple-negative. Since hormones are not supporting its growth, the cancer is unlikely to respond to hormonal therapies

" Your pathology report may say that the breast cancer cells tested negative for estrogen receptors (ER-), progesterone receptors (PR-), and HER2 (HER2-). Testing negative for all three means the cancer is triple-negative.

These negative results mean that the growth of the cancer is not supported by the hormones estrogen and progesterone, nor by the presence of too many HER2 receptors. Therefore, triple-negative breast cancer does not respond to hormonal therapy (such as tamoxifen or aromatase inhibitors) or therapies that target HER2 receptors, such as Herceptin (chemical name: trastuzumab)."

..."In addition, triple-negative breast cancer: Tends to be more aggressive than other types of breast cancer. Studies have shown that triple-negative breast cancer is more likely to spread beyond the breast and more likely to recur (come back) after treatment. These risks appear to be greatest in the first few years after treatment. For example, a study of more than 1,600 women in Canada published in 2007 found that women with triple-negative breast cancer were at higher risk of having the cancer recur outside the breast — but only for the first 3 years. Other studies have reached similar conclusions. As years go by, the risks of the triple-negative breast cancer recurring become similar to those risk levels for other types of breast cancer."

Yup you have my attention now! stupid cancer!

"

Who can get it?: Anyone can get triple-negative breast cancer. However, researchers have found that it is more likely to affect:

• Younger people. Triple-negative breast cancer is more likely to occur before age 40 or 50, versus age 60 or older, which is more typical for other breast cancer types.
• African-American and Hispanic women. Triple-negative breast cancer most commonly affects African-American women, followed by Hispanic women. Asian women and non-Hispanic white women are less likely to develop this type of cancer. A study found that black women were 3 times more likely to develop triple-negative breast cancer than white women.
• People with a BRCA1 mutation. When people with an inherited BRCA1 mutation develop breast cancer, especially before age 50, it is usually found to be triple-negative.

A gene mutation?- well I am not sure, my mom was adopted and I don't know that much about my bio dads family...I will need to look into that further.

Right Breast Mammogram

So back to St. Josephs breast clinic again. Wednesday May 21st 10am. I am ready for this! Mammogram check, and ultrasound check. I start to pray in the waiting room.Go back for another ultrasound as the head doctor looks at the results on one screen and the ultrasound on another. He says yes there are about 5 cysts but not cancerous! which meant no biopsy! what a roller coaster. I was pretty much thinking I would be getting one or several that day. During these days I have been keeping life as normal as possible. Keeping the door open for any questions the kids may have and watching closely how they are doing. I continue to keep my emotions private. Take them top swimming, piano, family day at Catons Island Camp, appointments, what ever they normally would do.When at Catons Island they have this huge climbing wall, I was thinking about it the night before. You know I would love to do that wall but don't like heights. Why can't I do that wall?, it can't compare to being told I have cancer!. I might not have another chance  that wall,. So I did the wall! Anita and I did the darn Wall!!

Picked my mom up from the airport on Thursday May 22 for her to come and help me.  
School is almost over. June 6th is the last day for them. What great timing, thank you Lord! Get the call that my MRI, catscan, and bone scan. The dreaded MRI! which my mother in law calls the "coffin". I dread this- everyone says its so bad, all I know is I have to get a dye injected into me and lay on my stomach. Oh ya and one of Deans cousins had a bad reaction to the dye and got really sick from it! A few hours of tests on June 3rd Tuesday. I can do this!!

MRI and a crazy week

So it's now June and my MRI and other tests are booked for Tuesday at 10:15 AM. Marilee, my neighbour and dear friend, who recently lost her husband to ALS, took me in to the regional this time. I had a hard time sleeping the night before thinking about the "coffin" and the dye that I would be injected with and the fact that the heavy metals in my old tattoos could react to the MRI by burning. It was a long day but seriously nothing to fear. I went to get the contrast injected, that helps outline any abnormalities. For the breast MRI, I had to lay on my stomach with my with my breasts in a holder(see photo I found on the internet). I think it took 45 minutes, I am not sure, I just laid there and listened to the machine wiz and make some banging noises. I could hear the technician talking to me. I had to lay very still. And there seemed to be a blur of time.

A MRI is:  uses powerful magnetic forces and radio-frequency waves to make cross-sectional images of organs, tissues, bones and blood vessels. A computer turns the images into 3-dimensional pictures. An MRI of the breast is not routinely used to diagnose breast cancer, but may be done in certain situations to:

• find the primary tumour in the breast
  • MRI may be used if cancer is found in the axillary lymph nodes or if a woman has Paget disease of the nipple.
• find out the extent of cancer in the breast tissue (local disease)
  • MRI may be used when test results from physical examination, mammography or ultrasound are not clear.
• better examine an abnormality found on mammography
  • MRI may be used if the abnormality cannot be found with other tests, such as a clinical breast exam or breast ultrasound.
  • It may also be used if the abnormality can be seen from only one view of the results of a mammography.

After that I had to get dye injected into me into me for the CAT SCAN or CT scan.

A CT is:  "is an X-ray technique that gives doctors information about the body’s internal organs in 2-dimensional slices, or cross-sections. During a CT scan, you lie on a moving table and pass through a doughnut-shaped machine that takes X-rays of the body from many different angles. A computer puts these X-rays together to created detailed pictures of the inside of the body. Before the test, you need to have a contrast solution (dye) injected into your arm through an intravenous line."

CT scan was not problem. You lay on a bed and get pushed into another donut hole machine that open at both end and is thinner then an a MRI and it just has something in it that wizzes back and forth from side to side.

After that I was sent for a bone scan. A bone scan is: uses bone-seeking radioactive materials (radiopharmaceuticals) and a computer to create a picture of the bones. It is used to see if breast cancer has spread (metastasized) to the bones.

It has open sides and is more square than the MRI or the CT scan.

So that was that, got through the day. So somewhere along this crazy ride someone tells me that surgery with be in August, then June.The next day I met with Walter. I thought it was time enough to get the family burial plots chosen and paid for up on Kirkhill Cemetary. 2 people now that I know are up there. It is just across the road basically and has been there a long time. I wanted to do this years ago, but as usual it just didnt happen. Now, I thought was a great time to do this. Walter C. manages the plots. He said is there anyone you don't want to be next too? lol small town humour I guess! And I said no. He showed me the map. I chose our plots to be next to Marilee and her husband plot. 

Monday June 9th. The kids go on a school trip to Acadia Village. Mom goes with them. Since they will be gone all day, I have booked make up and hair session at Element 5 in Saint John. I get my make up done and then my hair straightened by a really nice lady from Columbia. Her sister died from breast cancer. It is amazing the stories from peoples hearts that you come across once you are open about having cancer. They did a wonderful job at the salon. I could not believe how straight my hair came out and it lasted for a few days.

The next day I go see breast surgeon Dr.Scarth- Tuesday June 10. He tells me all tests were clear. We go over everything as of this day and make plans for what is coming up. I agree to getting a skin sparing mastectomy, which will give me the option to get fat from my belly put into my chest after. At this point I am thinking all this happens at once. Operation and reconstruction. I tell him fake boobs are never an option for me. I will be getting a sentinel Lobe biopsy once they open me up. They will just check a few and if they show anything they will take lots out.

"A sentinel lymph node biopsy (SLNB) is the removal of the sentinel lymph node to see if it contains cancer. The sentinel lymph node is the first lymph node in a chain or cluster of lymph nodes that receives lymph fluid from the area around a tumour. Cancer cells will most likely spread to these lymph nodes. There may be more than one sentinel node, depending on the drainage route of the lymph vessels around the tumour. This test may also be called sentinel node biopsy or sentinel lymph node dissection (SLND)."

The surgeon injects a radioactive substance (radiotracer), a blue dye or both into the tissue around the tumour or into the area from where the tumour was removed.

• The radiotracer is injected anywhere from 1–16 hours before the surgical procedure.
• It takes about 5 minutes for the blue dye to reach the sentinel nodes, so the dye is often injected in the operating room just before the surgery.

The dye or radioactive substance is taken up by the lymph vessels. It travels along the lymph vessels draining the area around the cancer to the sentinel lymph node(s).

A special scanning device detects the radioactivity in the sentinel lymph node(s), or the surgeon looks for the lymph node(s) stained blue.

• Sometimes, the sentinel lymph node cannot be identified.
• If the sentinel lymph node is positive or if it cannot be identified, then more lymph nodes will need to be removed."

So along with all this info I was getting on what was the results and what was going to happen, it was on this day that I learned that my surgery has been moved up to June 19th, yes thats right, a week and a half from now! yup my head was spinning...across the hallway from Dr.Scarth, I go see Kathy Woodhouse again, my cancer navigator...