Patience

It is easy to grow impatient when we need something desperately.  I am now a Survivor, NED, No Evidence of Disease/ Remission/ Cancer Free.  Did I say cancer free?  On a visit with my oncologist I asked her the question, "In my case, what terms can I use after the completion of my treatments?"  "Can I use Cancer Free, NED, or Remission?"  She responded that I could use any of these terms.

I am still getting followup MRI's and Mammograms.  At the last mammogram, I waited for the technician to say I was clear to go.  The technician appeared at the door and said they needed to take more images and she would be ready for me in a minute.  A minute seems like a short period of time but forever when you want some answers.  While waiting, for 1 second I had myself back at testing and chemotherapy.  I didn't like what my brain was thinking.  I took a deep breath and told myself to hold on.  The technician took some more views and then I was cleared to go.

I can only believe that God has a plan for me and He will reveal it in Divine Time.   I will have to learn this as I go to each follow-up appointment with apprehension.

Mammogram Showed Cancer May 10, 2016

Today a year ago is when I went for my routine mammogram. I had my mammogram, went back to the waiting room. Waiting for that "all clear" the technician came back and said the doctor wanted more pictures. No worries I thought. The technician came out again and said the doctor wants to see you. He said I am so sorry, from what I've seen I believe you are in the realm of having breast cancer by 85%. I, of course was in shock. I went home, told my husband and prayed to be in the 15%. It's a year later, many biopsies, tests and scans, 2 lumpectomies. HER2 positive, ER+ (5%) PR-, IDC and DCIS cancers. I completed chemotherapy and radiation.  I will be getting Herceptin until the end of July 2017. I have gone to lymphedema therapy to learn exercises for my arm, to stretch out the muscles.  I will be taking anastrozole for 5 years to take the estrogen out of my body.  I am now working on my "new normal". This past month has been filled with many emotions. I am a person who is strong through an event and then cries later. I have been positive during my journey, I just believe my emotions are built up and need to release. This journey is a form of grieving.

This article explains it well

http://www.webmd.com/breast-cancer/features/life-after-breast-cancer-treatment#1

“Life after breast cancer means returning to some familiar things and also making some new choices.

The song says "It ain't over 'til it's over," but when you've had breast cancer, you discover that it's not even over when it's over.  The day of your last radiation treatment or chemotherapy infusion doesn't mark the end of your journey with breast cancer.

Instead, you're about to embark on another leg of the trip. This one is all about adjusting to life as a breast cancer survivor. In many ways, it will be a lot like the life you had before, but in other ways, it will be very different. Call it your "new normal."

"Chemobrain" and Other After-Effects

You watched the last dose of chemotherapy drip from the IV into your veins six months ago. Your hair has really started to grow back. So why are you still so tired? When are you going to feel like you again?

"Your body has just been through an enormous assault, and recovery is a huge thing. You're not going to just bounce back right away," says oncologist Marisa Weiss, MD, founder of Breastcancer.org and the author of Living Beyond Breast Cancer. "You've been hit while you're down so many times: with surgery and anesthesia, perhaps with multiple cycles of chemotherapy, perhaps with radiation."

Two of the biggest hurdles women with breast cancer face post-treatment are fatigue resulting from chemotherapy and/or the accumulated effects of other treatments, and a phenomenon some women have dubbed "chemobrain" -- mental changes such as memory deficits and the inability to focus. If you tried, you probably couldn't pick two more frustrating and troubling side effects for women handling busy lives, managing careers, and caring for families.

"You expect them to go away as soon as treatment ends, and they don't,"

How long after breast cancer treatment ends can you expect fatigue, "chemobrain," and other post-treatment side effects to persist? Everyone's different, of course, but as a general rule of thumb, Weiss tells her patients to expect a recovery period about the same time from your first "cancer scare" moment to the date of your last treatment. So if you found a lump or had a suspicious mammogram in April, and had your last radiation treatment in December, it may be August or September of the following year before you reach your "new normal."

"Even then, that doesn't mean that you're fully back to yourself again.  Ongoing treatments, hormone treatments, like arimidex, can affect the process.

Breast cancer survivorship is a marathon, not a sprint. That means learning to handle the symptoms that stick around after treatment ends.

Entering the Stage of Confusion

My breast MRI had shown an additional area of concern.  I had a biopsy of a suspicious lymph node under my left arm.  Those results came back that it was benign.  Surgery date was scheduled for the 30th of June.

A radiologist who initially read my breast MRI was concerned about another area.  On Jun 27th I was scheduled for a breast biopsy.  The suspicious area was around 10 - 11 on the clock dial.

I went into the ultrasound area and the technician tried her best to locate the spot of concern.  She really did not find the spot however took some pictures in that area.  A radiologist came in.  On a shallower spot, she found a lymph node.  She said it appeared to be a benign lymph node.  She then compared this image to a previous mammogram in 2011.   It was determined to be a benign lymph node and I was told they wouldn't be doing a biopsy.
Sounds great right?    It was very confusing.  I was thinking "so now what".  The next day the surgeon called and I was rescheduled for the biopsy and my surgery date was moved to July 5th due to results coming back in 2 days later.

I could now enjoy my 4th of July weekend with family and friends.  On the other hand I just wanted to get this surgery behind me.

The biopsy came back benign and surgery was on for July 11, 2016.

Tests, Tests and More Tests

On June 10th I had CT Scans and Bone Scans - They came out Negative for showing other cancer in my body.


Jun 13th = Echocardiogram

On Jun 15th I met with my Oncologist and she talked about the role of chemotherapy and radiation.

On Jun 16th we met with my surgeon to discuss options after all of the testing came back.

Jun 17th I had my port placement.

• Implantable port or port-a-cath. A surgeon or radiologist puts in a port, usually with local anesthesia or conscious sedation. The catheter goes under the skin of your chest or upper arm. 

A port is completely under your skin. You might see or feel a small bump on your chest or arm. But you will not see the tip of the catheter. To give treatment, your nurse may first numb the skin with a cream. Then, your nurse cleans the skin and puts a needle into the port. Treatment or blood samples go through the needle.

Benefits of catheters and ports

A catheter in the upper arm or neck can stay in place for weeks or months. Your team can use it to:

• Reduce the number of times a nurse or other team member sticks you with a needle. Health care team members call this a needle stick. This helps if you have small or damaged veins. These veins are often harder to take samples from. A catheter can also help if you need blood tests often or are anxious about needles.
• Give blood transfusions or more than 1 treatment at once.
• Reduce the risk of tissue and muscle damage. This can happen if medication leaks outside a vein. Leaking is more likely with an IV catheter.
• Avoid bruising or bleeding if you have bleeding problems, such as low platelet counts.
• Lets you have some chemotherapy at home instead of the hospital or clinic. Continuous infusion therapy is given this way.

Ports can remain in place for weeks, months, or years. Your team can use a port to:

• Reduce the number of needle sticks.
• Give treatments that last longer than 1 day. The needle can stay in the port for several days.
• Give more than 1 treatment or medication at a time. If this is done, the port has 2 openings.
• Do blood tests and chemotherapy the same day with 1 needle stick.

Genetic Testing My Testing came back Negative - Great News !~

Three of the most well-known genes that can mutate and raise the risk of breast and/or ovarian cancer are BRCA1, BRCA2, and PALB2. Women who inherit a mutation, or abnormal change, in any of these genes — from their mothers or their fathers — have a much higher-than-average risk of developing breast cancer and/or ovarian cancer. (Abnormal PALB2 genes are suspected to raise the risk of ovarian cancer, but larger studies need to confirm that risk.) Men with these mutations have an increased risk of breast cancer, especially if the BRCA2 gene is affected, and possibly of prostate cancer. Many inherited cases of breast cancer have been associated with mutations in these three genes.

The function of the BRCA and PALB2 genes is to keep breast cells growing normally and prevent any cancer cell growth. But when these genes contain the mutations that are passed from generation to generation, they do not function normally and breast cancer risk increases. Abnormal BRCA1, BRCA2, and PALB2 genes may account for up to 10% of all breast cancers, or 1 out of every 10 cases.

Most people who develop breast cancer have no family history of the disease. However, when a strong family history of breast and/or ovarian cancer is present, there may be reason to believe that a person has inherited an abnormal gene linked to higher breast cancer risk. Some people choose to undergo genetic testing to find out. A genetic test involves giving a blood or saliva sample that can be analyzed to pick up any abnormalities in these genes.

Genetics counseling was quite interesting.

Genetics is a small portion of breast cancer cases.

What to Do if Your Genetic Test Results Are Negative

The following recommendations are based on currently available but admittedly limited information — and common sense.

If your family has a defined breast cancer gene abnormality but you test negative for the abnormality, your risk of breast cancer is considered to be equal to that of a woman in the general population: 12-13% over the course of your lifetime. Men who test negative for a known breast cancer gene abnormality have the same very low risk of developing breast cancer as men in the general population. Whether you are a woman or a man, testing negative also means that you could not have passed the genetic abnormality on to your children.

As a woman considered to be at average risk of developing breast cancer, you can follow the screening and lifestyle guidelines recommended for most women:

Practice regular breast self-examination and get annual or semiannual clinical breast exams (depending on your doctor's recommendation).

Have screening mammograms following the current guidelines for women of average risk: a baseline mammogram at age 40 and annual mammograms after age 40.

Maintain a healthy lifestyle: eat a low-fat, well-balanced diet, exercise regularly, keep your weight under control, and minimize your intake of alcohol. These strategies will improve your sense of well-being and general health and possibly lower your breast cancer risk.

Breast MRI Jun 6th

Magnetic Resonance Imaging (MRI) - Breast

Magnetic resonance imaging (MRI) of the breast uses a powerful magnetic field, radio waves and a computer to produce detailed pictures of the structures within the breast. It is primarily used as a supplemental tool to breast screening with mammography or ultrasound. It may be used to screen women at high risk for breast cancer, evaluate the extent of cancer following diagnosis, or further evaluate abnormalities seen on mammography. Breast MRI does not use ionizing radiation, and it is the best method for determining whether silicone breast implants have ruptured.

6/6/16 - Findings:

There is mild background breast parenchymal enhancement. The breast composition is scattered fibroglandular elements. There is an approximately 7 mm x 8 mm x 7 mm, mildly irregularly marginated, heterogeneously enhancing mass, with mixed slow progressive, plateau and washout type internal enhancement kinetics, in the anterior depth of the parenchyma of the 6:00 to 7:00 radian of the left breast (e.g., series 8003, image 136), and with a HydroMARK biopsy marker abutting its superior margin; this is the known sonographically evident recently biopsied invasive breast carcinoma.

Also noted are multiple, sub‐1 cm in mean diameter, areas of clumped nonmass enhancement, with slow progressive type internal enhancement kinetics, scattered in the anterior depth of the parenchyma of the left breast from the 6 o'clock through the 10 o'clock radians (e.g., series 8003, images 568‐614), and which are likely sites of multifocal, and possibly even mildly multicentric, DCIS. This nonmass enhancement pattern partially corresponds to the recently biopsied malignant pleomorphic segmentally distributed left_ breast calcifications seen on mammography but also suggests that the mammographically evident calcified DCIS may slightly underestimate the extent of residual DCIS in the patient's breast.

LDex Screening

http://www.breastcanceranswers.com/ldex-score-how-it-helps-to-monitor-lymphedema-risks/#.V2qJcrgrKCg

This is about an LDex.