I April of 2007 I was diagnosed (dx) with Adenocarcinoma or Invasive (infiltrating) Ductal Carcinoma (DCIS). My breast cancer was of the triple negative (TNBC) variety meaning that it was not positive for receptors of progesterone, estrogen and Her2Nu. The tumor was large and aggressive. It seemed to be attaching (pulling on) to the chest muscle. So, it was preliminarily staged at IIIA. They were not sure about how the nodes were affected, but are concerned about the aggressiveness, the size (over 5 cm considered a T3), the triple negative and the involvement with the chest muscle.

Treatment (tx) for this cancer included 6 months of neoadjuvant chemo therapy from April to October 2007. 3 months of weekly ACT followed by 3 months of Taxotere. Then, shortly after chemo was over I had a mastectomy (November 2007) followed by 8 weeks of daily radiation treatments (January-February 2008). It looked to be a clean bill of health and March 2008 was a month for celebration! I had my port removed thinking I would not need it anymore. I had a mammogram in April 2008 and things looked good.

In May I visited my regular doctor because I was having bronchitis type symptoms. I was coughing a lot. He told me it was probably just bronchitis and it would go away. When it did not go away, I started investigating and thought I might have Radiation Pneumonitis. I went back to my regular doctor and after messing around for a few visits and starting steroids, he did some chest x-rays. By this time I decided to go to one of my cancer doctors. My oncologist (Dr. P) was on maternity leave, so I went to see my radiologist who is very good. He agreed that I probably had pneumonitis in some small areas of my lungs. I also showed him a spot on my stomach that looked somewhat like a boil that had popped up over the last month or two. After looking at the chest x-rays, he was a bit suspicious of some of the lymph nodes around my airways, so we did a PET scan. Sure enough I lit up. There were spots in the lymphs and in the lungs. So it was biopsy time!

I had the biopsy on August 1st, 2008. The biopsy was not enough to tell if the cancer is still the exact same type, but it is breast cancer and they are assuming that it is still triple negative adenocarcinoma. So here we go again.

At this time I am not sure what stage this is, but since it has metastasized, I would assume it is Stage IV. Once again a good place to learn more about this if you are interested is the American Cancer Society web site. Tipple negative type Breast Cancer is a more aggressive type than those that have positive receptors.

This time it is a recurrence and I think they would not call this a “localized recurrence” as it has spread to the lymph system (near the lungs and airways as well as probably under my right arm) and to some small extent the lungs. So this is called metastatic cancer and will be much harder to fight. I do feel that we caught it early and I am lucky as it is still small spots of cancer and not a massive amount.

I got a new Oncologist based on recommendations from my Oncologist (Dr. P) via email from her maternity leave. I think he will be good for me as he seems to take the time to talk with me and help me to understand things. Here is a bit of what he told me. I have metastatic breast cancer, meaning it has spread from the breast to other parts of the body. At this time it is confined to my chest area, my lymph nodes around the lungs and about 3-4 small cancerous nodules within my lungs. The plan of attack is chemo therapy with a different set of drugs (CMF) than we used during the first go round. As many of you probably know, Metastatic breast cancer is not curable. Best case scenario, they can put me into remission and I will need to be monitored for my whole life. When it comes back, I will go through the whole thing again. Worst case scenario, the chemo does not work and the cancer continues to grow and spread. Then they have to try different things to see if they can stop it. Let’s hope for the best case scenario. I also went back in to have my infusion port put back into my chest on August 26th. This should make things easier, but damn, I just got it out in March!

So, with Dr. H, I started Chemo on August 15th with the CMF protocol. I was supposed to get it every 3 weeks for 6 months. After the first 3 weeks it was determined that is was probably not working as the tumor on my stomach had gotten a bit bigger, redder and was now causing me some pain as well as some pain in the area under my right arm (the side where they took my breast). So, on September 5th, we changed protocols. I am now on Gemcitabine (Genzar) (1960 mg) and Carboplatin (CBDCA) (650 mg). I get both on the first week and then 8 days later get the Germcitabine again. Then IO get a week off and start the cycle again. These are all intravenous, so chemo last about an hour, not too bad.

At this time Dr. H decided to get another base line CT scan to see where things stand. Today (September 12th) is the 8 day chemo day so I got my Germcitabine and talked to the Nurse practitioner about my CT scan from Tuesday. I now have a copy of the results of that scan and it looks like we guessed correctly. The cancer has grown a bit, although it is only a small amount and in some place it may have actually shrunk or made no change. So I do not think it is time to panic just yet!

I do feel like this new treatment is working better than the last as the tumor on the outside is not as red and does not hurt like it did two weeks ago. So, this may be a positive sign. We will just have to wait and see. As for now, I am handling the chemo well. I am working full time and teaching two classes online, so I guess I am holding up.

Thanks to everyone for all the thoughts and prayers. They all help to heal the soul and encourage the body to follow along!

For those of you looking for additional information about all this, here are some links that may help. I am also collecting some of them here for me that I thought were particularly interesting and I want to go back and take some time with.

Good descriptions and some breast cancer lingo that will help you decipher some of the other sites: http://www.cancer.org/docroot/NWS/content/NWS_1_1x_Stubborn_Form_of_Breast_Cancer_Linked_to_Age_Race_Ethnicity.asp

A site specifically for TNBC: http://www.tnbcfoundation.org/index.html

This is an interesting article and quick video from CNN that has some information: http://www.cnn.com/2008/HEALTH/conditions/06/16/hm.triple.neg.breast.cancer/index.html

This is a pretty good article from DR. Susan Love on TNBC: http://www.dslrf.org/breastcancer/content.asp?L2=6&L3=5&SID=381

ABC News has a site about Breast Cancer. I especially liked the Girlfriend section:
http://abcnews.go.com/Health/OnCallPlus/