The last few days have been a roller coaster ride with highs and moments of panic. The swelling and bruising after the biopsy, on the other hand, are minimal with little to no pain. I did try to throw a tennis ball for Dolly (our faithful labrador), but my arm flopped down pathetically at my side as the ball landed at my toes. The look of utter disgust from her sure did make me laugh.
I did get the initial results back on my biopsy and its official, I have my diagnosis: Invasive Lobular Carcinoma, Grade 2 (Grade 2 is the level of aggressiveness, 1-3 with 3 being the most aggressive).
I am still waiting on the immunohistochemistry (Er, PR or HER2) and the staging these follow in the next few days. The kind of cancer I have is rare and not often found in someone my age; it's more typical in woman over 60 years old and post-menopausal. I am none of those but have Invasive Lobular Carcinoma all the same.
Now that I have the diagnosis with knowledge of where it starts and how it travels, it all makes complete sense. Lobular Carcinoma is a type of breast cancer that begins in the milk-producing glands (lobules) of the breast. Invasive cancer means the cancer cells have broken out of the lobule where they began and have the potential to spread to the lymph nodes and other areas of the body.
Sadly, my cancer did break out of the lobes and has invaded my lymph nodes (Metastatic Lobular Carcinoma). Invasive Lobular Carcinoma tends to be more difficult to see on mammograms than Invasive Ductal Carcinomas. That is because instead of forming a lump, the cancer cells more typically spread to the surrounding connective tissue (stroma) in a line formation.
By the time it has made it to the front of the breast and I saw the dimple, it had invaded 80% of the tissue! There is still a lot of data I am waiting to come back, and until my medical team has gathered everything, they cannot finalize my treatment plan.
I did get to meet the man who will be my surgeon. Walking into the oncology ward, I was reminded just how challenging times currently are for us all. The sign welcoming me warns that visitors are not allowed. You must go to every appointment on your own. No one is allowed to sit next to you to hold your hand when you get overloaded with information.
I am not short of comfort; just today I was reminded that I am not alone when I met with my surgeon. A friend of mine sent a wish note to Israel. The wish note was placed in the West Wall, asking for a full and speedy recovery. Coincidentally, I found out my surgeon is Israeli. His strong Israeli accent reminded me of my incredible support network.
Dr. Avisar is wonderful, and I could not be happier with his bedside manner, thorough explanation, and the confidence he gave me during our meeting. He shared a lot of information and cannot say with complete certainly if I will need chemotherapy before surgery, but he suspects not. He seems to favor surgery followed by chemotherapy. The reason is that my kind of cancer does not typically respond as well to the chemo to reduce the sizing. I will likely need the mastectomy and then will be treated by Dr. Vogel, who is the specialist that will prescribe and manage the therapies that go throughout the body like chemotherapy, targeted therapy, or endocrine therapy.
None of these treatments will be finalized until my genetic testing and full biopsy results come back. Dr. Eli Avisar did however find a few more lymph nodes that he fears are infected and has asked me to go for a bone scan to rule out spread to my bones. This has always been a fear, but Sonja and I have decided my bone scan is clear as I have enough to deal with. He also ordered me to have L-DEX sleeve. This will monitor my fluid levels to assist in early lymphoma detection.
Silver Linings:
Melanie keeps reminding me of silver linings and Helene keeps talking about perky new breasts. I did receive a silver lining today; as I am a large-breasted girl, I may be able to undergo reconstruction at the same time as my mastectomy. I am meeting my reconstructive surgeon Dr. Oeltjen and together he and Dr. Avisar will perform the surgery. One surgery will remove my diseased breasts and the other will provide me with the perky new one’s Helene keeps talking about.
The silver lining that my head immediately goes to is how this will really shorten the overall length of my cancer process, getting me back to my life and beloved team and the Addison as quickly as possible. For now, my wish to the universe is for an all-clear bone scan and no genetic markers, as I want a family of women free of the genetics associated with breast cancer.
I walked into work today to be confronted by my desk laden with love. The amazing woman that I have the honor of working with put together a basket filled with such thoughtfulness it made me cry. They read my mind in so many ways. I have had so many thoughts running through my mind since being diagnosed; family and loved ones, work and how I will stay on top of day to day life when I will be at my worst. These ladies have me covered. The beautiful pillow that they printed with the message WE GOT YOUR BACK packed a punch like no other.
The Addison, our couples, and the team that makes magic happen every day has been a labor of love for me for 16 years. I do not want my short-term absence to impact anyone. These words were a message of unity and I can rest easy they have me covered. Their words and support are profoundly comforting. The basket was filled with everything I need from sensible PJ’s to house cleaning services.
They even reached out to a past colleague of ours Kourtney, who is and always will be a member of the Addison family. She also happens to be a talented artist. Her gift and message were not only moving, but it really inspired me. No matter what our faith looks like, we all need to believe. Believing in something greater than ourselves gives us strength in our darkest hours and her message of support gave me a renewed energy to conquer cancer; it was also a profound reminder to believe!
She sent me an Angel to watch over me, a bouquet of flowers to bring me joy, a journal to bring me comfort through writing, and three bracelets to wear as a daily reminder of how strong I am. The first bracelet is a bracelet of hope; the second bracelet has a tree, which is there to remind me of my strength - and to take root in my support system. The third bracelet contains a mustard seed, because of the passage Matthew 17:20.
Driving home, I received a message that I was being nominated by my favorite non-profit (Boca Helping Hands) to be a Tiffany Hometown Hero. The nomination was for my efforts during these crazy COVID-19 times. Please know these efforts were very much a team effort, but the day left me choking back tears for the umpteenth time today - not because I was scared or sad, but because I am so very blessed to have so much love from so many amazing people. ...and this love and support makes me so very happy and gives me more courage to fight EVEN harder.
My day was amazing and uplifting and the silver linings just kept coming. My cancer is ER (Estrogen Receptor) Positive and PgR (Progesterone Receptor) Positive. It is also HER2 Negative (Human epidermal growth factor 2). This is great news because HER2 positive is a protein that is present that promotes cancer growth. I do not have that protein present.
Next week will be a busy one. The last three pieces of the puzzle are: my bone scan, appointment with my reconstructive surgeon, and appointment with my chemo specialist. Completing these appointments will allow my treatment plan to be finalized just in time to launch The Pink Fight Club that will share my journey - but more importantly, will aim to give back.