Rhandom Schittshowe Cancer Journey

Trip List Calendar

2023-11-20 : Mammogram and Ultrasound
BILATERAL SCREENING MAMMOGRAPHY WITH TOMOSYNTHESIS
HISTORY: Screening.
COMPARISON: March 10, 2021.

FINDINGS
ACR Breast Density Category C: Heterogeneously dense, which may obscure small masses.
No suspicious masses, microcalcifications or architectural distortions seen.

IMPRESSION
No mammographic evidence of malignancy. Yearly mammogram screening recommended.
Due to breast density, supplemental breast ultrasound has been scheduled with the patient at Insight
US AUTOMATED BREAST ULTRASOUND
HISTORY: Supplementary ABUS as requested.
TECHNIQUE: Multiple, continuous axial 1 mm image series were obtained through both breasts and reviewed with multiplanar reformatting software.

FINDINGS
Right Breast: Hypoechoic mildly irregular area measuring 6 mm at 8:30N3.
Left Breast: No concerning solid or cystic masses.

IMPRESSION
1. Questionable lesion at 8:30N3 in the right breast.
2. Characterization with hand-held ultrasound will be arranged.
BI-RADS 0: Need additional imaging evaluation

Note: When they called me back for additional imaging, they said that "they didn't get a good enough picture the first time". They didn't indicate that they saw something. I asked if it was ok if I went to Mexico for the winter (we were scheduled to leave on Dec 4), and they said sure - no problem.


2024-03-04 : Targeted Ultrasound
TARGETED RIGHT BREAST ULTRASOUND
HISTORY: Followup to ABUS.

FINDINGS
Corresponding to findings on ABUS at 8 o'clock 3 cm from the nipple in the right breast, there is a small mass with irregular margins measuring 10 x 7 x 9 mm. It is wider than tall.

IMPRESSION
Suspicious mass in the right breast as discussed above. Biopsy of this lesion has been arranged for March 7, 2024 at 2:30 pm.
BI-RADS 4: Suspicious abnormality - biopsy should be considered
This patient has findings that require follow-up or additional investigations. Attending physicians can refer this patient to the Comprehensive Breast Care Program (CBCP), Alberta Health Services and Covenant Health. The program supports physicians and patients through the diagnosis and care of breast disease.

Note that when I went in for this targeted ultrasound, I felt like I was the only person in the room who didn't know that I was there because they "saw something" in November.


2024-03-07 : Biopsy
US BREAST BILAT AXILLA BILAT
HISTORY: Right breast 8N3, 9 x 6 x 8 mm solid mass. Query malignancy.

FINDINGS
Lobulated, hypoechoic mass in the right breast at 8N3 measuring 9 x 6 x 8 mm.
No other suspicious mass in the right breast.
No suspicious mass within the left breast.
Axillae: There is no adenopathy.

ULTRASOUND-GUIDED BIOPSY BREAST RT 1 SITE
Technique: Ultrasound-guided large core biopsy.
Informed written and verbal consent were obtained after risks and benefits of the procedure were explained.
Under sterile technique and local anesthesia, samples were obtained as follows:
Right breast, 8 o'clock, 3 cm from nipple
Dimension of Lesion: 9 x 6 x 8 mm
Core Samples: 4
Biopsy Marker: No clip placed.
Associated Calcification (TR, AP, CC): None


2024-03-13 : Diagnosis
SUMMARY OF PATHOLOGY: Invasive ductal carcinoma.
Radiology-Pathology: Concordant.
BIOPSIED BREAST MASS AND/OR ARCHITECTURAL DISTORTION
Lesion #1
Side: Right
8 o'clock, 3 cm from nipple
Size: 9 x 6 x 8 mm
Multiple Lesions: No
AXILLA
Suspicious Lymph Nodes on Ultrasound: No adenopathy.
RECOMMENDATIONS/FOLLOWUP:
Lesion in the right breast at 8N3 corresponds with invasive duct carcinoma and surgical referral is suggested.
ER+ = 5 (moderate)
PR-
HER2+ = 3+ (high)
Grade: 2
Stage: ??


2024-03-14 : Call from GP
GP phoned to notify me of diagnosis


2024-03-17 : Pathology Report
A. Left breast, mastectomy:
- Benign breast tissue with focal fibrocystic changes, periductal chronic inflammation, apocrine metaplasia, and stromal fibrosis
- Focal intraluminal calcifications
- Benign overlying skin with focal hemangioma and seborrheic keratosis
- Small portion of attached benign skeletal muscle
- Negative for atypia or malignancy

B. Right breast, mastectomy:
- Invasive ductal carcinoma, NOS; Nottingham grade 2/3
- Maximum size: 9 mm
- Background ductal carcinoma in situ (DCIS), estimated field diameter at least 20 mm
- All surgical resection margins negative for malignancy
- AJCC stage: pT1b-pN1a(sn)

C. Lymph node (right axilla sentinel node #1, reading 8740), biopsy:
- One of two lymph nodes positive for metastatic carcinoma (1/2)
- Maximum size: 4 mm
- Negative for extranodal extension

D. Lymph node (right axilla sentinel node #2, reading 980), biopsy:
- Two benign lymph node (0/2)
- Negative for malignancy


2024-03-22 : Surgeon Consultation Scheduled
Comprehensive Breast Care Program provided a LOT of information, and scheduled surgical consultation. They gave me a 60+ page document of information of what to expect, including... a FLOWCHART! There's almost nothing I love more than a good flowchart. I keep the flowchart handy and refer to it often.


2024-04-01 : Surgeon Consultation NUDES
Scheduled double mastectomy with flat closure and no reconstruction for May 1.
I thoroughly researched the surgery options. My preferences for surgery are:
1) Double mastectomy with (1) Aesthetic Flat Closure, (2) Regular Flat Closure, (3) Fat Grafting or (4) Goldilocks
2) Lumpectomy with radiation
3) DO NOT WANT: Unilateral mastectomy, Implants

I wasn't sure how hard I would have to push to get flat closure. Turned out that, with my surgeon, there was no pushing required - she respected my decision and described how she would achieve aesthetic flat closure.


2024-04-03 : Told my Mom (and Facebook)
I told a couple of friends when I was diagnosed, but other than that I was keeping it tight until I could tell my mom in-person. I didn't want to tell her over the phone or on video. We had some shite weather that kept Brent and me from driving to Red Deer, so the waiting was longer than I had hoped. Telling my mom was harder than getting my diagnosis. Ugh. But, once Mom knew, then I started posting on Facebook.
I'm coping largely with inappropriate humor. One of my favorite things to do is dream up "alternative prosthetics" that I'm going to get in place of my boobs. Here are some favorite ideas:
- Bicycle repair tools on retraction chains.
- Beer taps (would require a backpack with two bladders to hold different types of beer).
- Laser pointers (to play with cats).
- “Bang” flag guns
- Tasers (to protect from robbers)
Facebook Post:
There's no good time, and no easy way to drop bad news, so I'm just going to "out with it".

On March 14, I was diagnosed with breast cancer. On May 1 I will be having a double mastectomy with aesthetic flat closure and no reconstruction. This was not required - I could have had a lumpectomy and radiation, but I chose to go flat. Just wait 'til you see how much faster I'll be at hiking and cycling after...

About two weeks after that I will find out if the cancer has made its way into my lymph system, which will determine what kind of additional treatment I’ll need (for example, chemotherapy).

I was waiting to "go public" with this news until I could tell my mom in person, which I did earlier today. Telling my mom was as bad as, or maybe even worse than, getting the actual diagnosis.

Brent and I are coping well, and are leaning heavily on (1) our wonderful community of friends and family, and (2) inappropriate humor about my situation. I'm happy to speak openly about it if you have questions, and I'm especially delighted to welcome some inappropriate humor about it. My favorite so far is to talk about which "alternative prostheses" I will get afterwards. So far the front-runners are:
- Bicycle maintenance tools on retractable chains
- Beer taps (which would require my wearing a backpack with two separate beer bladders so that I could dispense two different kinds of beer)
Some of our other ideas are: laser pointers (to play with cats), tasers (to protect from robbers), movie projector, jack in the box. Please send more suggestions if you have any.

The next time you see me after May 1, you may notice something different about me (or… I mean… maybe you won’t). Hint: I did not get a haircut and I did not get new glasses.

I am going to go ahead and assume that you all feel bad for me. I am grateful for all of your support and concern, but please try to keep to positive messages, and inappropriate humor (about my situation). I will take every positive vibe you have to send, but sympathy just makes me feel worse, so please keep it light until further notice. Thank you. ❤


2024-04-04 : Surgery Rescheduled
Surgery Rescheduled
Surgery rescheduled from May 1 to April 17. YIKES! I'm not ready! I've scheduled a "Bye Bye Boobies" party for the end of April.


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