My Cancer – The Medical Bit
I found a hardening of the outside of my left breast whilst in the shower and when it hadn’t gone away after a week I went to get it checked out. It wasn’t a distinct pea-sized lump, so I wasn’t sure if it was anything sinister, I actually thought it was just a change in the breast due to some hormone tablets.
So, after a visit to the GP, what followed was a roller-coaster of – mammogram, ultrasound, core biopsy, MRI, waiting…waiting, decision making.
Result? Stage 2 Invasive Lobular Breast Cancer, ER+, HER2 Negative.
My Cancer started when cells in the breast began to divide and grow abnormally. Those cells started in the lobules (the milk producing glands) and spread outside of these into the surrounding breast tissue, rather than starting in the Ducts and forming a distinct lump. My Cancer was a mass which is subtler and therefore additional tests and scans like an MRI are sometimes required to assess the size of the tumour and get a more accurate picture of its size.
The mammogram showed the tumour was a certain size, the Ultrasound showed it was bigger, so I was given an MRI to get the exact size.
One of the tests from a biopsy confirmed my Cancer was hormone sensitive (Oestrogen receptor positive, or ER+). This means there are receptors on the cell surface that bind to Oestrogen and it stimulates the Cancer cell to grow. I was going to require Hormone therapy after the other treatment to block any natural Oestrogen from attaching itself to cells.
The other important test on the biopsy is to find out the levels of HER2, which is a protein that makes Cancer cells grow. Mine was negative so the drug given to target that will be of no benefit to me.
Cancers are complicated. In Breast Cancer you can be positive for one thing, negative for another, or negative all round. Each one must be looked at individually and the best course of treatment for one, will be different for the next person. Decisions made will be according to the Cancer but the patient too. Age, general health, and their wishes are all taken into account.
Course of Treatment
After quite lengthy appointments, it was decided I would have a Wide Local Excision, or conservatory surgery. I was told that due to the size of the tumour, a sizeable amount would be removed and there would be the possible need for further surgery to obtain clear margins. If that was unsuccessful, a Mastectomy may still be required.
At the time of surgery, I would also have a Sentinel Lymph Node Biopsy taken to check for Lymph Node involvement.
Unfortunately, at surgery, due to 14 nodes being visibly diseased, a decision was taken to undertake an Axillary Clearance.
After surgery they confirmed the size of the tumour was 54mm. I couldn’t believe something so big was inside me and I didn’t know.
They didn’t get clear margins at the first surgery (it can be very difficult to see what is diseased and what is good tissue in the breast), so I was booked in for the second operation a month later. Thankfully no node involvement next time so I had a quicker recovery.
Then it was the Oncologist’s turn. It was decided because of the size of the tumour and the node clearance I had, that I needed:
Chemotherapy: 6 x cycles – 3 of FEC (Fluorouracil, Epirubicin and Cyclophosphamide), followed by 3 of the ‘T’ – Docetaxel.
Radiotherapy: 20 sessions – 4 weeks of daily blasts Monday to Friday (oooh weekends off!)
Hormone Therapy: initially a 5-year course of Tamoxifen.
I was classed as ‘young’ aged 43 so they wanted to throw it all at me.
I was quite chuffed at being classed as young again, actually…