When Doctor Shows Start to Look a Little Personal

I spoke with my nurse navigator on Monday and received the last of my pathology information (I also got the final report today to read).

I have invasive ductal carcinoma, grade 3.

80% of breast cancer diagnoses are invasive ductal carcinoma. Basically means my cancer started in the milk ducts and traveled to the tissue outside of the milk duct. 

Grade 3 is the score associated with what the cells look like and how much they look like normal cells. 

• Grade 1: The cells are slower-growing, and look more like normal breast tissue.
• Grade 2: The cells are growing at a speed of and look like cells somewhere between grades 1 and 3.
• Grade 3: The cancer cells look very different from normal cells and will probably grow and spread faster.

I am HER2 positive, but estrogen/progesterone negative for receptors. 

HER2 is a growth protein on the outside of all breast cells. My body is producing too much HER2 and the cancer is spreading through it. This differs from estrogen/progesterone positive cancers as those are growing because of those hormones. You can be ER+ or PR+ and HER2+ (you can also be triple negative aka none of the receptors are present). In my case, I only have HER2. About 20% of breast cancer is because of HER2 (hormone basically makes up the rest and triple negative is less common than HER2). HER2 breast cancer is known for growing and spreading faster than ER/PR+, though. I’m hoping this means I can avoid hormone therapies, but not sure at this point. 

My KI-67 Score is 30%.

The KI-67 score has some disagreement on how to use it for treatment, but it is a protein in cells that increases as the cells get ready to divide. The test looks at how many cancer cells have KI-67 in it. The more there are, the more they’re dividing and making more cells. Can be coupled with an S-Phase test (cell cycle time) but I didn’t seem to get that. 

        < 10% - Low

        10-20% - Borderline

        >20% - High

High basically means it can be aggressive and spread quickly, which, frankly, considering the HER2 also indicates that, I guess I’m not that surprised. 

I’m not liking my chances on avoiding chemotherapy. Given my age, HER2+, and KI-67 of 30%, I have a feeling the treatment choice will be to attack hard and fast. Guess the MRI will help in determining how much chemo/radiation rounds I go through (in addition to what kind of surgery). 

With that, I had my first ever MRI today. Chris drove me. I was going to, but I had to stop at the Cancer Resource Center to pick-up my “intro” binder and meet the Nurse Navigator. It was kind of a crazy one-way road, can’t turn left here, small parking lot, yaddy, yaddy, and had to go to the MRI afterwards. I didn’t want to drive. I still don’t like driving, especially in places I don’t know and I have to park. Haha At any rate, Chris picked up on that and decided to drive me and wait for me at the MRI. <3

Anyhow, I was kind of laughing at myself because everyone would ask if I’ve had a MRI before and would explain it was a loud machine and what it was like. I wanted to be like, “I like medical dramas...I’ve seen them a lot on TV.” (I refrained!) Then I had to lay on my stomach for the MRI so I couldn’t see anything (I was tempted to fall asleep haha), but I flat out imagined the 2 ladies in a medical drama. It was kind of amusing to me. I came home and started to watch a medical drama and kind of chuckled to myself. I guess doctor shows are looking a little personal these days!

The technicians told me that my doctor put a rush on the MRI so I should have results in a day. I was initially told by the nurse navigator it’s usually 2-3 days so probably by Friday I’ll know if I’m going back in for more biopsies or not. I’m really hoping for no more biopsies and it’s not even really because of the spreading factor. My last biopsy spots are still sore and it’s been a week! One of them is because of where it is and it hits a seam on any bra I wear (sports or regular). So that’s unfortunate...

I had 2 blood draws last week and an IV today and my arm still has a bruise from one of the blood draws from a week ago. My other blood draw spot (other arm) took days to stop hurting (didn’t bruise). To say the least, I had a moment today where I was understanding why people get ports because the needles are insane to constantly get poked, even if needles don’t bother me! My downer moment today...

Assuming I don’t have more biopsies, my surgeon appointment is next Monday. 

I put a 3-D puzzle of the Burrow (Harry Potter) together the past 3 days. I’m trying to not worry too much about the future so trying to stay mentally busy and “in the moment.” The FB groups are both informative and freak me out. Since I still don’t have a treatment plan, the freaking out is a little premature because I have no idea how much (if anything) I’ll be going through. Guess I’ll get to that road once there’s a plan...

What a crazy turn this year has taken. What a crazy thing to now look at pink ribbons and have an entirely different meaning and connection to it. I got a pink ribbon in my binder today and it was kind of an “oh” moment that now I actually represent one of those. Crazy.