Initial Diagnosis

I had my bi-lateral biopsy on May 15th, the day before my cardiac ablation. The same radiologist who performed my ultrasound the week before also did the biopsy. Because I needed to have both breasts biopsied, the procedure took about an hour and a half.  

The radiologist used ultrasound to locate the area of concern in both breasts and marked the best spot for the biopsies. Local anesthetic was injected to numb the area and then he made a small incision where the biopsy needle was inserted and began taking several samples and left a marker clip when he was done.  

Throughout the procedure I chatted with both the radiologist and the technician assisting him. After the procedure I had a mammogram to confirm the proper placement of the marker. Despite a bit of bruising and mild pain, it was an easy procedure, and I was back to work within a few hours and hanging out with family who were in town to visit.   

The samples were sent off to pathology and once again it was a waiting game. I received a notification via MyChart that a test result had arrived before I received a call from my doctor. Dory and I read the results together and did our best to interpret them. We were fairly confident the prognosis was good, and that was confirmed with the calls from my primary care provider and the Cancer Care Coordinator the following day.   

The biopsy for the left breast came back benign. The right breast, however, tested positive for invasive ductal carcinoma, which is the most common type of breast cancer. The pathology report provides information about the type, grade, and receptor status of the cancer.  

The grade describes how different the cancer cells look compared to normal cells and how quickly they are likely to grow and spread. A grade of 1 is well-differentiated (slow-growing), while a grade of 3 is poorly differentiated (fast-growing). My results indicated grade 1—good news! 

Tests are also done to see if the cancer cells have estrogen receptors (ER), progesterone receptors (PR), or HER2 receptors. This helps determine which treatments might be most effective. I have positive estrogen (ER) and progesterone (PR) receptors and negative HER2 receptors—again, good news!  

What this means for treatment at this time is that because the cancer cells are hormone receptor positive, hormone therapies (which require taking medication for five years) are often effective in blocking the hormones that fuel the cancer growth. Surgery and radiation will also likely be part of the treatment plan. 

People have asked what “stage” of cancer I have. I actually won’t learn my stage until after surgery. This is because staging involves examining the extent and spread of the cancer. Stages range from 0 (non-invasive) to Stage 4 (metastatic). The staging system considers factors like tumor size, lymph node involvement, and whether the cancer has spread to other organs.   

Once receiving the official diagnosis, things started moving quickly. Breast cancer patients are assigned to a Cancer Care Coordinator who helps to explain test results, schedule appointments, provide referrals, and answer questions as they come up. I met with my oncologist within a week of receiving my diagnosis. The following week I had a breast MRI and two weeks later I had a genetic counseling appointment, met with the radiation oncologist, and had a consultation with the surgeon. In between those appointments I met with the oncology dietician and started physical therapy in advance of surgery.  

It was and continues to be a lot. A lot of information, a lot of emotions, and a lot of appointments. It’s all a lot...and my prognosis is good. That is what was most surprising to me. Previously when I heard someone had stage one cancer, I always thought, “good, they caught it early.” What I’ve learned though is that even when you catch it early, it is intense, it's scary, there are still unknowns, and you work with multiple providers each with their own area of expertise.  

There is also a lot of hurrying up and then waiting...waiting for test results, waiting for appointments, waiting for phone calls back from providers, and waiting for surgery. As I write this post, I’m almost three months out from my original mammogram. While there have been some hiccups along the way, I have an excellent care team. I trust their judgement, their knowledge, and their skills. I’m just ready to get past the waiting and on to treatment and recovery.