Last Thursday brought my BIG appointment....oncology. This was my first time meeting my hematologist/oncologist, and I must say I am smitten. He explained everything thoroughly and didn't even break a sweat with my barrage of questions. So, here are the details........
They consider me cancer free. Even though there was vascular invasion in my tumor, the first place you would see the cancer cells travel to is the sentinel nodes, of which I had three removed and all were cancer free. The margins surrounding my tumor were clean, meaning the entire tumor was removed during the mastectomy. What I really wanted to know was 'my number.' That number was my Oncotype DX score. This test looks a a piece of my tumor and can predict my rate of recurrence. It measures a group of breast cancer genes in the sample to see
how active they are. The result
of the test is reported as a number between 0 and 100, known as the
Recurrence Score® result. A lower score means the cancer has a
lower chance of returning, and a higher score means that there is a
higher chance of the cancer returning. From what I have read, a score below 17 results in chemotherapy not being used. My Oncotype was 7! Obviously this was amazing news, but I wasn't quick to celebrate. I had to ask a whole lot of questions before I felt comfortable with this decision. So, chemo is a no go, but I do need hormone therapy to further reduce my risk of recurrence. Dr. Smartypants said that with a double mastectomy, I reduced my cancer recurrence chance to 30%, with additional hormonal therapy that risk drops to 15%. By the was-my left breast was completely benign-sorry lefty, but it had to be done.
So, this Thursday brings menopause. Normally, an estrogen receptor positive breast cancer would be treated with Tamoxifen for 5-10 years as hormonal therapy to further reduce recurrence risk. Well, Tamoxifen also has a chance to cause blood clots. Seeing as I had a DVT post-op, Tamoxifen is not a treatment option for me. So, I need to get a monthly injection of Lupron to shut down my ovaries(where most estrogen is made) and take an aromatase inhibitor, Arimidex, to further eliminate estrogen in my body. This will be for the next 5-10 years. This isn't too bad a gig, seeing as a major study just came out this year finding that ovarian suppression + aromatase inhibitor had greater risk reduction than Tamoxifen alone. Of course these medications come with a lot of side effects, but I will try them and see. Earlier today I had a baseline bone density scan, and my bone health will be monitored every two years going forward.
Last Thursday I also had my last drain removed. I felt lost for a day or two, but quickly forgot about him. Now I will go to the plastic surgeon for weekly fills of my tissue expanders and if all goes according to plan, momma may have a new rack for Christmas!