Walking With Brenda

Brenda had a bunch of scans recently with some good news and some interesting news.

• A recent CT scan verified that there is no sign that the cancer, first detected in her lymph node on February 1, has spread or landed on other organs. That would have been bad.
• A recent mammogram did not find anything abnormal, unusual, or suspicious. Evidently, mammograms are decent screening tools but often miss a lot.
• A recent MRI scan did find something suspicious in her left breast: a small-ish lump that is believed to be the prime suspect to “represent the primary breast malignancy”. Gotcha! It thought it could hide, but no. The size is classified as “moderately-sized”, but just slightly larger than a lump that would be classified as small. It’s definitely on the small size of moderate. Now that they’ve narrowed down its location, they want to biopsy the bugger. So they’re going to use the MRI as a sort of map, and try to zero in on the area using ultrasound. If that doesn’t work, they’ll do an MRI-guided biopsy.

It turns out that they can assume a lot from the shape (margins) of a lump. That’s why they can often be pretty sure whether a lump is benign or cancerous just by looking at a scan of it. A biopsy can verify the suspicions.

Anyway, all this was divulged by a very capable surgeon, who also added a couple of things. First, she said that there’s a chance (albeit unlikely) that the lump found on the MRI has already been clobbered by the body, I guess after it had delivered some nasty cells to the lymph node. Apparently, sometimes the body can self-heal cancerous lumps on its own. Unlikely, but possible.

The surgeon also said she was “optimistic” about the treatment. That’s the first time I’d heard that. It was nice.

She also sketched out a draft treatment plan. It’s subject to change, but it would probably look something like this:

• neoadjuvant therapy (that’s chemotherapy), primarily intended to murder little cancer cells that may have spread from her lymph node to other parts of her body, but haven’t landed or otherwise found a home anywhere (about 4 months);
• a little rest to recover from the chemotherapy (about 4 weeks);
• a surgical procedure to remove the lump (a “lumpectomy”) and offending lymph node;
• another little rest to recover from the surgery (about 6 weeks)
• radiation therapy (maybe, but maybe not; the oncologist will recommend whether this is needed after surgery);
• hormone-blocking therapy (because the biopsy indicated the cancer would respond to this sort of thing).

It’s hard to say exactly, but we think that Brenda will be off work for up to a year. This is a long game.