Walking With Brenda

Hi friends! Lots to catch you up on in this installment.

• New port installed. It turns out that Brenda has somewhat iffy veins (which we sorta knew) so they elected to install an “implanted port” (often called a “mediport” or “port-a-cath”). It’s basically a port implanted in the left side of her chest wall, directly into her vein, to allow the chemo drugs to flow directly into her bloodstream. It’s an alternative to repeated IV arm stabs into her veins, which carry the risk that the chemo drugs will incorrectly flow outside her veins and under her arm skin, which would be very bad. The port also can suck in contrast dye for imaging scans. Anyway, the port was implanted on Friday, April 14, as an afternoon day-surgery procedure at Royal Columbian Hospital. She was pretty beat up afterward, but walked out under her own steam and asked to go out for dinner at White Spot.
• Ultrasound-guided core needle biopsy. Earlier the same day, Brenda had an ultrasound-guided core needle biopsy of what’s being called “L2”. More on the results below. But the combination of biopsy pokes and the implanted port installation made for a very sore day. She’s always upbeat, but it was a hard day to endure.
• Round two of chemo. On Tuesday, April 18, Brenda had her second treatment of chemo at Burnaby General Hospital. It was boring and uninteresting. Almost literally nothing happened. They dipped clear fluid into her veins for 4.5 hours, and that’s pretty much it. I sat in the next room and did nothing at all.
  • We’re told that chemo side effects tend to show up in about two-to-three days or so after treatment. And, right on cue, Brenda started to experience some joint pain and finger/leg tingling a few days after treatment. It passed after a few days. Overall, Brenda seems to be tolerating the chemo rather well.
• Biopsy results. You might remember that we’re pretty sure Brenda has two breast lesions: “L1” is the slightly larger of the two, and expected to be the main cause of all this nastiness. But ultrasound doesn’t see it, so we’re waiting for the MRI-guided more needle biopsy on Tuesday, April 25 to verify things.
  • What did they biopsy? L2, you might remember, is the smaller lesion that was spotted by both the ultrasound and the MRI. L2 was “moderately suspicious” and was biopsied, and we now have the results.
  • What was the result of the biopsy? The biopsy report said it was “Invasive Breast Lobular Carcinoma” — that’s confirmed as cancer, the second-most common type. “Invasive” means that the cancer cells can spread to other parts of the body. “Lobular” means it’s in her milk-producing glands, as opposed to ducts.
  • More about the results. The results said that the lesion was Grade 2, cells look less like normal cells and are growing a bit faster (but still not very fast.) Obviously, it would be better to have Grade 1 cells, but not as bad as having Grade 4 cells.) Finally, the results also said that Both estrogen receptor and progesterone receptors are positive, and HER2 is negative. So it’s not the fast-growing, triple-negative type, which is good.
  • What about L1? L1 is going to be biopsied on April 25, but it’s more of a known quantity. L1 is thought to be the “breast primary” — the one whodunit. Some details might be new, but we know it’s cancerous, and quite a bit about its nature. But the combination of the two cancerous lesions have made us curious about what options the surgeon might recommend for Brenda.