The pathology from the mastectomy showed that my tumor was 3.2 centimeters which was successfully reduced from somewhere in the 6.5-8cm range when I was first diagnosed. I had 15 of 19 lymph nodes that tested positive for cancer.
When I was first diagnosed my tumor grade was rated using the Bloom-Richardson grading system as moderately differentiated, which meant it wasn't the most aggressive types of cancer. Unfortunately, after the pathology came back from the mastectomy they upgraded the cancer to poorly differentiated. My tumor grade is 8 of out 9. I've always had high grades in classes and graduated with honors from Berkeley but this is one exception where a high score is NOT a good thing. The tumor grade helps determine your prognosis and treatment plan. In my case since I was pregnant at diagnosis the only treatment plan was neo-adjuvant chemotherapy to shrink my tumor and kill any cancer cells that may
have spread throughout my body. Here is more from wikipedia:
- The Bloom-Richardson grading system is a breast cancer staging system that examines the cells and tissue structure of the cancer to determine how aggressive and invasive the cancer is:
- What percent of the tumor makes normal duct structures? In cancer, there is a breakdown of the mechanisms that cells use to attach to each other and communicate with each other, to form tissues such as ducts, so the tissue structures become less orderly.
- How many mitotic figures (dividing cells) can the pathologist see in a microscope field? One of the hallmarks of cancer is that cells divide uncontrollably. The more cells that are dividing, the worse the cancer.
- Are the cell nuclei uniform like normal breast duct epithelial cells, or are they larger, irregular, and darker (pleomorphic)? In cancer, the mechanisms that control genes and chromosomes in the nucleus break down. Irregular nuclei are a sign that the mechanisms that control cell reproduction are breaking down.
- Each of these features is assigned a score ranging from 1 to 3. The scores are then added together for a grade that will range between 3 to 9. This value is then used to grade the tumor as follows :
- 3-5 Grade 1 tumor (well-differentiated). Best prognosis.
- 6-7 Grade 2 tumor (moderately-differentiated). Medium prognosis.
- 8-9 Grade 3 tumor (poorly-differentiated). Worst prognosis.
- Lower grade tumors, with a good prognosis, can be treated with less aggressive surgery and medication, and have a better survival rate.
- Higher grade tumors must be treated with more aggressive surgery, radiation, and drugs with worse adverse effects, and have a worse survival rate.
Overall my staging is considered Stage IIIC. That is much further along than any of us expected. None of my doctors are saying anything dreary or negative but it is what they AREN'T telling me that makes me worried. They really are throwing in "everything but the kitchen sink" to treat my cancer. Two different rounds of chemotherapy. Mastectomy and lymph node dissection. 35 rounds of radiation plus a low-dose chemotherapy pill to boot. Holy crap. This cancer better be dead and then some.
Today after radiation I felt some burning on the incision site of my breast. Nothing major, just mild burning like a sun burn. I kept putting lotion on it all day. I had number eleven today. I'm not even close to being half way done. I hope that I can keep the "burn" like side effects at bay with my potions and lotions.
But the BIGGEST side effect is this fatigue that has started. Today I really wanted to take Abby to the zoo. I tried so many times to get her dressed and she just wasn't interested and I didn't want to tell her we were going to the zoo quite yet because if she got too excited and I couldn't deliver then I would feel terrible. I already knew how tired I was when I woke up and I couldn't shake it off...so I figured I might not make it. Leo has a lingering cough (one of the lasting effects of RSV) and he had an albuteral treatment Monday at Dr. Gordon's office that seemed to help. When I heard Leo cough a few times I decided it was much more important to take him for another treatment that it was to go to the zoo. She went with Agnes to the park instead. Leo and I got home from his treatment and he went to nap and I thought, "hallelujah"!!, I'lll get to nap too before Abby gets back. I literally could not keep my eyes open one second more so I slept on the twin bed in Leo's room. Not even half an hour later he woke up. I was so desperate to get that nap and it just didn't happen. My body hurts I am so tired. I need to work on my energy level. Stupid radiation.
Perhaps walking or hiking would help? Or Ballet? I just don't feel I have the energy to do anything though. They say movement and exercise will help relieve fatigue so I guess I better try it. I have to figure out something that I can do that doesn't leave me feeling guilty or selfish like I leave my kids with people all day so I can go workout. I know I shouldn't feel that way since taking care of me is what I need to do right now but I still have those thoughts. What I really want is to just lay in bed all day. I want to check into a hotel and watch movies all day for a week. How selfish is that? Except I love my husband and I love my kids so what the heck am I supposed to do?
I went back to acupuncture too yesterday. And I'm drinking the horrible chinese herb tea prepared just for me (that tastes like drinking black smoke, its the oddest thing). I'm hoping the herbs and acupuncture start to work ASAP.
All that being said my therapist is helping me acknowledge that I should be proud of myself for ALL that I am doing. That I shouldn't judge myself so harshly and be so critical. And I am proud of myself.
I've even made dinner three nights in a row even though I am exhausted! That is an accomplishment I am very proud of...healthy dinner the whole family can enjoy.
And now I am going to sleep at 9PM....
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