Ann Martinez Angels for Ann

My journey with cancer began at the end of March when I noticed a lump in my right breast.  To be honest I thought nothing of it, as I just began a new birth control and knew hormonal changes to my body could occur.  Persistence from my husband, led me to seek a consultation with my primary care physician.  I was able to be seen the following day by the nurse practitioner, who confirmed I needed to be sent to look into this further with a mammogram and ultrasound.  I was fortunate to get in for imaging that afternoon and knew my mind would be at easy shortly.  The radiologist confirms a 1.4 cm mass round in my right breast with dense breast tissue surrounding.  I was told this was most likely a Fibroadenoma, which is a benign tumor, and common in women my age at 31.  It was suggested that we continue to monitor it and repeat imaging in 6 months; however, if I was going to "worry about it the whole time" we could just get a core biopsy now to be sure.  My biopsy was scheduled for the following week and I remember thinking, "This is expensive way to get piece of mind but guess it's worth it."

Worth it, it was and on April 10, 2017, I received the call that would change my life forever.   My doctor explained she had been stalking my biopsy results all morning and unfortunately the tumor was cancerous, Invasive Ductal Adenocarcinoma.  A million emotions flooded my head.   I immediately shut down that I actually just received this news about myself and went into medical mode.  Being a nurse working in veterinary oncology, I knew I needed more answers and this was not the time to worry when I could not even process the news. 

The next day I met with a breast surgeon to review my biopsy results and discuss a treatment plan.  So a lot to take in during this appointment and way way too much to explain. Glad my husband, Joel and my mom were there to help process.  In a nutshell: this week would need to schedule an appointment with a plastic surgeon as well as an appointment for genetic testing and a MRI. This will determine if I have gene mutations for all the various types of cancer, not only in breast but full body. Based off of these tests, that I was known E+ P+, and the pending FISH test for Her2nu, would determine if I will receive chemotherapy at all, before surgery, and/or after surgery.   Surgical options given were lumpectomy, mastectomy, or double mastectomy. After a 2 hours discussion, it had been decided that even after all these tests whatever the results will be, my best option for decreasing risk of relapse and for symmetrical purposes, a double mastectomy with reconstruction surgery is what I'm about to endure. (Probably 1st week in May). With lumpectomy I would need radiation daily for 6 weeks and still leaves risk for doing this all over again plus ever 6 months mammogram with ultrasound for monitoring. Double mastectomy ideally I won't need radiation unless tumor aggressive and no need for mammogram with ultrasound just yearly exam. MRI will determine if there are other tumors in either breast and if my nipples can be saved. Meeting with plastic surgeon this week to discuss flap vs. implant reconstruction. Flap will take tissue from my own body to fill or implants is my other option. Surgeon leaning toward implant for symmetry and cause I don't have much extra tissue/fat to fill with. May need second reconstruction after a few months to get things looking perfect. Lots more about fertility, hormones, no more kids, etc.

(April 15-23) The next week we took a much needed family trip to Diseny and during our vacation, I found out my Her2nu negative.   Just needed to get through a straight forward MRI when I returned and surgery was already in the works for May 8th. Or so I thought....I've learned real quick start preparing for the unexpected.  

(April 25) The MRI results brought me to my new reality.  The tumor is not the size they believed from the ultrasound.  MRI shows over 5cm with probable lymph node involvement. The tumor is too close to my nipple to save it if we went to surgery now. If my lymphnodes are involved,  I will need chemotherapy for 3-4 months prior to surgery, but given the size I will likely need chemotherapy regardless prior to surgery to shrink the mass enough to safely surgically remove it with clean margins and save my nipples. I will likely lose my hair, but they hope to give me medications to counteract the other side effects. Again due to size of the cancer, radiation daily for 6 weeks is also likely in my future to prevent against regrowth. I had a second ultrasound with lymph node biopsy scheduled for that Thursday then will regroup with my doctors next the Wednesday to discuss pathology and chemotherapy treatments. This was the hardest to swallow and understand. I felt like I kept getting kicked down, but I knowing this is my journey and I must be strong.

(April 27) It had been a long week with more twist today. Went in for repeat ultrasound and biopsy of my lymph node but ultimately ended up with a lymph node biopsy and additional biopsy of my breast. The radiologist believed that based off of the ultrasound and MRI imaging that I may be dealing with two separate masses. We know the core of the tumor is 1.4cm Adenocarcinoma, but he wanted to sample the tissue involved around the tumor that's incapsulating it. Predicts that this may be a secondary cancer that is causing the lymph node involvement. This is why it measures over 5cm on MRI. Both biopsies were taken sent for pathology so just waiting the results for the latest update. These answers will give us a direction on treatment prior to surgery. My doctor said he would call me with pathology as soon as it comes in and genetic mutation results should be back within the next couple of weeks as well. Hopes were to make a plan with an oncologist to begin chemotherapy as soon as pathology was back and we knew what we were fighting.  I was no longer fighting this alone, I realized the overwhelming flood of support around me and God had placed me with the best team of doctors to guide me during my journey.

(May 1) So pathology report from today is inconclusive for the surrounding tissue in my breast  resulting in reactive scar tissue cells, but the chance for malignancy is high given my lymph node pathology did result in 95% metastatic malignancy invading that lymph node meaning other surrounding lymph nodes are probable to be infected as well. I would meet with my oncologist the next day to discuss pathology and my chemotherapy protocol. My doctors said my cancer is very aggressive so we will answer it with an aggressive chemotherapy.  I would also setup an appointment to surgically place my chemotherapy port. They would like to see me receive chemotherapy by the end of the week. Again this was terrifying but I'm was ready to get started killing this parasite! 

(May 2) After meeting with the oncologist, I have been diagnosed as Stage III and will complete imaging this Friday with echo and CT scan. I am scheduled for a 16 week course of chemotherapy then potential surgery in 18 weeks. We decided on Wednesdays for treatment days so that hopefully when I am feeling under the weather it falls on the weekend. I will be out all day on treatment days because it is given over a 5-6 hour infusion. First Adriamycin/Cyclophosphamide together 4 doses (8 weeks) and then Paclitaxel 4 doses (8 weeks). Treatments are every other week. They both will make me feel crummy with side effects but going to push through. Lots of other details of orals and clinical trails I will take along the way to help me feel as best as I can but too much to list. I will lose all of my hair by second dose so in about 3 weeks from now. Plan for this Friday in between appointments to go get my hair cut and donated it to children with hair loss.  My mom researched a place for me when I told her my idea and they donate it to kids with hair loss.  This helped me take my pain and turn it into good!


(May 4) Port placement went fine but ended up with a corneal abrasion of my left eye. They said I must have rubbed my eye coming out of surgery. Just my luck..seriously!!  My eye was more annoying then anything else. I was sore in my neck and collar bone but manageable. 



(May 8)  Echo and CT scan CLEAR!!! Only showing right breast cancerous mass and lymph we already know about. Chest and abdomen clear. Contrast flowed slowly through my liver but not concerning because no nodes or highlighting present. Chemo was still on for Wednesday, May 10 with blood work tomorrow.