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"It's breast cancer" is something I thought, I hoped, I'd never hear again. However, on the evening of June 8th, I found myself hearing those exact words. My Oncologist had called to give me the results of a CT guided lung biopsy that I had undergone a couple of days prior. Up until this point, the impression was that this was likely infections or inflammatory in nature, although given my history, cancer couldn't be ruled out.
Here is a brief synopsis of the recent events leading up to the biopsy: In May of 2016, my annual screening breast MRI- an exam I've had for the last 12 years- showed a small pulmonary nodule in my right lung. Since MRI is not the best imaging modality to characterize lung abnormalities, I was recommended for a chest CT. The CT scan also demonstrated a solid pulmonary nodule in my upper right lobe, measuring about 9 mm in size and was at the time considered indeterminate. Additional features near and around the nodule raised the suspicion for infection, however, short term follow-up was recommend. Fast forward 6 weeks- the CT scan was repeated and showed stable appearance, however, given my history, documentation of long term stability was warranted. In November the chest CT was repeated. Similar story as before- stable appearance- favored to be a result of a prior infection- follow up in 6-12 months recommended. This brings us to this past May- CT scan was repeated- this time, however, the scan demonstrated interval growth of the pulmonary nodule (it now measured 12 mm). For better characterization of the metabolic activity of this lesion, a PET-CT scan was recommended. Although the nodule showed low level uptake of the radioactivity (high uptake corresponds to higher metabolic acitivity, which in turn can be characteristic of a cancer), the appearance of the nodule was still indeterminate- either "infections/inflammatory process or low grade/well differentiated neoplastic process." Under the strong recommendation of my Oncologist, rather than waiting for a repeat CT scan in 3-6 months, we decided to biopsy the area. So, on June 6th, in a department I'm very familiar with, the pulmonary nodule was biopsied with CT guidance.
After hearing the biopsy results, Rick and I were set up with an appointment to meet with my Oncologist to lay out a plan for my new diagnosis- Stage IV metastatic breast cancer. Much to our surprise, she was not recommending chemotherapy or radiation- instead, she was referring me to a thoracic surgeon with the hope to remove the portion of my right lung containing the cancer. In addition to surgery, she was also recommending shutting down my ovaries to stop most of my body's estrogen production (my cancer is estrogen positive, so estrogen serves as the "fuel"). This could be accomplished 2 ways- either chemically with monthly injections- or surgically by removing my ovaries.
I remember telling myself years ago that if I had to go through this again, I'm not sure I would have the strength to do it. But, here I am, with a slightly different perspective than before, but somehow still finding the strength to fight.