Journal entry by Jewell Williams

Week 1 Summary
  • Had diagnostic imaging, including a 3D mammogram, ultrasound, two biopsies, and an MRI (with and without contrast).
  • Received pathology reports and shared the news with my immediate family and my team at work.
  • Cried myself to sleep the first few nights with thoughts of leaving Eden and Justice here on Earth.

IMAGING

How ironic is it that I work for an imaging company whose images, tools, and diagnostic skills saved my life?!?! For the record, I don’t believe in irony.

One of our imaging centers is in Anderson, SC. I forever will be thankful to the team at Anderson Imaging for the excellent care and communication they provided…God knew exactly who I needed in every room, every time I visited. If you live in SC, call one of our centers to schedule diagnostic testing, immediately! Their website shows the centers we have in other states. 

All of my tests were virtually painless. Every image gave us a different view of the areas of questionable tissue.

THE DIAGNOSIS

The pathology report says I have multifocal, invasive, lobular carcinoma. The tumor stage is 2A. The Hormone Receptor Test was positive to both Estrogen and Progesterone (and negative to HER2).

  • Multifocal means that a mass exists in more than one quadrant of the breast. If you mark a cross on the breast with a Sharpie (my doctor drew a picture of this!), you can imagine the breast divided into 4 quadrants. I have a mass near the 1:00 position and two small masses in another area. Since these locations fall in different quadrants of the breast, it's referred to as multifocal and the standard protocol is a mastectomy (vs. a lumpectomy).
  • Invasive means that it did not remain where it started. Instead, it traveled/spread to surrounding tissue (or beyond). Fortunately, mine appears to have spread only within the right breast. On MRI, chest wall and lymph nodes look clear.
  • Lobular indicates that the cancer started within the lobules, which are located in the back of the breast and are also known as the milk glands. 

This type of cancer is not common. Just for statistical fun, invasive lobular accounts for only 5% of breast cancers. The majority (80% or more) are ductal in situ (originating and remaining in the ducts).

It's also hard to discover. Instead of forming in the shape of a lump or sphere, it grows as one cell in front of the other. When this line of cells branches off, it appears like the veins of a leaf - still, one cell lines up in front of the other. It makes the tissue feel thick, but it does not form a lump like we are all told to check for.

MORE PATHOLOGY DETAILS

That was the bad news. From there on, every lab update that I received was encouraging, considering the potential:

-     Stage 2A: Tumors are diagnosed with an estimated stage (from 0 to 4), based on several details. They’re also given a grade, indicating how likely they are to spread rapidly. Mine is not a high grade and it is a stage 2A, with a 95+ % chance of success.

-     Hormone Receptor Status: When cancer cells are biopsied, they are tested to see which hormones they are receptive to. This helps determine what fuels their growth and which treatment options will be most effective after surgery. My tumor is positive for Estrogen and Progesterone, and negative for HER2. In short, this provides several treatment options after surgery and means, most importantly, that chemo is not likely.

-     Benign, Left Side: The biopsy on my left breast was benign. This is important because it eliminates the need to test lymph nodes on the left side of my body during the mastectomy. It also means that my left arm is my new blood-pressure cuff arm, and the arm in which all future blood will be drawn and IVs inserted. It also confirms that we caught this fairly early, before it had a chance to travel across my body.

I’m not an expert. But I studied it enough to be able to wrap my mind around what I’m battling so that I can arm myself to survive and thrive.

I will not be shaken.

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