The Devil is in the Details

*** Spoiler alert - this post contains TMI about my long lost boobies ***

Before I was diagnosed, I thought cancer was cancer.  Well, maybe I realized that elbow cancer was different from eyelid cancer, but I thought breast cancer was breast cancer.  Holy camole, was I wrong!  There are endless permutations of what kind of breast cancer one can have, and all of those permutations dictate details like your chance of survival, likelihood of recurrence, and what kind of treatment is recommended.

My tumor was:
- stage Ic
- 2 cm at its widest part (doesn't sound very big, but in cancer-lingo, its not tiny)
- ER+/PR+
- Her2+
- No evidence of it having spread to lymph nodes on either side
- Clean margins (expected, considering that they entire cut both boobs off)
- 5 of 9 on the Nottingham Histologic Scale (i.e., how "ugly" the cancer is)

I won't bore you with what that all means in English.  If you're interested, check out this link.  Bottom line is that:  (i) the ER/PR + means it will respond to hormone therapy like Tamoxifin; (ii) the Her2+ means it grows aggressively and has a higher likelihood of recurrence; and (iii) the existing tumor in the breast has been completely cut out, and there's no solid evidence that there are any other tumors anywhere else.

Insurance also paid for getting a full genetic screening.  If you know my family, you know the cancer cards are stacked against me, genetically speaking.  But, to my surprise, I had no gene mutations.  Which means this cancer was probably caused by exposure, not genetics.

So, you would think that since the margins were clean, and we caught it before it went to the lymph nodes, I would be able to avoid chemo.  Not quite.  The Her2+ means that its likely to come back, and if it does come back, it will grow wicked fast.  Also, because I don't have any breast tissue left, if it comes back, it will be metastatic in another organ.  So, the recommended course is to do a standard chemo regimen to clean out any stray cancer cells that might be floating around undetected.  That starts next week.  More details on that some other day.

See I told you the devil was in the details!