I was back at the hospital on Friday morning for more test results and now have a somewhat better idea of what cancer is inside me.
I've now had 2 ultrasound scans, a mammogram, and an MRI. My right side is all ok. On the left side there is a 22mm tumour and a 6mm "satellite" tumour close by. (The little one will be a result of a cancer cell breaking off from the main tumour and starting to divide and create another tumour). Tumour sizes are divided in to 4 classes. (T1-T4) Mine is T2 (2-5cm) so not the smallest category but still on the small side.
There was also cancer found in the core biopsy of the close by lymph node that was enlarged. I expected this. The lymph nodes are part of your body's immune system. It's the lymph nodes job to catch things like waste material, bacteria, viruses, and cancer cells. Cancer spreads through the body either through the bloodstream or lymph system. Cancer in the lymph nodes is very common with breast cancer. Most cancer cells that end up in the lymph nodes get killed off by your body's immune system. But some may escape. So the fact that there is cancer in the lymph nodes does mean there is a risk that cancer has spread elsewhere. In my case, with a smallish, low grade tumour (see below) there are unlikely to be any tumours anywhere else in my body (I will be having a CT scan at some point to check) but there might be odd cells floating around. (It is chemo that deals with these little bastards, more on that another time.)
The stage of your cancer describes how far it has spread. I won't know this until after surgery and my CT scan (surgery will give a better idea of how many lymph nodes are affected, and CT scan will check the rest of my body for tumours). But I think at best it is stage 2B.
Breast cancer is graded on a scale of 1 to 3. The fact that my cancer is "Grade 1" is good news. It means that the cancer cells look similar to normal cells and are probably growing quite slowly. Grade 1 cancer cells are less likely to spread.
When looking at the biopsies they test to see whether the cancer is responding to the hormones estrogen and progesterone, and the protein her2. The results of this determine what drugs you are given.
Mine is very strongly estrogen receptor positive. (ER+) This means the cancer is feeding off estrogen in my body. So the doctors will be shutting my ovaries down (before removing them, sooner rather than later I hope because of my ovarian cancer risk). Having breast cancer that is ER+ seems to be a good thing as there are lots of different drugs available to prevent recurrence after treatment.
Mine was also her2 negative (her2-). This was good news, as her2+ cancers are aggressive.
What does this mean?
It's a shame there is cancer in my lymph nodes, as there's a risk of spread, and I will need a bunch of lymph nodes removed, putting me at a 20% risk of lymphedema. However, other than that, from what I can tell, under the circumstances, it is pretty good news. It's a smallish, not particularly aggressive tumour, and there are lots of treatments I can have to blast it.
My treatment plan isn't entirely clear yet. I will write about that separately hopefully tomorrow.