To All My Stage III Friends

Update: Thanks to everyone for all their kind
thoughts and wishes! I do hope my continued presence on this forum is ok.  I would like to share new insights here also if they may be helpful. 

I had my appointment with my oncologist today.
The bottom line is she wants to get a biopsy first to confirm the
pathology.  My Ca 27:29 results came in at 51 which is above the max normal value of 38 so it seems likely I have a recurrence. 

The differential dx is:

1. Breast Cancer Recurrence (most likely)

2. Lymphoma (possible based on the presentation)

3. Sarcoidosis (unlikely)

I
am scheduled to see a Head/Neck surgeon this Thursday and he may decide
to do a simple biopsy the same day or have me come back later if he
decides to do a more invasive surgical procedure. I have a palpable lymph node
at the base of my neck which seems to be the most accessible node for
biopsy/excision. The others are all deep in my chest or abdomen and
would require a more invasive procedure.

If it is a BC recurrence,
my oncologist plans to stop the Aromasin and place me on Faslodex
injections. 3 months after the start of Faslodex she will repeat the CT
scan. If the current status has not regressed or stabilized, she will
move on to Afinitor + Arimidex. If the 2 bony lesions progress we will
need to start an additional med, most likely Xgeva.

As my
oncologist said a recurrence in my case is "not unexpected but is also
not a disaster". The fact that I still feel good and there are no signs
of organ involvement is a positive indicator. There are many options
at this point and if I respond well to hormonal therapy the chances are
good I can get several more years of quality life. Generally speaking
my oncologist says the length of time between completion of active
treatment and a recurrence is a good indicator of the aggressiveness of
disease and possible length of survival time after recurrence. There
are many variables of course, and cancer pathologies can change which
could impact survival time, but I am encouraged that I had an extended
period of NED these last 8 years.  Hopefully, there are new treatment modalities just around the corner that will increase survival.

I must keep reminding myself....one day at a time....one day at a time!

Thank you again for all the support and encouragement!

Mar 11, 2014 05:28PM jennyboog wrote:

LL...this is exactly what I went through more than a month ago. TM's on the rise, PET showed uptake & enlargement to LN's behind sternum, was told it was a reocurrence, or lymphoma maybe sacoidosis, went to a thoracic surgeon for biopsy, path showed it was a granuloma and they're not really sure as to why or how. I'm hoping the same outcome for you. Sending you hugs and prayers, may HE hold you tight and give you the strength you need. 

Jenny, that is really interesting!  So was it a node under your sternum that was biopsied?  Do they treat a granuloma? I'm very happy you had good results! Thanks for the encouragement!  

22 minutes ago lkc wrote:

Hi Linda,

It's weird that you
present with multiple enlarged nodes; cervical, chest and abdomen and no
organ involvement which would be expected for a BC recurrence.

There certainly are few possibilities

Did they confirm Bone mets?

I
think your docs have a great plan, and it is so true that EVEN if it
is BC recurrence, your long periods of remission are favorable for a
slew of reasons

Please let us know
about how the biopsy goes and the results.. I'll be keeping my toes and
fingers crossed for you. and please stay here with us!

Thanks Linda K!  Yes no apparent organ involvement is strange given the degree of lymphadenopathy but I gladly accept that good news.  There are some issues on CT regarding my right kidney and right adrenal gland, but that is even more ambiguous at this point and seems to be related to other longstanding issues.  I apparently have a congenital extrarenal pelvis of the right kidney which is often misinterpreted on CT as kidney pelvis enlargement and partial obstruction of the ureteral-pelvic-junction (UPJ). I have no renal symptoms but will be scheduling a visit with a nephrologist to determine for sure if anything is happening there.  I have been getting CT scans at least annually for the last 14 years and they have always noted a small stable "mass" on top my right adrenal gland.  It has historically always been referred to as a "likely adenoma".  Now that I have enlarged lymph nodes I sometimes wonder if the radiologists start "seeing" what they have been seeing for years in a different perspective....thus now they are saying all these old findings are consistent with metastatic progression.  So for me the waters are somewhat "muddy" until we get a definitive biospy and path report.  I'm sure it is possible to have concurrent disease / anatomical abnormalities at the same time as a recurrence.  The 2 small bone lesions were noted on last year's CT but this year's report interprets them as "slight progression in size".  SO....too many variables at this point other than trying to pin down the cause of the lymphadenopathy!  A repeat CT scan in 3 months should be more definitive on any actively changing processes.

(I'm remembering again that old "being on the roller coaster" feeling!) 

29 minutes ago lkc wrote:

Hi Linda Lou,

hmm....Ok all the more improbable for BC mets. My bet is something of an inflammatory explanation. Fingers + toes XXX!

Thanks Linda K... From your lips to God's ears!!  

Still wondering about that 51 result on my CA 27:29.  Max normal range is 38. Can inflammation cause an elevated CA 27:29?