Recently diagnosed nurses or not
Hello everyone, this is my first post but not my first attempt. I feel like I don't know where to start, I start to type, get distracted and then withdraw without posting. I do find some comfort in reading the posts from women going through the same or similar crazy experience. I was not sure where to post, where to start and how much of my story to tell. I have so much family support and they do mean well however I think the people in these groups are the only ones that really know and understand and everyone's experience is unique, so I have committed sometime this morning to share and decided to start my own thread so here goes...
I was diagnosed about a month ago and I found my cancer on fluke. I am 39, 3 months shy of my 40th birthday and I am a nurse practitioner that just graduated about a year ago today. Before that I was a nurse for about 20 years, oddly I worked in a cancer hospital before we moved from my home town of Buffalo, NY. I preface my story with this because being a nurse any kind for any number of years does not prepare me any better than anyone else but did give me the paranoia to investigate my initial concern that led to my diagnosis. Last October I presented a women's health education program highlighting breast cancer. I knew the basics from what I have learned in school and have taken care of in the past but I learned volumes when I sat down and really researched the topic. I read about different types of presentations of breast cancer including skin changes and Paget's disease. If there are any nurses out there you might be able to relate that everything you learn about you sometimes think you have. I think every nurse at one point thinks she has a brain tumor from odd headaches in actuality it is just stress. I had developed some odd itching in my right nipple, then some mild dermatitis, but I read that Paget's usually affect women in their 50's so I kind of blew it off.
Then I diagnosed 2 women in my practice with breast cancer, neither had symptoms and were simply over due for mammograms. I started reading their consult notes from the surgeon I referred them to and started looking back at myself, something struck me in their notes, asymmetry and fullness in both notes. So I looked harder at myself, noted the scaling and itching was cyclic with my cycle. My mother's mother had breast cancer at age 34 and again at 80. I saw the fullness in my right breast and noted hypersensitivity, so I conceded to a diagnostic mammogram and that led to an ultrasound because of the radiologist said "you have crazy dense breast" but we didn't see anything on the US. So he says wait a couple of months if I feel concerned about it I can get an MRI. He actually said my symptoms were indicative of inflammatory breast cancer that can be aggressive and only show on MRI, my thought was no kidding I read that too.
Now I am not a super religious person but I do believe you are given situations or put in situations to learn from, because if I had not done that women's health talk, took care of those 2 women I diagnosed with breast cancer, I may never have met the breast surgeon I referred them to. She had called me to discuss one of my patients and I took the moment to curbside her about my situation. She insisted I get an MRI NOW. I was at first thinking well calm down you haven't even seen me but she is the expert so I did. An hour after my MRI the radiologist from my group called said I had a 2 cm inflammation on my MRI and needed to see a breast surgeon. Well I automatically call the breast surgeon that encouraged me to go in the first place and by the next afternoon I was in her office getting a punch biopsy. That was a Thursday and by Saturday I was told I have IDC but due to all the dermal cells present from the punch biopsy we had to rule out any dermal cancer. So I held out for some dermal abnormality and a mistake it was breast cancer. My colleague now my surgeon is pretty honest with me and says it is IDC but further testing would be needed to assess it's characteristics and what it will respond to best. That was the longest 2 weeks of my life. I got the CT of my chest, abdomen and pelvis and bone scan and my braca genetic testing. Thankfully all scans and braca was negative except for a nodule on my right lung that at this point they are not concerned about but will rescan in 3 months due to my breast cancer diagnosis. My pathology confirmed it was ER positive 100%, PR negative and HERS2 negative with an intermediate proliferation rate that was really on the low end of intermediate so I really hopeful it was going to be luminal A that studies had shown chemo had no long term benefit and is really not needed. I had a blueprint done that looked at all the different characteristics of my cancer and drilled down that it was a luminal B requiring chemo. Damn seriously come on, I feel like I can't catch a break.
I met with my oncologist, oddly enough the one my patients were referred to and they rave about how wonderful he is and I agreed because he calls me personally to discuss my patients I refer to him and shows genuine care and concern. He took hours with my husband and I to explain everything, which awesome for me because at this point I can't define simple words in my head like beast and my husband works with electronics so we were equally lost. The plan thus far is I start TC on Thursday, yes in 2 days. I had my sentinel lymph node biopsy this past Friday and as far as I know it went well but I'm waiting for my results. If my nodes are positive this will alter my treatment by adding adriamycin and require a port placement. I hopefully find out today, as I am not exactly patient and every time I have tried to stay optimistic I am let down by more negative news.
I hope those who read my post do not find it long winded but helpful whether you work in healthcare or not. I do find it cathartic to put my experience on the screen in hopes that this may help other women feel less alone and find some support for one another.
Comments
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I do believe the Lord leads us to where we need to be, to encounter those we need to share the journey with. Thanks for posting your experience. Sometimes we know the info but do not apply it to ourselves. I wish you the best in you treatment, am glad that you have strong support around you, and I know that you will be just fine. Best wishes.
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Hi leo. I am an RN x 30 years so your story really struck a chord with me. I am a little different situation but can relate to how you feel. Getting post op path results this week.
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PatRN10, I am praying your post op path report is negative and for the best outcome possible. I just got my node report last night and unfortunately they were positive. Tomorrow I get my port and meet with oncology tomorrow afternoon to set up the treatment plan for ATC and radiation therapy. A bump in the road but I am holding on tight to the wheel and moving forward.
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Thank you Bettysgirl! So true, its crazy being on this side of the fence.
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Hi leo. I am a little confused. I thought Luminal B was HER2 pos or is yours with a neg with a high ki67?
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By definition Luminal B is ER positive, HER2 negative, and either Ki-67 high or PR low. My cancer has high Ki-67. Here is link to a great research article the breaks it down, I found it helpful in my search to learn what the heck this was all about.
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Thank you so much for the link. Luminal A is pretty clear but I had a hard time wrapping my head around Luminal B as some papers said different things. I get my final path report today. I am concerned because on my bx report, my pr and er were both pos but just stained weak at 25% each. Now I know there is benefit to me taking the adjuvant hormone blockers but I am concerned with 75% out there pr/er neg. I am anxious to have appt. with MO to discuss this. I have read a couple articles that link outcome to the degree of er/pr positivity.
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You are welcome. I know it is hard to wait but try not to dwell too much. I know that is hard having to wait 10 days for my blueprint. I am not sure where you live but my surgeon runs a blueprint test from Agendia that looks at cell specific characteristics of the cancer cell. Look it up just look up mammoprint or blueprint by agendia. This helped my doctor determine the luminal B specific characteristics. It made my course of treatment determination a little easier to wrap my head around and is based on some recent data for improved survival rates. Now as my MD did remind me not to be freaked out by the current data giving a scary percentage rate of luminal B because the data of current survival rates have not been trialed long enough to show a greatly improved survival rate based on what they have already seen. Not sure that makes sense. My point is the blueprint was a game changer for me. I did find out that of the 2 sentinel nodes biopsied one was positive with a 5 mm area in positive node. Its ok, I got a plan. My advise is to wait for the info as hard as it is, get the plan to address that info and wait for the result of the next step. Girl you will make yourself crazy getting ahead and wrapped up in what ifs and it could be outcomes. That has been the best advise I have been given. I got the port today and saw the oncologist. We got a treatment plan based on analysis of each piece of data that has been gathered with each test and result determining the next test to be done to get this point. Hang in there and PM if you need to talk. I am praying for you!!
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sounds like a long day for you. My node was neg. Thank goodness and hormone/her. Status remain unchanged. Sure looks like lumina A but in my excitement I forgot to ask BS But oncotype or mamma print . I will bring up at MO appt.. Hang in there. Praying for you too!
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nurse or no nurse we are women and in this together for support, i workedin O R as a instrument tech 15 yrs then in city clinic for almost ten when i found the lump,just being women together will get us thru. i was 42,planning 2nd marriage, i am now a 21yr Survivor(Praise GOD). msphil -
Congrats msphil on 21 years!!!!!Pat
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Hello Leo1975,
Thank you so much for reaching out to us. Your post was quite touching. I, probably like you, am not used to being on this side of the bed. I've been very healthy my entire life and I'm really having a hard time with this. I am still new to my diagnosis....just about 10 days in so far, so I'm still trying to figure out what exactly is going on. My path report came back, and the shoe dropped. I'm triple negative, but I'm trying to be super hopeful.
I'm also 39 and I just completed my first year of my NP program. Oddly enough, in my epidemiology class, I ran across some literature from a radiology journal praising MRI for dense breasts in addition to mammo. Almost simultaneously, I noted what I thought was a swollen gland in my axilla so I asked for an MRI. My mammo just 5 months ago was fine, so I figured all was well, but I have a strong family history. According to the diagnostic mammo and ultrasound,the gland is (hopefully) fine, but the diagnostic mammo found another mass in my breast. So far, the axillary region simply appears to be accessory breast tissue, but I'm awaiting surgery and node dissection still. Of course I'm trying to work up until the day before they schedule surgery. I've found the more I sit, the more I'm reading depressing data, so I hope they schedule me soon.
Hope you are feeling well and will continue to post here.
pavlovsbell
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I am also triple negative and cancer free for 12 yrs. Braca also! Had double mastectomy. Great decision. Currently worried about inherit pancreatic risks due to Braca/ .. to get a scan or not of the pancreas.. even though I am healthy... Big decision!
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pavlovsbell, hang in there, and indeed, keeping yourself busy with work is a great idea. Please naturally keep us posted!
Linguist52, yes, that is a big decision. Do the physicians recommend it? What do they want to do if they would see any changes?
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Linguist,
That is the most awesome news I've heard in a LONG time! 12 years!! I am lining up all my genetic testing stuff still, so I understand that must weigh heavily on your mind.
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