I'm Getting a Tattoo!

And you're not gonna see it... or them. OK, so they'll look like freckles. Not exactly a cool thing. The Hello Kitty tattoo'll have to wait.

Met with the radiologist, Dr. Chada, at BI today. Lovely woman, very well spoken, thorough, and approachable. Another winner--I feel so lucky. Although we didn't establish the treatment plan--more of the waiting game--she did go over the whats, hows, whys, etc. To sum it up, we want to kill all the remaining cells that could be lingering around in the breast. More than likely, there will be a six week course of treatment. These take place five days a week. The first 4.5 weeks, the entire (right) breast is targeted; the last 1.5, the exact site of surgery. The armpit (location of sentinel node biopsy) is not intentionally treated but may get radiated. After we finalize course of action, I make a "sim" or simulation appt. We designate the actually spots that get treated which are marked with tattoos in order for the machinery to be properly aligned every time I go back. There won't be a treatment done this time.

This site is one of many that can answer questions about radiation + its side effects. Quick ease of mind, no, I won't be "radioactive" and won't be a walking florescent mushroom cloud. Please read this for some quick Q+As.
http://www.ucsfbreastcarecenter.org/radiationtherapy.html

So why didn't we finalize everything today?

During the next appt, I met with the oncologist, Dr. Malamud. A dapper man in a pin stripe suit, funky neon tie, elephant cuff links and nice tan (I asked him where he got it. He said, "Eh, New Jersey. No ozone."). Dapper, smart and funny. Who can ask for more.... The use of chemo is TBD. There's a relatively new test (has been used for two+ years) called the Oncotype DX. In essence:
The test was developed for women like me w/early stage bc that is hormone receptor positive and lymph nodes are negative.
A sample of the tumor tissue is sent to the Genomic Health Reference Lab in CA.
Ones "gene signature" is reviewed and gets translated into what's called a Recurrence Score: from 1-100, what's the likelihood of the bc returning within 10 yrs of diagnosis.

The higher the #, the more aggressive, the more likely the use of chemo. The use of chemo is based on the assumption that I am getting radiation treatment and taking tamoxifen (hormone therapy). If my #s fall in the middle, then even more careful consideration goes into the decision to use it or not. IF, and only IF, I were to proceed with chemo, it would be completed before radiation over the course of a few months. Chemo is used to kill anymore cells lingering in the entire body; the radiation is targeting just the breast.

Anyway, this is a great test which helps the pt and dr be more informed about the individual's cancer and enables the drs to tailor the treatment plan accordingly. The results will come back in a couple of weeks and will be reviewed w/ the dr on 10/17.

For info on this test, go to:
www.oncotypeCX.com

The use of tamoxifen would begin when the radiation is started. Tamoxifen is the only drug for pre-menopausal women and is also referred to as 'hormone therapy." This is not to be confused w. taking any synthetic or bio-identical hormones.

I took this from a website: Estrogen promotes the growth of breast cancer cells. Tamoxifen works against the effects of estrogen on these cells. It is often called an “anti-estrogen.” As a treatment for breast cancer, the drug slows or stops the growth of cancer cells that are present in the body. As adjuvant therapy, tamoxifen helps prevent the original breast cancer from returning and also helps prevent the development of new cancers in the other breast.

For more info go to:
http://www.cancer.gov/cancertopics/factsheet/Therapy/tamoxifen

A lot of info I know. In summary:
1. Wait, wait, wait, tap fingers, wait some more.
2. On 10/17 review Oncotype DX results w/Dr. Malamud.
3. Results determine likelihood of recurrence and therefore use or not of chemo (hopefully and likely I will test low on the scale and not see a definite need for it).
4. Review this info w/Dr. Chada who will plan out the radiation dates based on whether or not chemo is administered.
5. If chemo's used, do that for four months followed by six wks of radiation. If not, then book sim appt, get new sexy tattoos, and soon after begin the six week treatment.
6. Regardless of use of chemo, take tamoxifen for five year pd at time radiation starts. (five years being the amt of time during which it was tested on pts; it's not a random #)
7. Pray for no side effects of any of these treatments. Big OY VEY but I don't think anything intolerable.
8. Closing ceremonies for boob blog. (TBD)