Recap - Being Dense

So I'll try and recount the history of what's been happening here. But the good news is my brain seems to be back functioning at normal speed. I had been nervous that I would be foggy for the full time of chemo so it is exciting to be feeling more like myself.

I was diagnosed with breast cancer in the middle of October. But starting last May I had found an area of my breast that seemed to be lumpy but changed over the course of the month. I went to see my doctor - and had a regularly scheduled mammogram - which came back negative but hard to read due to density of patient's breasts. This was effectively the report I have gotten back on all 13 of the mammograms I have had since turning 30. (Early vigilance due to my mom's diagnosis 15+ years ago. She's also healthy and doing great.) If this sounds a wee bit bitter, it is because I am. But we'll come back to that. I spent much of the summer and early fall surreptitiously obsessed with whether something was happening in my left breast and finally in September went back to my doctor. She sent me for a diagnostic mammogram, which I scheduled for October 3 and after scores of pictures the radiologist saw something that might be something but it lacked dimensionality. This led to an ultrasound where the radiologist saw something about 11 mm that he wasn't that concerned about but he was willing to give me the options of having an MRI, having a biopsy or waiting 6 months. No one thought what they were seeing was different than dense, lumpy breasts.

I opted for the biopsy and had it a couple of weeks later. At this point I could feel something larger but it wasn't very distinct and was happy taking comfort in the small size. The biopsy came back positive - and I was then scheduled for an MRI. (At this point I wasn't all that surprised and had already convinced myself it was cancer.) Not to be fatalistic but since my mom's diagnosis - breast cancer has been the thing I've thought I'd be most likely to get and in some ways was resigned to it. Too many friends and friends of friends have been diagnosed. While upset, it also seems treatable and beatable - again due to the others who have had to deal with this before me.

The point where I lost it and the bitterness flowed was after the MRI - turns out my tumor is 5-6cm and there is a not very well defined grey area that is the tumor that was probably there in at least the May mammogram. I understand MRIs are more expensive and ironically I would have been eligible potentially to get one done based on my mom's age of diagnosis, but the 13 years of poking and prodding seem a bit like a waste of resources and energy.

I'm not trying to discourage anyone from getting their baseline (and regular) mammograms but it seems like there should be more discussion of whether this is that good a tool once you get into different subgroups. Turns out I might not be that unique - for women with dense breasts mammograms miss tumors. The high effectiveness rates have a lot to do with the fact that it is still the case that most diagnosed women are post-menopausal. So having a big tumor in some ways has bummed me out more than having a tumor.

On the positive side - the cancer is hormone receptive and protein negative. My doctors are great and think that doing chemo first has a good shot of shrinking the tumor to a size where a lumpectomy may be a fine option. So the pathology looks good, there is no evidence of metastization and I've embarked on 4-6 months of chemo including first A-C for 4 treatments and then taxol.

I'll report more about the testing and why I may need to adopt a diet of chicken fried steak to get my blood pressure up to a normal range. Don't I seem more volatile than someone with blood pressure that stays low should have? More about the joys of the mediport later.