Paging Dr. Getz

(written by Sunny)

On Tuesday, February 17, 2015 Lindsie received a call from her radiologist confirming what she already suspected to be true: Multiple masses in her right breast and at least one lymph node were malignant. Lindsie was diagnosed with Invasive Ductal Carcinoma (IDC). That same day we met with a surgeon, Dr. Getz (whom Lindsie needs to describe in her own words sometime because he really is the best thing ever), who confirmed the diagnosis and laid out a plan for treatment based on the characteristics of Lindsie's cancer. I warned you it was going to get real technical and real boring real fast.

Characteristics

• Invasive Ductal Carcinoma (IDC)- This means the cancer originated in a milk duct. It is invasive because it has spread into surrounding tissue. This is the most common type of breast cancer.
• Grade 3- This is different than staging. Grading refers to how different the cancer cells appear from normal cells under a microscope. The highest grade, or most change, is 3. These cells are often dividing rapidly. This can be helpful during treatment because most chemotherapies and radiation specifically target fast-dividing cells.
• Estrogen Receptor Positive (ER+) 95%- ER+ means the cancer cells have receptors for estrogen and the estrogen is promoting the growth of the cancer. Hormone therapy to reduce estrogen in the body or to shut down the estrogen receptors is recommended in ER+ cancers.Lindsie's ER+ score was 95%, meaning that of 100 cancer cells examined 95 had estrogen receptors, making Lindsie a great candidate for hormone therapy.
• Progesterone Receptor Positive (PR+) 2%- The cancer cells also have receptors for progesterone. However, only 2 in 100 cells showed receptors. This should not impact treatment.
• HER2/neu- A protein whose presence or lack thereof affects the course of treatment. Lindsie's results wouldn't be back for two weeks after this meeting. We will discuss the implications of those results in another post.

Further Tests

• MRI of chest- To happen on a regular basis to follow changes in the right (affected) breast and watch the left breast.
• PET/CT scan- For staging purposes. This shows any tumors in other areas of the body such as the bones, liver, lungs, brain, etc.
• Genetic testing for any known mutations associated with breast cancers.

Treatment

• Install a port beneath the skin through which chemo will given.
• Chemotherapy for about 4 months to shrink or eradicate the tumors in the breast and lymph node.
• Double mastectomy. Removal of the left breast is not medically necessary, but easiest for reconstruction purposes.
• Radiation to the chest wall to eradicate any possible remaining cancer cells.
• Remain on the hormone blocking drug Tamoxifen for 5 years to insure that any estrogen fed cells that may be left in the body cannot grow.

With what we knew at that appointment the goal of treatment was cure, meaning there is no cancer left in the body. It meant a difficult road, but an attainable positive outcome.

At the time of this appointment Lindsie and Josh had planned and paid for a family trip to Disneyland for the coming weekend. They were set to fly out Saturday, February 20th and fly home the next Saturday. Dr. Getz encouraged them to take the trip. He felt an additional week would make no difference in the progression of the cancer and the positive experience would only boost Lindsie's immune system and help her through the treatment ahead. Lindsie felt super positive about the trip and the outcome at the end of treatment.

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Mardie

3/17/2015

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