What kind of cancer do I have?
Breast cancer. Stage 2. There were multiple, and various, cancerous masses within my left breast and some cancer cells spread to the lymph nodes underneath my left armpit.
(As though having to regularly say "breast" to colleagues and acquaintances isn't enough, I must also hit them with the word "armpit".....!)
How did I discover it?
My very first mammogram (ever) — in September 2024 — revealed microscopic calcifications that made the doctors want to do a biopsy, which revealed cancer. Further scans and biopsies revealed several cancers within the left breast and also cancer in my L armpit lymph nodes.
**None of my doctors, not even my breast surgeon, was able to feel any of my tumors when they gave me hands-on breast exams, right up to my surgery date when they removed the breast tissue.**
Do not rely on self-exams or doctor-administered hands-on exams exclusively. GET A MAMMOGRAM EVERY YEAR, PLEASE, beginning as early in life as is practical for you.
What is the treatment plan?
- Surgery #1: Double mastectomy (w/reconstruction) + lymph node biopsy
- Two rounds of chemotherapy (lasting five months total)
- Surgery #2: axilla dissection surgery + immediate lymphatic reconstruction
- Radiation (six weeks, daily Monday-Friday)
- Reconstruction of breasts (optional) -- major surgery
- Oral hormone blocking therapy (pills) for 5-10 years (which will artifically put me into menopause, because they rob my body of estrogen; my tumors fed off of estrogen)
How long is the recovery?
My two surgeries + chemotherapy + radiation will take place over the course of one year; April 2025-April 2026.
After radiation wraps up, likely April 2026, if everything stays on course (which is not guaranteed), I'll begin endocrine therapy; taking 2-3 medications in pill form for 5-10 years.
And I'll have to keep my port in my chest until at least August 2026, since the Herceptin is administered that way.
And if I decide to continue with reconstruction (more details below in "Timeline" section), then I'll need an additional surgery for that.
Finally, because so many lymph nodes have already had to be removed from my left side (with more to be removed soon), I can never again get an IV or a blood pressure cuff placed on that arm, due to heightened risk of lymphedema.
Do you have a MealTrain set up?
Thank you so much for asking. At this time, I do not feel I need one.
How am I (Sarah) doing with all this?
Honestly? Fine. I feel quite matter-of-fact about the whole thing, which is a relief.
I cry more than I did pre-cancer, sure. The tears are never too far from the surface. It feels like a lot to process. I am feeling "information overload" in a very real way. I notice myself forgetting words when speaking sometimes, which is not caused by anything chemical but rather just an onslaught of terminology, decisions to make, details to organize/remember/update people on, appointments to make and attend, etc.
I'm not angry at my left breast, or my body, for "allowing" this to happen, which is also a relief. I'm sad for that left breast, that it was having such a tough time, and glad I'm taking better care of it now that I know what it has been needing for who knows how long- for the innards to take a bow and exit stage left. Done.
I will note that it "didn't seem like" I had cancer for a long time; it just seemed like I was having a lot of doctors' appointments (Jan-April). Every once in a while it hits me -- like when a doctor looks at me and says something particularly major or when I receive a really kind card from a friend -- and in those moments I think to myself "oh, I seem to really have cancer".
Mostly, it still seems like just a thing that's going on with my body that I need to coordinate with doctors on and go to appointments to fix. Which... it is. Chemotherapy will likely really drive the point home.
It's a relief to stop thinking about having cancer and just be me, when I get to do that. Running into people I know through work stuff is a joy because I feel a visceral shift into the person I am there- interested, attentive, helpful, enjoying my professional relationship with an interesting, dedicated Mainer. (vs. feeling like a recovering patient, pulling a dryer door open with two hands to minimize discomfort to my recovering body)
What makes me the saddest/most emotional is thinking about the fact that it's extraordinary that I have access to excellent treatment and that I can afford any treatment at all. I am a unicorn in this country, and that fact makes me despair. I have twelve weeks of paid leave from the best job on earth and colleagues who demand that I think not of the daunting load they carry daily, as they take on my work as well as their own cheerfully, who instead insist that I simply rest and recover and do what I need to do to get this cancer out of my body and life.
My understanding job which I'm able to pause, my kind and accommodating colleagues, my generous paid medical leave, my access to treatment, my ability to afford that treatment -- having all of these things are highly, highly unusual in this country, and I am grateful every single day for how I'm able to navigate this.
What can you do to help?
Please check this blog for updates vs. asking me to bring you up to speed! Apologies for the bluntness, but it gets overwhelming in a hurry to keep up with all the communications from caring friends and family. It is A LOT.
I always appreciate your concern and caring, please know that, but the truth is I feel overwhelmed easily these days (2025, my job, this cancer, plus normal life going on in the background), and I feel badly because I can't get back to each of you with the level of thoughtfulness you deserve.
What's helpful is if you send me a text or email suggesting things you are available and willing to do (e.g. drive me to chemo, which I think is a half day project; pick up pharmacy stuff for me; send cute cat videos; make healthy food for me, etc.) I'm keeping a list of those kind people and what specifically they've offered so I'll have it as needs arise. Please note that offering "hugs" and "prayers" and "light and love", from however far away, also gets added to the list!
Where am I receiving treatment?
Right here in Maine! Specifically at New England Cancer Specialists in Westbrook, ME. (Next town over from Portland.)
I have been dazzled by the professionalism, kindness, and competence of every member of the NECS staff since Day One, particularly my breast cancer surgeon (Dr. Paige Teller) and medical oncologist (Dr. Chiara Battelli) and their medical support teams.
My plastic surgeon is Dr. John Kirkham with Plastic & Hand Associates in South Portland; the only plastic surgery practice in Southern Maine, and he has been terrific.
What's the timeline? (Shorter version)
Sept 2024: first mammogram ever, age 42
Jan 2025: biopsy of left breast; diagnosis of cancer
Feb 2025: biopsy of L axilla lymph nodes; cancer diagnosis goes from Stage 1 to Stage 2
March 2025: numerous discussions with teams about what order to pursue: chemotherapy then surgery, or vice versa. It is decided we do surgery first, then chemotherapy. Meanwhile, I go to Dana Farber in Boston for a second opinion and am not impressed. Delighted to choose New England Cancer Specialists for my breast surgery and oncology moving forward.
April 2025: SURGERY. I choose to have a bilateral mastectomy (both breasts are entirely removed from my body), with immediate reconstruction (which means plastic surgeon inserts temporary implants called "tissue expanders" to keep the skin stretched properly where the breasts used to be, to achieve, down the road, as flawless a result as possible with new fake boobs). Temporary, not permanent, because you have to wait until after radiation to do permanent.
May 2025: the pathology comes back from surgery; turns out they found cancer in 4 of the 5 lymph nodes they removed. I'm told I not only need a second surgery for additional lymph node removal, but that I'll also need extensive chemotherapy.
May 2025: SETBACK: infection in my right breast; emergency procedure to remove right tissue expander which was culprit. I am now lopsided, uniboobed.
June 2025: I go back to work, following six weeks off for medical leave
June 2025: I have a port inserted into my chest, semi-permanently. Chemo meds and blood draws will happen via the port (to save the veins in my arm, since I can now only put needles in one arm)
June and July 2025: chemotherapy part one, treated with "AC" drugs
June 2025: three weeks into chemotherapy, my hair falls out in massive clumps and it's annoying and incredibly saddening. I sob to my mother over the phone who promptly travels many hours and miles to be with me. Three days later, I get a buzz cut with my sister at my side.
August 2025: SETBACK: infection in my left breast; caused by tissue expander. Emergency procedure performed to remove that tissue expander. (I am now flat-chested.) Start of autumn chemo delayed because of this infection and surgery, which is not good. Then, I have a major allergic reaction to the chemo drug (Taxol) once they do start, necessitating another week of delay.
September 2025: I finally start part two of chemo, albeit 4.5 weeks late. This round is once weekly, on Fridays, for 12 weeks, drug is Abraxane. I also get Herceptin every three weeks.
December 2025: recover from chemotherapy
January 2026: SURGERY #2, in Boston (it is not performed in Maine). Dissection (removal) of many more axilla lymph nodes in case they also contain cancer. Lymphatic reconstruction of left arm performed.
February/March 2026: begin radiation. likely six weeks, treatment every single day Monday-Friday.
April 2026: begin 5-10 years of pills (endocrine therapy); this is when they remove all the estrogen from my body to starve any remaining cancer cells.
Fall 2026: absolute earliest I could have a surgery to reconstruct breasts, if I choose to do so.
What's the timeline? (Longer Version)
September 2024: I get my first mammogram ever in the waning days of being age 42. No doctor told me to get that mammogram; I requested it, because I noticed in my portal that I had an automatic message telling me I was overdue for one, which must have been working off old guidelines that had women start doing mammograms somewhere around age 40-42. (Current guidelines are more like age 45, I believe.)
I don't like being told I haven't done something when I didn't realize I needed to do it, so I mainly called to yes, get an important medical test done, but really to get that condescending message off my portal. I'm joking, but only slightly. Anyway, glad I'm stubborn and happened to notice that message in the portal.
October 2024: I'm told they'd like to biopsy two locations in my left breast. I say fine, but I'm going on vacation to Turkey so that will have to wait. 😆
January 2025: They biopsy my left breast and diagnose me with breast cancer.
I am diagnosed on January 15. A madman ascends to the highest post in the land on January 20. It is a rough week. I feel zero symptoms, just marvel at the fact that my country and body seem to be breaking down in tandem.
February 2025: They biopsy a lymph node (which they'd observed as "inflamed" via an ultrasound) in my left axilla (armpit) and find cancer there. This finding moves me from Stage 1 to Stage 2 designation.
March 2025: I undergo what seems like a test a week (PET scans, etc.) to further assess what’s going on in my body so we can determine how to treat it. My medical oncologist and breast surgeon deliberate whether I’d be better served by undergoing surgery first, then chemotherapy or vice versa.
Late April 2025: Surgery (double mastectomy plus reconstruction, biopsy/removal of five lymph nodes from L axilla). Surgery involves breast surgeon (to remove the breast tissue) and plastic surgeon (who "begins reconstruction" [of the breasts] right there in the surgery, inserting temporary implants to hold the space so the skin doesn't shrink back, since at the time I thought I ultimately wanted permanent breast implants.
Everything my breast surgeon removes from my body is sent to pathology, which reveals that four of the five lymph nodes she removed contain cancer. Also of note: once she got in there with her tools, my breast surgeon Dr. Teller found two additional cancers in my left breast that had been "occult to imaging". Wild.
Given that four of five lymph nodes biopsied contain cancer, considered to be a high number, Dr. Teller suspects there may still be lymph nodes in my left axilla that contain cancer. She recommends chemotherapy as soon as possible, to be followed by a second surgery to remove all of the lymph nodes in this particular "pocket". Note: the second surgery will not remove all of the lymph nodes in my axilla/armpit, but all of the ones in this particular section of the axilla -- where cancer has been found.
Again, the goal is to get every cancer cell out of my body. Chemotherapy's job is to spread poison throughout my body that will kill any cancer cell that may have already have escaped my left breast/left axilla region. The second surgery will remove so many lymph nodes (in an effort to make sure any and all cancer cells are removed) that it will put me at about a 30% risk for lymphedema in my left arm. To combat that, moments after a breast surgeon performs that "axilla dissection surgery" on me, a lymphatic surgeon will perform a "lymphatic bypass surgery" which should decrease my risk of developing lymphedema to 10%. There are 11 locations in the U.S. where this experimental surgery is performed; one of them is Boston, so the fact that that's relatively close by and my immediate family lives there is another blessing.
May 2025: Setback: Recovering from surgery, I develop a bacterial infection in my right breast, necessitating removal of the tissue expander (temporary implant) on that side to let my body heal.
This means I have one visible breast for the foreseeable future.
Update! In August 2025, I got an infection in the left breast, caused by the foreign object placed there during my April bilateral mastectomy-- necessitating emergency removal of the left breast tissue expander and lots of antibiotics.
So I am flat-chested to the naked eye for the foreseeable future.
(June 1: I return to work)
Late June 2025: I get a port placed in my chest. It's a half day, outpatient procedure; they put you half under anesthesia but not all the way under. It's painful and there's a lot of scarring. And the port sticks up from underneath your skin. The whole thing feels very invasive and makes me look Frankenstein's monster-esque.
June & July 2025: Chemotherapy round one. A and C drugs (adriamycin and cytoxan). Once every two weeks, four times. Nausea, headaches, tired the few days after each dose- really not bad overall. Thank god for medical advances made over the past few decades.
August 2025: Setback. I battled infection in my left breast due to tissue expander (temporary breast implant); same situation I experienced in May with the right breast. Recovering from that emergency surgical removal + my allergic reaction to the first chemo drug they tried (Taxol) meant the start of my fall chemo regimen was delayed a whopping 4.5 weeks. This is not great; you want to get chemo in your body ASAP, to kill any cancer cells lingering in the body before they have the chance to do any more damage. Happily, the fact that I had surgery first, then chemo, means a chemo delay is less cause for alarm. Were the surgery/chemo order reversed, the chemo delay would have been more of a concern -- since the tumors themselves would still be in my body, wreaking havoc.
September-November 2025: Chemotherapy round two begins. Abraxane is the chemo drug. Once weekly for twelve weeks. At this time, I also begin receiving Herceptin in the chemo chair every three weeks for one year.
November 2025: chemo scheduled to finish late November
December 2025: body recovers from chemo
January 2026: surgery in Boston (full Left side axilla (armpit) lymph node dissection + lymphatic bypass reconstruction). 4-6 week recovery.
March and April 2026: Radiation therapy; daily Mon-Fri for five or six weeks.
May 2026: begin antiestrogen pill therapy which I take for 5-10 years. I will be artificially put into early menopause by this drug, at the age of 44. (My original cancerous masses were of the "hormone loving" type, meaning that if you take estrogen and progesterone out of my body, it starves those cancers)
Also begin Verzenio, a pill therapy, which I take for two years.
Fall 2026: I may undergo a third major surgery, this one to "complete breast reconstruction" - i.e. create artificial breasts. One must wait six months after radiation to insert permanent breasts (whether those are articial or made of body tissue from another part of the body, so this is a decision to be made down the road (as of time of writing this, Sept 2025))
2027: I hopefully take an epic vacation!
Is Fergus still cute?
Fergus the Cat IS still cute! He is a wonderful caretaker and I'm grateful for him every day.
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