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Friday, February 26, 2016

Next steps

First, a little more explanation as to why the negative result for the BRCA gene mutation is such good news. If you test positive, the recommended next steps are a double mastectomy, removal of ovaries, and yearly screenings thereafter for pancreatic cancer. You do all that because the percentages are so high for recurrence of breast cancer, and onset of ovarian or pancreatic cancer. SO grateful that those are not part of my journey.

We met with the medical oncologist (Dr. A) today and, as before, he gave us super clear, detailed info.

MRI results - they found two small "masses" which are predicted to be benign, but a followup ultrasound is recommended. If that doesn't clarify matters, there are one or two other MRI/Ultrasound/Biopsy tests they can do, and of course it's recommended that those are done before surgery.

Chemotherapy - as I indicated in an earlier blog, I fall in the hazy middle ground for the test they now  do (Oncotype DX) to help determine whether or not to do chemo. Percentages say that by continuing with the anti-horomone med I'm currently taking, my chances of cancer recurrence are about 13%. If I do chemo, my chances of recurrence are about 9% - only a 4% difference. But it can be an important 4% since if the recurrence is somewhere else in the body (bone/liver/lung/brain are most likely, in that order) it's not curable.

I'm torn. There's a lot of nasty side effects with chemo, most of which dissipate with time, but some occasionally don't. Plus the idea of putting that stuff into my body is just something I'd rather not do. On the other hand, lessening the chances of a recurrence sounds pretty good.

What we came up with for now is to wait for the pathology report after the surgery. I'm already taking the anti-hormone med, based on the suggestion from the surgeon not in our network, but most docs don't prescribe that til after surgery. Her experience is that if the post-op report comes back showing the cancer cells are dividing at a significantly lower rate than they were before, then we would know the drug is doing good work and chemo is likely not necessary. I get the sense that this isn't a typical suggestion by Dr. A, but he really respects that surgeon, and he agrees that it could be a helpful indicator one way or the other regarding chemo treatment for me. There's always about a 4 week waiting period between surgery and chemotherapy anyway, so at this point, I think I'll wait for those results.

Thankful for a "negative result" on the genetic test!
Thankful for super helpful medical team!
Thankful for super friends and family team!

Praying for:
Clear results from the MRI followup tests
Clear direction for chemo/no chemo decision




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