It was a dark and stormy morning the other day in the Big Apple but, fortunately, that is no longer the mood here, though the clouds still remain on the horizon. Two months ago I barely understood that hearing the margins are clear and the lymph node was negative from a breast cancer surgeon was a good thing, but that is what my wife heard this morning. In plainer English my wife's breast cancer did not spread into her lymph nodes and the surgeon says he got all of the cancer and she doesn't need more surgery. Now she waits for the result of
the Oncocyte DX test (analyzes the activity of a group of genes that can
affect how a cancer is likely to behave and respond to treatment, the higher the score, the more likely there will be a recurrence, meaning the benefits of chemotherapy outweigh the risks) and sees the oncologist to see if chemo is necessary (probably) or she can get away with just radiation.
One troubling bit of information though. We examined her pathology report a bit more thoroughly after she returned home. Her Bloom-Richardson score was 8 out of 9 (details below). This information is used for prognosis / risk of recurrence and scoring an 8 means that the risk of recurrence is higher than someone whose tumor was grade 3, for instance. Also, from the time of the initial biopsy just 4 weeks before surgery, the tumor had grown and was about to be on the move. While it means that by catching it early we were incredibly lucky, this is not good. What this ultimately means is unclear. Short term, we see what the oncologist says. Long term, the outlook is unknown, but then that is the case for all of us. Still, it is one of those times where I wish I didn't have a cold, unemotional but logical skill set for work. Hopefully her oncologist can set our minds at ease when she starts planning out my wife's treatment plan.
To really put it in perspective, my wife has a co-worker, 40 (just a year younger than my wife), who is not as "fortunate." This woman had her first mammogram a few weeks ago and her doctors discovered not only much more cancer than what my wife discovered, but that hers had already spread into very bad places. She hasn't even been staged yet but from what my wife said her outlook may be very grim -- the cancer may possibly already be in the chest and bones. Worse, she is a single mother, living paycheck to paycheck with young children and already out of sick time. So, from that angle, we are blessed (by whom I have no idea) to have gotten away with just a speed bump -- for now.
To really put it in perspective, my wife has a co-worker, 40 (just a year younger than my wife), who is not as "fortunate." This woman had her first mammogram a few weeks ago and her doctors discovered not only much more cancer than what my wife discovered, but that hers had already spread into very bad places. She hasn't even been staged yet but from what my wife said her outlook may be very grim -- the cancer may possibly already be in the chest and bones. Worse, she is a single mother, living paycheck to paycheck with young children and already out of sick time. So, from that angle, we are blessed (by whom I have no idea) to have gotten away with just a speed bump -- for now.
For now, we are focusing on the positive. As far as most of our friends and family knows, all is well and, for now, that is the truth. In the mean time, her next appointment at Sloan is not until January 2013, and then every 6 months until 2018. Nice to have long term plans. Hopefully we can keep them.
Stats from the pathology report:
- Histologic grade was 3 out of 3 possible (minimal or no tubule formation)
- Nuclear grade was 3 out of 3 possible (marked variation in size and shape)
- Mitotic Count was 2 out of 3 possible (8-16 mitoses per 10 high power fields)
See website links for detailed explanation
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