About

My name is Katie and on September 9, 2013 I was diagnosed with breast cancer. This page is meant to provide detailed information on my diagnosis and treatment history. To learn more about my current treatments go here.

Diagnosis

On September 9, 2013 I was diagnosed with triple negative, Grade 3, Stage 2A breast cancer. I found a lump in my right breast in late August of 2013. I went in to see my primary care physician who referred me to get an ultrasound at Georgetown University Hospital. I ended up getting an ultrasound, mammogram and biopsy on September 4th and was diagnosed the following week. The original cancer was a 4.7 x 4.7 cm lump in my right breast an a 1 cm lymph node in my right auxiliary (armpit) that turned out to be cancerous.

My cancer is triple negative which means that it is not have receptors for estrogen, progesterone or HER2 (the three known receptors). I have 0 estrogen and progesterone receptors and have been found equivocal for HER2 which means I have some receptors but not enough for targeted treatments to necessarily work.

I have also tested negative for BRCA genes as well as a panel of more than 25 other genes that have a known link to breast cancer.

Fertility Treatment

Before I began chemo I received fertility treatment to preserve my fertility. I ended up having 52 eggs harvested and 25 were successfully fertilized. This is an incredibly high number so others going through the same thing shouldn’t necessarily expect similar results. To learn more about my experience with fertility treatment see this blog.

Chemotherapy

Because my tumor was large it was recommended that I have neo-adjuvant chemo in order to shrink the tumor as much as possible. I was part of a clinical trial called I-SPY II so my regimen was as follows:

October 2013- December 2013 – Taxol and MK-2206 (an experimental chemo), 12 weekly rounds

My symptoms included:

Hair loss- I shaved my head after the 2nd round because it was falling out but still had hair growing back through the end of this treatment and kept some eyebrows and eyelashes through the end
Stomach upset- The best way I could describe it was it felt like I had a sponge in my stomach for several days following treatment
Fatigue- I was usually super drained the day of treatment and on the second through fourth day after treatment- this lasted longer as the treatment wore on
Heartburn- I had terrible heartburn and was on Prilosec for most of my treatment
Nail issues- I developed dark spots on some of my nails during this treatment and all of my nails (toe and finger) fell off about 6 months later which I blame on this treatment. Basically as my nails grew out they split about half way down and fell off so I still had about half a nail left. It wasn’t pretty but it also didn’t hurt and it was less noticeable then you might imagine. It took about 4 or 5 months for them to look normal again
Neuropathy- I felt tingling in my hands and feet that resolved after treatment ended
Amenorrhea- I had my last period in October of 2013 and developed menopausal symptoms such as hot flashes and night sweats
Rash- The MK-2206 caused an allergic reaction around the 7th treatment that included a full body, incredibly itchy rash. The only thing that helped was covering my body in ice packs. We reduced the dose of the MK-2206 and the reaction went away
Pericarditis- I ended up in the ER once with a swelling of the lining of my heart which caused chest pain- this resolved pretty quickly

January 2014- February 2014– Adriamyacin and Cytoxan, 4 rounds every other week

My symptoms included:

Hair loss- on this treatment I lost all of the rest of my hair including eyelashes and eyebrows
Nausea- the nausea was much more intense on AC then on Taxol- I never threw up but I needed more anti-nausea meds to control it
Gastric reflux- I had terrible gastric reflux and a lot of problems with stomach acid on this treatment
Burning eyes- I had some problems with really dry eyes during this chemo- apparently this chemo permanently damaged the part of my eye that produces an oily layer that holds the tears to the eyes- I still have problems with dry eyes
Mouth sores- I had enormous mouth sores that covered my tongue and throat- I didn’t find much to relieve it
Fatigue- I was usually deeply fatigued and sick feeling for roughly a week after treatment

April 2014- June 2014 – Carboplatin and Taxotere, 4 rounds every 3 weeks

After my mastectomy they discovered that the previous treatments had only caused my cancer to shrink by about 20% and they found it had spread to my lymph nodes. Even though it was off-standard care they decided that additional rounds of chemo would be beneficial given how aggressive my cancer was.

My symptoms included:

Hair loss- my hair had started to grow in a little before this treatment and it continued to grow in after but was relatively thin
Nausea- it wasn’t as bad as during AC but I still had some stomach problems
Fever- my fever spiked after every treatment which forced me to go to the ER after every treatment
Neutropenia- I couldn’t have my last treatment on time because my red blood cell count was too low
Fatigue- I usually felt sick for about a week after treatment

Surgery

It was recommended that I have at least a single mastectomy since the tumor was still so large when I finished chemotherapy. I opted to have a double mastectomy because with triple negative breast cancer in young woman survival increases by 5% with a double mastectomy. I was able to have skin and nipple sparing surgery on March 11, 2014. My surgeon, Dr. Shawna Willey, recommended that I have my right nipple removed as the cancer was quite close to it but I protested and she agreed to test the skin under the nipple. If it had been positive I would have had it removed in a second surgery but it turned out to be negative. I also had a lymphadendectomy and had 11 lymph nodes in my right auxiliary (armpit) removed. Three were positive for cancer with the largest at 1 cm. The scar on my left breast is below my breast and the one on my right is across the right side closest to where the cancer was.

I also had a reconstruction with expanders placed under my pectoral muscles. They started being filled at 200 ccs and eventually were filled to 400 ccs total. I am still waiting on replacing the expanders with permanent implants.

I lost range of motion in both of my arms although it was much more severe in the right arm. I had to have physical therapy but still have tightness on my right side and pain in my chest.

Radiation

I had 33 rounds of radiation to my right breast, auxiliary (armpit) and neck. These were given 5 days a week. The last 5 rounds were boosters that were given to the scar. My main symptoms were fatigue and burned skin. I used Calendula cream which was very helpful. I got one blister which was on skin that I thankfully had no feeling on so it wasn’t that bad. I used medi-honey pads to help heal the blister. The skin discoloration mostly disappeared within the first 6 months although the skin remains a little bit tighter on the right side than the left.

Recurrence

I completed treatment on August 25, 2014 and was put on 3 month follow ups. My follow ups included only blood work, no scans. My first follow up in December of 2014 showed normal blood work. Then on January 4, 2015 I discovered a small lump in the lymph node above my clavicle. An ultrasound, biopsy and PET scan showed that it was triple negative breast cancer and that it had not spread to any other part of my body. The lymph node was 1.2 cm x .5 cm. To learn more about my treatment course see my Treatment page.

Last updated: 4/19/2015

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