Anna's Book of Days

Now that I understand my pathology, I'm starting to be able to understand my treatment options.  Both Dr. Giuliano and Dr. Miller said that neo-adjuvant (pre-surgery) chemotherapy with antibodies is necessary. Dr. Miller explained that the chemo will shrink the tumors, so much so that they'll probably be completely gone by the time I have surgery, which is what they call a pathologically complete response. However, both doctors said that chemo without surgery is not an option - the rate of recurrence is just too high. Dr. Miller said that I would probably need six cycles of chemo (once every two weeks). Once the neo-adjuvant chemo is done, I'll need some time to recuperate and get my white blood cell count back up - possibly four to six weeks. Then I'll have surgery. I have three surgical options: lumpectomy, single mastectomy, and double mastectomy. I went into my appointment with Dr. Miller thinking that I wanted to have a lumpectomy if possible, it being th...

Dr. Yashari had mentioned that several of his patients had had good experiences with their breast cancer treatment at a practice called Pink Lotus. After reading about the importance of getting a second opinion, and reading about Dr. Kristi Funk, the founder of the group, I made an appointment for Friday, August 29. Dr. Funk was not available, so my appointment was with Dr. Marian Miller, another doctor in the group. Dr. Miller turned out to be very young, probably younger than me, and while I have no idea how good a doctor she is, she was an excellent communicator. In fairness, between our appointments with Dr. Giuliano and her, we had read the pathology report and had two more days to process and research what we'd heard from Dr. Giuliano, so we were able to hear what we were being told much better. Still, it was obvious that Pink Lotus had designed and trained their doctors to use a framework for talking to women about their illnesses so that they could actually understand ...

Since getting my diagnosis, I've had a lot of thoughts about luck, both good and bad. I've always felt like my life was full of blessings, never more so than in the last few months with my healthy, happy baby boy, my wonderful husband with whom I am deeply in love, loving family and friends, a beautiful home, and a stimulating career that I was excited to return to. And then I got breast cancer at 35, which at times feels like the unluckiest thing that ever could have happened to me. From age 30 to 39, a woman's absolute risk of getting breast cancer is 0.44%. This means that 1 in 227 women in this age group can expect to develop breast cancer. Put another way, of the 20 million women in the US today who are in their thirties, 88,000 have been diagnosed with breast cancer or will be before they turn 40. I can picture what 88,000 people looks like - an almost-capacity crowd at the Coliseum - but I can't decide if that seems like a lot or a little. A little, I suppose, co...

Dr. Yashari referred me to Dr. Giuliano, a former colleague from St. John's who is now at Cedars-Sinai. Dr. Giuliano is very renowned in the world of oncology; he pioneered the practice of sentinel lymph node biopsy as an alternative to removal of underarm lymph nodes, and we were later to hear from others who consider him to be the best surgical oncologist in LA. Perhaps through Dr. Yashari's influence, or maybe just the kindness of Dr. Giuliano's scheduler, Fernando, I was able to make an appointment to see him on Wednesday, August 27, less than 24 hours after receiving my diagnosis. The appointment has already become blurred in my memory, but certain things stand out. I remember Dr. Giuliano saying that my cancer is high-grade, which sounds like a good thing but isn't (it means the cancer cells are extremely different from my normal cells). He also said my cancer is HER2-positive, which used to be a bad thing but isn't anymore, because there are new therapie...

On August 26th, I was diagnosed with breast cancer. Since then, I keep trying to say it out loud - "I have breast cancer" - so that I can start to believe it, but each time it sounds like something that couldn't possibly be true. About a month ago, I noticed some lumps in my left breast. I thought that my milk ducts were plugged, and I started trying the recommended home remedies - hot compresses, massage, extra nursing and pumping, lecithin supplements, hot showers. Nothing made a difference and I waited in dread for mastitis to set in. But no signs of infection appeared.  After almost two weeks, at the urging of Seth and my doula Cheryl, I consulted an OB. Dr. Yashari examined my breast and said that the lumps were fibroadenomas, benign breast tumors that are common in young women. He said they were nothing to worry about and would go away after I stopped breastfeeding. He also said that normally with fibroadenomas, they would just monitor them every few months, but jus...