"In May 2011, I found a large mass in my right breast and realized that there was also what looked like a stretch mark down one side of the breast. I had done regular self exams, and had been checked by doctors, but later learned that with lobular breast cancer, it is not unusual that the cancer is not detected until quite advanced.
"I immediately booked an ultrasound at my local diagnostic lab, which is attached to a small private clinic. We live in Athens, Greece, and most neighborhoods have walk-in diagnostic labs, where you can get blood tests and other diagnostic tests. I chose ultrasound because it seemed the simplest, but it turns out that ultrasound is also better than mammogram often at detecting lobular breast cancer. This I paid for myself, the standard cost being 50 Euro.
"The ultrasound indicated cancer, and the doctor performing the exam urged me to consult with a breast specialist as soon as possible. That same week I met with a breast surgeon in the same clinic. We did an MRI right then and there, which confirmed the diagnosis of locally advanced breast cancer. The MRI was Wednesday night, and the diagnosis was confirmed by Thursday morning. At that point I had my private insurance involved, and the private insurance paid for the MRI.
"Not having great confidence in the doctor who made the diagnosis, we tracked down, through a friend, one of the leading breast surgeons in town, and I saw him that following Monday. By Thursday he had me in the hospital (private hospital) for two days of testing, including a surgical biopsy. I requested the surgical biopsy, since needles and I are not good friends. My private insurance covers 100% of hospitalization, in the hospital of my choice, as well as 100% of any testing performed in the course of a hospitalization. The tests were: full blood panel, CT of head, chest and abdomen, a bone scan to look for bone metastasis, an MRI of the liver to rule out some suspicious spots seen on the CT as well as the biopsy, as mentioned.
"While in the hospital, I consulted with the oncologist who works with my surgeon and we discussed the possibility of neo-adjuvant chemotherapy, due to the large size of the tumor.
"The following week the pathology report came in from the biopsy, allowing us to finalize the treatment plan: 4X FEC (chemotherapy), surgery, 4X taxotere and 6 weeks of radiation. At this point, I also discussed with the surgeon that I would want a double mastectomy. After making sure that I understood what the surgery entailed and understood that it would not be likely to improve my survival, he agreed. He also informed me that I would need to wait 2 years to reconstruct. He did not want reconstruction to interfere with treatment and recovery nor did he want it to interfere with the detection of local recurrence.
"The pathology report from the mastectomy showed that the neo-adjuvant chemo had been successful in reducing the tumor drastically, but there was still active cancer left, as well as cancer in 7 nodes. The report further showed extensive LCIS in the supposedly healthy breast, which according to current hype, I should have kept. The cancer was staged at IIIB, III because of the size and nodes, B because of the stretch mark on the skin.
"Since I was premenopausal at diagnosis, but much preferred to go on Femara (letrozole) instead of tamoxifen, my final, active treatment, a few weeks after completing radiation, was a partial hysterectomy performed with the DaVinci method (robot). This was an easy surgery and recovery. My oncologist thought this was a drastic approach, but my surgeon backed my decision. A few months later the research was published showing that letrozole is more effective against lobular cancer than tamoxifen.
"I am now three years out from surgery and still healthy. I have very few side effects of treatment. It should be noted that I had excellent private insurance all the way through and that I was treated by some of the best doctors available in Greece. Considering how advanced the cancer was, it is anyone’s guess how long I will stay healthy, but the longer it is, the better the chances that new treatments will be developed. I have no great wisdom to offer. Cancer is a bitch and she is a tough one, but my only advice is to have fun and enjoy in whatever way you can. Treatment is far more bearable if you have some good laughs and some good friends along for the ride."
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