Revenge of the Killer Boob

The saga really started almost 2 years ago. November 2009, I noticed a lump in 10 oclock left breast. It seemed to have grown fast, I had it ultrasounded/mammogrammed. It was determined to be a harmless fibroadenoma. 2 month later, I noticed it had almost doubled in size, so I had it ultrasounded again, and confirmed its size increase to triple size and 4cm in the longest dimension. Putting it to top 1% of fibroadenoma in size and growth rate.

At that point, I had a lumpectomy to remove it and pathology return benign. Not comfortable with a fast growing and big tumor in my breast, benign or not, I asked for a prophylatic bilateral mastectomy and was told to essentially seek psychological counselling instead. Multiple oncologists concurred. I was comforted by their consensus and started to put this worrying episode behind me.

Feb 2011, I became pregnant with my second child. The pregnancy was uneventful until midway, I started to feel another lump at 11o'clock left breast. I was not worried and assumed it's pregnancy related. Until again, I noticed it seemed to grow fast, doubling in size in about 4-8 weeks. At around 28 weeks, I had it checked out with ultrasound, followed quickly by biopsy. Result came back: IDC, ER+, PR+, HER2-, grade3, Ki-67 (20-30%).  5 year recurrence rate 10-15%.

I was in shock and rushed to lumpectomy with sentinel guided lymph node removal. The sample was sent off to oncotype DX. results came back: lymphovascular invasion, isolated tumor cells in the 1 sentinel lymph node removed. Ki-67(20-30%) Her2-, ER+/PR+ (both just made the cut for oncotype positive).

So I was 30 weeks pregnant at this results. I had the following choices:

1. 2 doses of AC chemo starting 31 weeks, with baby onboard. C-section delivery at 37-38 weeks, 2-3 weeks after that the rest of dose dense AC-T

2. wait for baby to be delivered at 37-38 weeks then start dose dense AC-T after 2 more weeks.

3. deliver early at 34-35 weeks, then 2 weeks later start dose dense AC-T

option 2 did not sit well with me, given that I know my previous tumors both doubles in size in 2 months. option 3 risks baby's health. option 1 has been the standard of care for 10 years, even though there are not much data on its impact on baby's long term health.

I chose 1. Made a promise to baby: if he stays and chemo with me, I'll give him extra weeks to cook. Then I prayed for him and for me. Tomorrow I'll meet him for the first time, but already I feel we have been through a lot together.