lymph node & a new cancer
I know things have been a little confusing over here and I haven’t had the time to write everything out. Below is what I know - and what my team seems to know. Unfortunately cancer is not black and white. We are stuck within the confines of what science knows so far and sometimes that feels like a lot of nothing.
So, backing up a little, in early October we paused Enhertu because my regular screening chest CT showed Interstitial Lung Disease in my lungs. This is a potential side effect of Enhertu. My oncologist followed protocol and held treatment while I started a round of antibiotics and steroids.
We did a follow up chest CT to check the status of my lungs - and SURPRISE! My left axilla lymph node (it’s in your armpit) was enlarged. We immediately biopsied the lymph node to learn if it was cancer.
This biopsy proved that it was cancer.
Because of the ILD and what we thought was progression to this lymph node, we stopped Enhertu.
The testing on the lymph node showed this cancer was a different sub-type from the bone mets. It is estrogen receptor positive, progesterone receptor negative, and definitely HER2 Low but we wanted additional testing to learn if it’s HER2+.
The sub-type is so important to know. This is how treatment options are considered and which will be the best to target the cancer.
Unfortunately, the additional testing called a FISH test failed. It was a “Quantity Not Sufficient.” So I had to do the biopsy of the lymph node AGAIN.
This second biopsy provided the pathologists more tissue to determine that it is likely a SECOND PRIMARY BREAST CANCER. Meaning, this is not associated or akin at all to the bone mets. This is a new cancer joining the party. This could get complicated - I’ll explain later.
Okay, now we’re all caught up to present time.
Yesterday I received the pathology report that read “Indeterminate” for the FISH HER2 testing.
Meaning - the pathologist could not gather or come to a conclusion on if it is HER2 + or HER2 Low.
I have not heard from my oncologist, yet.
Here’s what we definitely know:
My bone mets are stable - as of my last scan in early November.
The left lymph node is a new breast cancer.
The new breast cancer is ER+, PR - , and HER2Low but MIGHT be HER2+
There are two paths that we take;
Continue Sassy (aka Trodelvy) and it will clear the lymph node cancer and keep the bones stable
Learn if the lymph node is HER2+ and switch targeted treatments; putting a risk that my bones may not stay stable
So, a lot hinges on this HER2 testing and we seemingly cannot get a good answer here.
I’m awaiting more information from my oncologist and will keep you all updated as I know.
I’m working towards second opinions, however, that’s never an easy process either. I appreciate all of your thoughts and good vibes.
