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May 16, 2012 07:37 PM msmouse wrote:
Saw the MO yesterday and today started chemo. No port yet because they were in such a hurry. 2nd stick was the charm and they have it set up to re-use over the net few days until after the 10 days labs when they can schedule the port. Never thought I would miss that ugly thing! Chemo is carboplatin & etoposide. Today had both; thurs & fri the etoposide & friday I get my old nemesis neulasta.
PJB; its much easier so far than TAC. Started the generic compazine last night with generic prilosec. Compazine this am with the vitamins. Green tea & lemon loaf for breakfast after the gym. Then IV, premeds then chemo. It took maybe 3 hrs and most of that was getting the IV settled. A hour to run the carboplatin & 45 minutes to run the etoposide. Tomorrow may be an hr or a little more w/ the premeds. I'll let you know when/(if) it starts raining hair.
The appointment with the MO was good. I didn't get to see the path report until today but its WEIRD.
The biopsy shows sheets of tumor cells with round, ovoid or short-spindled nuclei, fine chromatin,
inconspicuous nuclei, and modest amount of cytoplasm. Nuclear crowding and overlapping are
prominent. There are frequent mitotic figures and brisk apoptotic activity, with large areas of tumor
necrosis. There are only occasional glandular structures with luminal formation. No bile or mucin
production is noted.
Immunohistochemical stains demonstrate the tumor cells to be positive for pancytokeratin (AE1/AE3) with
occasional paranuclear dots; positive for cytokeratin 7; and negative for cytokeratin 20, chromogranin,
synaptophysin, TTF-1, CDX2, ER, mammoglobin and GCDFP-15. Greater than 95% of the tumor cells
are positive for Ki-67.
The above.findings are consistent with a diagnosis of poorly differentiated carcinoma with features of
small cell neuroendocrine carcinoma (or small cell carcinoma). Re-review of the breast specimens (R12-
11259) shows two
foci of tumor cells in left breast lumpectomy specimen (SZ:S11-7058 slides B4 and B8;
11/15/2011) that exhibit similar neuroendocrine features, in addition to the presence of typical high grade
ductal carcinoma (slide B3). This finding thus suggests that the liver tumor seen in this biopsy represents
metastatic small cell carcinoma of breast primary. However, the possibility cannot be completely excluded
that both breast and liver tumors represent metastasis from other anatomic sites, particularly the lungs.
A zebra; or the "dark passenger" as I have decided to call it. In my MO's opinion its breast mets and makes me stage IV. UGH.
Monday I see the local small cell "expert". I think i'm going to ask what happens if the current plan A doesn't pan out what's on plan B,C,D etc. If it shrinks can they ablate it or cut it out. Do they need to look for a possible "other" primary? Do they need to sample chest & abdominal nodes? Do I even want them to? I know cure isn't a real goal but I'd like some time with NED to get my life in order. Oh, also forgot to ask if they checked for hormone markers. Will see if possible. Will still be on arimidex for for another 4 years & 11 months.
Coolbreeze, how are you doing?
hope you all are doing well and enjoying spring in your part of the world. In Las Vegas it has been WARM. It is not not HOT until its over 105. but is a DRY heat! LOL
Best of everything to you & yours.
Dx 5/31/2011, IDC, 6cm+, Stage IIb, Grade 3, 0/4 nodes, mets, ER+/PR-, HER2-Chemotherapy 07/05/2011 Adriamycin, Cytoxan, TaxotereSurgery 12/02/2011 Lumpectomy (Left)Radiation Therapy 01/16/2012 ExternalHormonal Therapy 04/01/2012 Arimidex