Tag Archive | breast MRI

Good news!

I saw the breast surgeon (Dr. Engel) today, and there was good news. The latest breast MRI came back completely clear of cancer. My oncology team had a meeting this morning to talk about my case and they were all quite impressed with how well the cancer responded to treatment. Needless to say, I’m extremely excited!

Unfortunately, it doesn’t change the surgery I have planned. I still need a modified radical mastectomy. Because of the size of the initial tumor, Dr. Engel will remove all of the right breast tissue and most of the axillary lymph nodes. Since I had a biopsy that verified the cancer had spread to the axillary lymph nodes, he’ll take most of them out just to be safe. I just have to decide if I want to do reconstruction on the breast or not. I’m having a hard time making a decision on that. I will meet with the plastic surgeon to get some more details and maybe that will help.

Once surgery is done, the pathologist will look through the tissue for any evidence of the cancer. If I’m really lucky, and there’s no pathological evidence of the cancer, I won’t even have to do radiation! That would be pretty awesome, but I’m not counting on it. Just having it not show up on the MRI improves my long-term outlook, and makes me quite happy today.

Third time’s a charm

I had my third (and last, for a while I hope) breast MRI yesterday. Dr. Li ordered it to see if that last little bit of cancer is gone after three more cycle of chemo. I am trusting that it is, but I’ll find out the result when I meet with Dr. Engel, the surgeon, next week.

Yesterday was the beginning of the upswing from chemo, but I still felt a bit nauseous. This particular cycle has been a little higher in the nausea than many of the previous ones. I didn’t think anything about it, though, until I had to lay on my stomach for 20 minutes inside the MRI. Not the most comfortable of positions. Even worse, it was actually warm inside the MRI room. By the time I was done, I felt a bit light-headed. The room was all sparkly for at least five minutes. I got a glass of cold water and put my head between my knees for a minute or two and felt much better. The higher level of nausea didn’t really go away until I got home and took some meds, though.

Here’s what my MRI machine looked like:

Machine set up for breast MRI

Machine set up for breast MRI

I wanted to get a photo of the apparatus they use to capture breast tissue, but the magnets from the MRI would have fried my iPod if I had taken it into the room. This photo was taken from the door. I lay on my stomach on the bed projecting from the MRI, with my forehead cradled on a foam structure. You can just see the cutout for the right breast curving below the head support (there’s a similar hole for the left breast). Arms go over the head (see the grey rectangular pad for an arm on the upper left of the bed), and you slide into the MRI. They hook up your IV to be able to add the gadolinium for contrast, and listen to clonking and whirring for 20 minutes or so. Relax as much as possible since the MRI captures more tissue if you’re relaxed than if you’re tense.

The other item of note was the pattern for my gown – it was different from last time.

photo(15)

Not too bad, although gray really isn’t a festive color. At least we get some spots of red for cheer.

Chemo four of six

Subtitled: In which there is good news and bad news

Good news: This cycle of chemo means I’m two-thirds done

Bad news: I don’t really count it as done until the side effects are gone, and the nausea started early this time. I felt a bit nauseous once the chemo drugs started going into my system, even with all the anti-nauseous pre-meds they pumped into me. Today is the same, but that’s typical.

Good news: My white blood cell count went up, and my platelets are still in the normal range.

Bad news: My red blood cell count is now low, and my hemoglobin and hemocrit levels remain low.

Good news: While the hemoglobin is low, it is stable, and my iron levels are normal, so no more iron infusions on the schedule, and I won’t need a blood transfusion any time soon. That means my chemo only took five hours this time – the shortest one yet!

Bad news: My liver enzymes went way up, even higher than that first time when they were high. Unfortunately, I didn’t have those values when I saw Dr. Li on Tuesday, so I’m not sure what it’s going to mean for the last two cycles of chemo. Questions to ask the next time I see him (and I’ll have new bloodwork at that point, so we can see if they continue to go up). The frustrating thing for me is there’s really not much I can do to improve my liver, beyond not stressing it out with other drugs to detoxify, which is why I’ve given up alcohol for chemo and only take Tylenol as a last resort (which I haven’t needed since my surgery for my port).

And I’ll end on unmitigated Good news: The breast MRI showed that the tumor which was taking up nearly my entire right breast has almost completely disappeared. There’s just a residual piece about one cubic centimeter in size, and that was after only half the chemo cycle. The last half of chemo should wipe that right out, which significantly improves my outlook. Here’s to good drugs!

Another breast MRI

Dr. Li scheduled me a breast MRI to get some pictures on how well the chemo is working. I know the chemo is working, because I can feel the difference in my breast, but he needs some documentation so it’s off to the Hamot Heart Institute for another MRI.

I forgot you’re not allowed any metal in an MRI machine, so not only did I get the awesome hospital shirt, but a pair of scrubs on the bottom. I also brought a knit hat for my nearly bare head. The hospital rooms are kept really cold so the equipment works best and I knew all that cold air blowing on my head would be quite chilly. At the same time, my usual hats wouldn’t work since the brim would get in the way when I lay down. Knit beanie hat it is, then.

All set to go into the MRI.

All set to go into the MRI. Such an awesome look, don’t you think?

The MRI was much better this time than the first time, and I have the technician to thank. She told me whenever a new scan would start and how long the scan would last. I learned all the quiet times were in between scans and each set of noises was a different type of scan. I also was easier to deal with the noises when I knew they wouldn’t last more than five minutes, although most of the scans were shorter.

I was a little worried about my drippy nose while I was laying on my stomach in the MRI. Without any nose hair, my nose drips nearly constantly. Laying on my stomach without the ability to move my arms could be a recipe for snot disaster. We put a couple of tissues on the table under my face to catch any drips. Turns out the rooms are not only cold but dry so no drips the whole time I was in the machine. As soon as I stood up, I had snot dripping out of my nose, but there are boxes of tissues everywhere so I was covered.

Side notes:

A friend and I were discussing how ugly most hospital gowns are, and this was no exception. Check out the pattern on my gown:

The pattern on my hospital gown.

The pattern on my hospital gown.

Someone obviously made it and chose it and thought it was a good choice. Really? It’s a weird light gray gown with random squares on it. Not anything anyone would choose to wear on purpose.

I also learned why they put that huge square of gauze under a bandaid that is so uncomfortable whenever you get a needle stick. The technician told me, after she unhooked the IV for the contrast, to leave the gauze on for a few hours since it was providing pressure to prevent bruising. Gotcha! I always wondered why I didn’t just get a bandaid, and now I know. (And knowing is half the battle.)

This entry was posted on September 20, 2013, in tests and tagged .

Meeting the oncologists

I finally got to meet the radiation oncologist, Dr. Figura, and the medical oncologist who is in charge of chemo, Dr. Li. My entire medical team had met that morning to talk about the results from all my tests and come up with a treatment plan. I will be getting chemo first in order to shrink the tumor to a size that is more easily operable, surgery, and then radiation treatment.

We met with Dr. Figura first, even though I’ll be under his care last. He talked a bit about how radiation therapy works. in my case, I’ll be getting 28-33 doses, five times a week until it’s done. The best thing was being able to see my PET scan. I love the digital imaging that doctor’s have access to these days. The PET imaged slices of my body, and you could see all the different parts – my favorite was the parts of the skull and the cross-section of my shoulder.

Dr. Li went over the results of my previous tests. The breast MRI showed no abnormalities in the left breast, and no chest wall or skin involvement on the right. Unequivocal good news! The PET scan, since it was a whole body scan, found a few abnormalities. Good news first – no involvement in the lungs, liver, or bones (the common places breast cancer spreads). They did find a dark spot on one of my kidneys. Since it’s dark, we know it’s not the breast cancer. It’s probably just a cyst, but it could theoretically be renal cancer, so I need a CT scan with contrast to check. Also, the ovaries showed some abnormalities, but it was unclear what’s going on (not enough intra-abdominal fat to resolve the image). So, I need an ultrasound to check that out. Also, I need a baseline MUGA test to check my heart functions. Off to schedule more tests!

First week of tests

So, before I start treatment, the doctors wanted to know how far the cancer has spread. We know it’s in the axillary lymph nodes, based on the biopsy, which means it could move about in the lymphatic system. Also, since it is lobular carcinoma, there’s a higher probability of it showing up in the opposite breast. Therefore, I was off to a PET scan and a breast MRI. With all the tests and injections for contrast, I’m also starting my own personal element collection of injections.

gd64Breast MRI. They have you lay face first on a cut-out structure so your breasts can hang down, and a plastic line goes down your breastbone. Your arms go over your head, and luckily there was no pressure on my port site or I couldn’t have done it. You get sent into the machine on your stomach, with a blanket over your eyes, so there’s no worries about claustrophobia. I even got headphones with my choice of music, not that I could hear it half the time because of the noise of the machine. They used an IV to inject the contract agent about half way through the test. I could feel the coldness as it flowed over the skin on my arm, but otherwise nothing. I did not enjoy the MRI because of the noise. So many different loud noises, randomly starting and stopping. Then, when you get out, you can hardly breathe because of the pressure on your breastbone that was supporting your weight during the test.

Element added: Gadolinium

f9PET scan. I had to fast for six hours before this test, although since it was first thing in the morning, it just meant skipping breakfast. They inject you with fluorine-doped glucose (I picked the other arm for the injection), that would move to any part of the body that was using lots of energy. To minimize false positives, and to make sure only cancer cells glow on the test, they inject you with the glucose, and have you sit quietly. You can listen to music, podcasts, or watch TV. No talking, no reading, just sitting quietly. After an hour, they send you through another tube. This one is at least quiet. They move you through the tube at a constant rate for an initial CT. After the CT is done, you sit at specific points in the tube, starting at the head and moving down the body, pausing for 5-10 minutes for each section. The isotope of fluorine they used had a half-life of only 110 minutes, but I was radioactive for the rest of the day. They even gave me a card if I went to the airport or court-house to show I wasn’t trying to bomb the place – just had a PET scan that day.

Element added: Fluorine