Diagnosis & Treatments

My Timeline:
No lump. Thickening of skin. Two mammograms- all clear
2005 March - Pressed on breast, yellowish sticky fluid discharged from nipple
2005 April - thickening biopsied
DIAGNOSIS #1
2005 April - Diagnosis - (DCIS) Ductal Carcinoma In-Situ, Subtype Her 2 neu Positive, Hormone receptors Negative, Stage 0
Bi-lateral Mastectomy, no chemo, no radiation 

DIAGNOSIS #2
2009 November - I discovered small (5 mm) lump below clavicle bone near center right of sternum
November 19th --my birthday--told the cells look cancerous, sent to Vanderbilt lab for confirmation.
Diagnosis - Invasive Breast Cancer, Subtype Her 2 neu Positive, Hormone receptors Negative, Stage 1
2009 - December 2010 - Chemotherapy: Taxotere, Carboplatin and Targeted Therapy:  Herceptin
2010 June - Radiation
2012 July - voice hoarse, CAT scan revealed nothing

2013 March - I found small lymph node above left side of right clavicle bone 
DIAGNOSIS #3
2013 April 1st (no joke) -  CAT scan revealed stage IV metastasis to lungs and mediastinal lymph node pressing on vocal nerve between lungs right side, confirmed by biopsy a few days later.
2013 May 6 -  #1 began chemotherapy:  Taxotere Targeted Therapies:  Herceptin, Perjeta
         May 29 -#2
2013 June 14 Port Placement
Neulasta shots throughout treatment with Taxotere
2013 July to December - treatments every 3 weeks.

2014
2014 January 13 -  #13 treatment
2014 February - dropped Taxotere. Herceptin and Perjeta only
2014 - after 12 weeks, visible hair growing back, no longer looking bald
2014 April - Scan showing progression in right lung
2014 May - slight 3mm progression confirmed in right middle lung nodule with shadows on bottom of right lung indicating additional progression in that area
2014 May - Began TDM1 also known as Kadcyla
2014 May 5th #18 overall treatment, #1 TDM-1
2014 May 28 #19 overall, #2 TDM-1 
2014 June 16 #20 overall, #3 TDM-1  
2014 July 14 #21, #4 TDM-1
2014 July 24 - scan shows NEAD/ No Evidence of Active Disease
2014 Oct 15 - scan NEAD/ No Evidence of Active Disease!
2014 Oct 24 - brain MRI/ Clean
2014 Oct 20 #26 overall, #9 TDM-1

2015
2015 January - scan NEAD/No Evidence of Active Disease
2015 January - painful neuropathy treated with Gabapentin 
PLATELET TROUBLE
2015 May 18th - Treatment #36, TDM-1 #19 Platelet count at 77 from 114. Reduced dose of TDM-1 (Kadcyla) dosage from 3.6 mg/kg to 2.88 mg/kg / Hoping platelets will recover to 100,000.
2015 June 3 - scans 
TROUBLE AHEAD - POSSIBLE PROGRESSION
2015  June 8th - Scan results -- delayed treatment.--compared to scan in April 2013 was 6mm, now increased in size by 4 mm
Might not be NEAD any longer(one lung nodule appeared--may not be cancer. Instead may only be scarring reappearing after being missed by several past scans.)
Blood work done in Chapel Hill--82,000 platelet count/ target # 100,000. 
2015 June 12th- Delayed treatment for following Monday.Blood work done at old oncologist close to home. Platelets 86,000.
2015 June 22nd. Treatment #37, TDM-1 #20. Blood work Platelets 78,000. Saw Nurse Practitioner. Decided target platelet # now will be 75,000.
treated with 20% reduced dose from 3.6 mg/lb. to 2.88 mg/lb. of TDM-1,
5 weeks since last treatment.
2015 July 8th- delayed treatment. Blood work done at Medical Mall close to home. Platelet #66,000  Check Blood again following Thursday.
2015 July 14 - Delay treatment again. Blood work done Platelet #64,000.
Check platelets following Monday. May treat with low platelet # but reduce TDM-1 again in hopes that platelets will recover to 75,000.
2015 July 20 - Delay treatment until following Monday. Blood work at Medical Mall. Platelets still 64,000.                     
2015 July 27th will be 5 weeks since last treatment. Platelets 88,000.
Infusion ##38, TDM-1 #21 done at reduced dose to 2.88 mg/lb. Dosage was 3.6 mg/lb.
2015 August 17 - POSSIBLE PROGRESSION, Platelets 90,000.
Infusion #39, TDM-1 #22. UNC Cancer Hospital Radiologist reviewed my June scan. Not sure if 4mm increase is progression. Scan will be done in September.
2015 September 8th- Infusion #40, TDM-1 #23 MUGA to check heart function - all good. 
2015 September 28th- Scans--Once a 3-4mm nodule, then a 7-8mm nodule, now 13mm.  YIKES! PROGRESSION CONFIRMED- took 2 scans (4 months between them) to go from possible to confirmed. Cyber-Knife treatment (My idea.) 
2015 October 1 -- Met with radiation oncologist (lung cancer, breast cancer specialist).
Plan to do targeted Stereotactic Radiotherapy (radiation) to 13mm nodule. 

2015 October 16  - Fiducial Markers Implanted. --metal for x-ray to find nodule and radiate. 

2015 October 29th - #1 Radiation
2015 November 3rd - #2 Radiation
2015 November 5th - #3 Radiation
2015 November 9th -  #4 Radiation
2015 November 11th -  #5 Radiation

Continue TDM-1 (Kadcyla)
2015 November 16 - Treatment #41, TDM-1 #24 continuingTDM-1still at 2.88 reduced dose
2015 December 7 - Treatment #42, TDM-1 #25 dosage 2.88 mg/kg Platelets down to 86,000/cubic mm or microliter

2016
2016 January 4 - Treatment #43 TDM-1 #26
2016 January 25 - Treatment #44 TDM-1 #27
2016 February 15 - Scan results NED! Treatment #45 TDM-1 #28
2016 March 7 - Muga scan for heart, Treatment #46 TDM-1 (Kadcyla) #29 
2016 March 28 - Treatment #47, TDM-1 #30
2016 April 18 #48/#31of TDM-1 
2016 May 9th #49/#32 of TDM-1
2016 May 31st #50/#33 of TDM-1
2016 June 9th #51 overall treatment #34 of TDM-1
2016 June 20th scans reviewed-Looking Good!, infusion #52/#35 TDM-1.
2016 July 11th infusion #53/#36 of TDM-1
2016 August 1st infusion #54/#37 of TDM-1
2016 August 22nd  will be infusion #55/#38 of TDM-1
2016 September 12th infusion and Muga scan, treatment #56/#39 of TDM1
2016 October 3rd will be infusion #57/#40 of TDM-1 
2016 October 24th -- Scans --Wonderful Scan--continue TDM-1! Treatment #58/#41 of TM-1
2016 November 14th -- infusion only #59/#42 TDM-1 Platelets slipping downward in 70,000  
2016 December 5 -- infusion, treatment #60/#43 of TDM-1 Platelets 75,000

2017
2017 January 3 -- infusion #61 overall, #44 TDM-1 Platelets in 80,000s
2017 January 23 -- saw PA, platelets 67,000 (Normal is between 150,000 and 440,000)
skipped infusion, will give body a break for an additional week.
2017 January 30 -- #62, #45 TDM-1
2017 scan February 20th -- NO EVIDENCE FOR DISEASE RECURRENCE OR METASTASIS!! BEST SCAN EVER!! infusion - #63 overall, #46 TDM-1
2017 March 13 - infusion - #64 overall, #47 TDM-1 
2017 April 3 - infusion - #65, #48 TDM-1
Supposed to be infusion #49 according to doctor - I must have miscounted.
2017 April 23 - will be infusion #67 #50 First Sunday treatment
May 5 - 3 years on  TDM-1
May 6 - first treatment for stage 4, 4 years ago.
2017 May 14 - will be infusion #68 #51
2017 June 4 - will be infusion #69 #52
2017 June 26 - Scan

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