Diagnosis & Treatments

My Timeline from the Beginning:
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 One Year since Cyber Knife!
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 overall, #48 TDM-1
Supposed to be infusion #49 according to doctor - I must have miscounted.
2017 April 23 - will be infusion #50 Kadcyla, First Sunday treatment
May 5 - 3 years on  TDM-1
2017 May 6 - first treatment for stage 4, 4 years ago!
2017 May 14 - will be infusion #51, Kadycla
2017 June 4 - will be infusion #52, Kadcyla
2017 June 26 - Scan- beautiful NED TDM-1 (Kadcyla) #53
2017 July 17 TDM-1 #54, genetic counseling and testing
2017 August 7 TDM-1 #55
2017 genetic results - no BRCA or PALB2 mutation
2017 August 27th - TDM-1 (Kadcyla) #56 (overall #73) 
2017 September 26th #57
2017 October 16th #58
2017 November 6 - Scan--some increased density of opacities around fiducial markers. Another scan in January to make sure change is from radiation. Radiation Oncologist suspects changes are from Cyberknife. Another scan will occur January 29, 2018. Considered "No evidence of disease". Infusion of Kadcyla #59!!
2017 November 11--2 years out from radiation to one lung nodule. 
2017 November 27 Infusion #60 for Kadcyla. 

Coming up
2017 December 16 - infusion
2018 January 6th - infusion
2018 January 29th - SCAN

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