I forgot one thing...

In my list of "Things I didn't expect from chemo", I neglected to mention my chemo-induced menopause and the annoying hot flashes that go with it. I've been assured by my doctor that most women my age return to a normal cycle after chemo has stopped. My fingers are crossed.

Ok... The long awaited information from my most recent appointments with my surgeon, my oncologist and the geneticist.

Dr. George visit (April 6th)-

*Highly suggested radiation

*6 to 12 months post-chemo wait before reconstruction can start (longer wait =greater satisfaction with reconstruction).

*appointment with plastic surgeon and him in July (which I have to rebook as we will be at the cottage).

*not allowed to gain weight for tram flap procedure, or ever (increases likelihood of recurrence).

*not allowed to drink...at least no more than 7 a week...and no saving up(also increases likelihood of recurrence).

*interested to see the results of genetic testing that will be done April 28th

Dr. Vandenberg visit (May 5th)-

*Also very interested to see results of genetic testing- will help to gauge if other breast and ovaries should be removed (if cancer is hereditary, then yes).

*Said ovaries don't usually give a problem until age 35 or so... so if it is hereditary, I will still have a few years to have a child before removal.

*Possibility of taking part in a clinical trial separate from the one I spoke if initially. A 10 year longitudinal study to investigate whether earlier administration of drugs given to people with bone mets (breast cancer spread to the bones) could help prevent bone mets in the first place.

*Set up a consult appointment with radiation oncologist for May 14 to discuss my radiation treatment.


Genetics testing with Dr. Ainsworth (April 28th)-

*Filled out a questionnaire regarding family history of cancer. It asked about people I didn't even know existed. This meant that my mother and I had to call my grandmothers to ask questions. I mean... there is nothing like calling someone in their 80's and drilling them for details about how their siblings/parents/husband died. Ugh.

*Spoke with the Geneticist regarding family history. In addition to breast cancer, he was concerned with the "inherited predisposition to...colon and/or endometrial cancers" on my mother's side of the family. He suggested colonoscopic and/or gynaecological surveillance for my mother and her siblings. Yippee.

*Indicated that given my young age, it is more likely that my cancer is hereditary.

*He then scolded me for my lack of (rather detailed) knowledge of DNA and mismatch repair genes (perhaps he didn't know I've been out of high school for almost 10 years).

*If they do not find a mutation, that doesn't mean that without a doubt, my cancer isn't hereditary. In fact, it could be the case that "the present technology isn't sophisticated enough to identify it." (it being the gene responsible).

*I then gave about a quart of my blood (from two different spots on my arm) and was freed to go home.

*The results should be back in 3-4 months.


Interesting facts-
BRCA1 carriers
Females- 65%(or more) will develop Breast cancer and 39%(or more) will develop ovarian cancer by age 70
Males- Increased risk of Prostate cancer

BRCA2 carriers
Females- 45% (or more) will develop Breast cancer and 11% (or more) will develop ovarian cancer by age 70
Males- Increased risk of Prostate cancer

"In addition there are reported to be above average risks for a number of other cancers which are especially associates with BRCA2 mutations including those including the stomach, pancreas, gall bladder and/or bile ducts as well as melanoma of the skin or eye."

The eye??? come on!! That's grossssss.

*In case you are wondering what I am quoting, it's a nice follow up letter that Dr. Ainsworth sent me, reiterating everything that we talked about in the meeting.