So What’s Actually Going On in There?
- timandcloe
- May 14
- 6 min read
Updated: May 14
It’s wild how quickly life can completely flip itself on its head.
And it’s taken me a while to really get my head around what’s happening - to the point where I finally feel like I actually understand my diagnosis.
From the moment I found another lump in my right breast, after having scans only nine months earlier for a different lump and being given the all clear, things moved very quickly.
Imaging. More imaging. Biopsies. Specialists. Phone calls. Acronyms. Consent forms.
Then more imaging again because apparently once you enter the cancer system, every department insists on taking their own glamour shots of your boobs. But without the compliments - rude.
At the same pace we were racing between appointments, we were also being inundated with information.
Scan results. Biopsy results. Cancer types. Treatment protocols. Hormone receptors. Genetic testing. Positive markers. Negative markers. HER2. ER. PR.
Honestly, it sounded like someone merged medicine with advanced maths and then removed all the vowels for efficiency.
So it’s been a lot to process and fully understand.
Then accepting it?
Eh...that took a little longer.
But now that I’m finally in a place where I have come to terms with it myself, I thought I’d explain my diagnosis, walk through the cancer blip timeline so far, and share the many unknowns still floating around in the background. Because I’ve had a few questions recently and I’m not entirely sure I’ve explained it well enough, or whether I’ve just created more follow-up questions in the process.
So here goes...
Current Diagnosis Is:
Multifocal IDC, St III, G3, +/–/+
Clear as mud? Yep - that's how I took it too. But let’s unpack it.
Now, a gentle disclaimer: this explanation is coming from someone with zero formal medical training (despite what I’d like to believe I’ve absorbed via The Pitt and sheer osmosis). I’ve also included the rather lovely annotated diagrams my breast specialist kindly drew for me - because nothing says “calm reassurance” quite like medically labelled artwork of your own insides.
Cancer Type
Multifocal invasive ductal carcinoma (IDC).
Which, in layman’s terms, means:
there’s more than one tumour;
they’re all hanging out in the same quadrant of the breast; and
they’ve spread beyond the milk ducts into surrounding tissue because apparently boundaries mean nothing to them.
Cancer Subtype(s)
I managed to hit two out of the three receptor jackpots:
oestrogen receptor positive.
progesterone receptor negative;
HER2 positive.
HER2 positive means the cancer cells have too many copies of the HER2 gene, causing them to grow, divide and spread more aggressively - basically a gym bro squad on pre-workout, screaming “ONE MORE REP” at everything in sight and refusing to stop for anything, ever.
The upside, though, is it’s highly responsive to targeted therapy. So... I'll take that.
Oestrogen positive means my own hormones are effectively feeding and supporting the enemy from within.
Which, clinically speaking, suggests my own female biology has chosen violence.
Grade
Grade 3.
Highest aggressive grade, a.k.a. the cancer equivalent of someone replying “per my last email” within 14 seconds. Jerks.
Stage
Stage 3 – locally advanced breast cancer, due to the size of both tumours and spread into multiple lymph nodes, but not beyond.
It’s however on a sliding scale, and the aim is that post-treatment and surgery it slides back towards 0 faster than a toddler who’s just realised they’re not being followed.
Time to Formally Meet the Globalists
Let me introduce you to the arseholes themselves that I spoke about in my first post.
First up, Donald.
Donald was the lump I actually felt in my right breast - loud, obvious, attention-seeking and impossible to ignore. Very on brand.
He’s sitting in the 7 o’clock position and measured pre-chemo via MRI at 33 x 17 x 21mm.
Then we have Vladimir.
Vladimir stayed completely under the radar because naturally, the Russian was hiding quietly in the shadows while quietly invading territory.
He’s at the 9 o’clock position and measured a chunky 35 x 23 x 33mm (dark spiculated mass). Which is particularly offensive considering I didn’t even know he existed and he still managed to be the bigger problem.
And finally, we have the Benjamins - the lymph nodes that lit up my PET scan like a politically complicated Christmas tree.
Currently, approx. five of the Benjamins have been confirmed involved.
There was also brief concern about a possible additional guest appearance in the left breast, but recent scans suggest no spread. Pathology after surgery will ultimately confirm that.
So for now, the left boob sits in the category of: “we don’t know yet - and frankly, neither do they”.
Love that for us. 🥳
Where I’m At Now
Because the cancer is HER2 positive and Grade 3, the team moved quickly to start neoadjuvant chemotherapy - chemo before surgery, in the hope of:
shrinking the tumours;
stopping further spread; and
giving us the best possible shot at a good surgical outcome later.
My current treatment regime:
two chemotherapy drugs;
two targeted therapies;
six cycles total, with three completed so far;
each cycle 21 days apart.
The current cocktail:
Taxotere (Docetaxel) - stops cancer cells dividing.
Carboplatin - damages cancer cell DNA.
Herceptin (Trastuzumab) - blocks HER2 signals.
Perjeta (Pertuzumab) - double-taps HER2 signalling, just to be sure.
...Basically a very expensive, highly organised hit squad. 🔫
Following chemo, surgery is next.
A double mastectomy with reconstruction, and hopefully only targeted lymph node removal if the treatment has done its job properly (if cancer is still in the sentinel nodes, a full lymph node clearance may be needed instead).
Post-surgery? Nothing is confirmed yet.
It all depends on post-surgery pathology and how well the tumours responded to the chemotherapy. So there may still be radiation, further chemotherapy, or additional therapies if any residual cancer remains in the tumours or lymph nodes.
But I will remain on some form of targeted HER2 therapy for a full 12 months regardless of any other form of treatment, because HER2-positive cancers carry a higher recurrence risk.
And because the tumours are oestrogen receptive, I’ll also be starting hormone blockers for at least 10 years, essentially launching me straight into chemically induced menopause, where my body and I will spend the next decade arguing about heat, tears, and whether this was really required.
Other Things I Still Don’t Know...Yet
Whether the current treatment is working - first progress scans happen after Cycle #4 next Friday.
Whether my nipples will survive surgery. A sentence I genuinely never thought I’d write but a question to ask my surgeon when we meet Monday week.
What my genetic testing results are, which may influence future treatment/surgical decisions.
Whether I’ll ever attend another medical appointment where someone doesn’t immediately ask to see or talk about my boobs.
Whether seahorses are the only animals where males get pregnant. Honestly, still one of nature’s better plot twists right there. 🤷
So here we stand
In a strange mix of terrifying, surreal, medically fascinating moments, and words that sound like Harry Potter spells.
But for now, the focus is simple: the stage directly in front of me.
One treatment cycle at a time.
One appointment at a time.
One result at a time.
Because when so much suddenly feels outside your control, you very quickly learn to focus on the things that still are.
Hydration. Rest. Mental health. Small moments of normality. Restacking the dishwasher the right way (all cutlery must keep to its shape on the shelf, people).
And I look forward to the day, once this is all said and done, where I can come back to this post to write the update:
“Now cancer-free”.
And then, I can go back to worrying about things that don’t need worrying over - like whether I’ve replied to a message too late and ruined a relationship, why I walked into a room with such confidence and no memory of the reason, and whether I’ve already said something out loud that I definitely only meant to think (‘Can we please, for the love of God, retire “cascade” along with “circle back” and "basic joy"… thank you!’)
This blog is to allow me to write a little more about it along the way. Partly to keep friends and family updated, and partly because writing has always been how I make sense of things.
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