My name is Fernanda. My cancer journey started at an annual physical at my family doctor’s office in November of 2022. I was 49 years old. I had zero health concerns. In fact, I was in, what I thought was the best shape I had been in since my teens. I was working out 4-5 times a week. I wasn’t a heavy drinker but had actually quite drinking completely during Covid. I didn’t smoke. I have zero family history of breast cancer. I did have a co-worker who was going through breast cancer treatment so I had made a point of asking about getting my mammogram at the beginning of my office visit. When I asked, my family doctor said that given my history the recommendation is to wait until I was 50. I was also told self exams were no longer recommended because it triggered too many false positives, and she could do one if I REALLY wanted to, but she doesn’t do that routinely. She then said we could circle back around and discuss further once the remainder of the cam was done. Fine.
At the end of the exam, my doctor tells me that I’m doing great. So great in fact that I don’t need to come back next year for a physical. I ask again about the mammogram. This time she says, well since there is no need to see you next year, she’ll go ahead and order it.
I had my first mammogram on December 29th, 2022. The staff at the breast imaging center at Mt Sinai in Toronto are fantastic! The walked me through everything and told me since this was my first mammogram it is very common to be called back in for additional imaging since all future images will be compared to the baseline images. Great, no problem.
The alarm bells in my head started to go off in my head when I read the report in the MyChart app over the new year’s holiday. The words “heterogeneously dense breasts”, and “microcalcifications” “dense lymph nodes”, and at the bottom of the report it said “breast density-C”.
I didn’t know what any of that meant, but I knew it didn’t sound good. It wasn’t a “normal exam”. I got a call on Tuesday January 3rd to come back for additional imaging. They asked me to come in on Friday January 6th. Again, alarms bells. That seems like a fast appointment. It wouldn’t be so fast if it was “normal”.
I go in on Friday. The mammogram is repeated with additional views. Then I have ultrasounds. I remember laying on the table as the technician is performing the ultrasound. Now as a side note, I am a technician in an Ophthalmology office at Mt Sinai. I perform ultrasounds on eyes. So even though I can’t see the technicians screen, I can hear and see the keyboard, and I can see and hear her measuring several “somethings”. I know the sound the keyboard makes as you move the calipers around on the screen to take measurements. At this point, I distract myself by looking at her lanyard and I see she is on staff both at Mt Sinai and at PMH. I also see years of service pins- the most recent is for 15years. This is a very experienced technician. She knows what she is looking at. She now starts to ask me questions about my history. “What prompted me getting a mammogram? Was I having any symptoms?” I tell her I am completely asymptomatic and initially my doctor wanted to wait until I was 50, but since I was so healthy, she went ahead and ordered it so I don’t have to go in next year. At the point she tells me, “I’m so glad you didn’t wait until you were 50. I’m going to talk to the radiologist and they are going to come in to talk to you about what we are seeing.” That’s when I knew for sure my life was going to change.
The radiologist came in and told me I would need to have biopsies done on both breasts. An ultrasound guided biopsy on the left and a mammogram guided biopsy on the right. I could have both done on Monday. I agreed. Of course I agreed. I worked across the street so coming to the hospital so frequently wasn’t an issue.
Monday January 9th, I go in for my biopsies. The density of my breasts made the biopsies challenging. It was difficult for the doctors to get the cyst. After several attempts they were finally able to get the sample. I asked the doctor again about what she was seeing. And she said point blank,” I’m always honest with my patients. On your right side, I’m not very concerned. On your left side, I don’t like this at all. But everything will be confirmed as soon as we get pathology back.”
Wednesday January 11, 2023, I saw the pathology report. Right breast benign, left breast, confirmed breast cancer. Invasive ductal carcinoma, Grade 3. Hormone positive, Her-2 (needed more testing results).
I sat at work reading those results over and over. All I could think about were my kids. I have a 10-year-old autistic son and a 9year old son. My husband also has his own mental health struggles with depression and anxiety. How were we going to get through this? I sat at work with a couple of my friends and told them first. I also tried to call my family doctor to talk to her about the results, only to find out she was away for a week. I am incredibly fortunate that I work at the hospital and my boss took the lead on getting me an appointment with the breast surgeon. I will forever be grateful to him for that. I was seen the next day by Dr. Escalon for an evaluation. He is such a gem of a human being!!! The first words he said to me were, “we are here to take care of you.” I was scheduled for surgery on February 10th. Left lumpectomy and sentinel node biopsy. At this point it doesn’t seem to have lymph node involvement so I would be considered a Stage 1 breast cancer and prognosis is very good. I would need to have a breast MRI before the surgery as part of the preop prep. Everything will be fine.
January 26, 2023, I have my breast MRI. It takes a full week for the MRI report. The MRI identifies 2 new suspicious areas. 1 in each breast. I’ll need to have another breast ultrasound before my surgery. I have the ultrasound on February 7th. The technician can’t find the spots the MRI identified. She brings in the radiologist. The radiologist can’t find the one on the left side, on the right, she thinks she finds the spot but dismisses the right side as all benign breast changes. For the left side she wants to talk to the surgeon to find out if he wants to order an MRI guided biopsy to find the spot on the left side. She tells me to go home and she’ll call me later to let me know what he says. At this point, I’m panicking. I’m supposed to be having surgery in a week. I get a call from the radiologist herself. The surgeon wants the MRI guided biopsy and she has arranged for me to have the next morning at PMH. She is hoping we will be able to keep the February 10, surgical date.
February 8th, I have my biopsy. I also get a call from the surgeon’s office. My surgery is now rescheduled to February 15th. The surgeon wants to be sure he has the biopsy pathology before the surgery.
February 13th, my case is presented at grand rounds. Even though the pathology on the new spot is that it is benign, given its proximity to the know cancer, the decision is made to remove it during the surgery.
February 15, 2023- surgery day. 2 masses removed and 4 sentinel lymph nodes.
March 7th- post op visit with surgeon and review of surgical pathology. The second mass was benign but likely pre-cancerous. And 2 of my 4 lymph nodes are positive for cancer. Thankfully I do not need more surgery, but I am now considered Stage 2 breast cancer. Next step in Oncology consult and possible chemo.
Oncology consult was March 16th and the recommendation for 8 rounds of chemo is made. First 4 rounds will be Adrimycin and Cyclophosphamide, and the last 4 rounds will be Placlitaxel.
I’ll need baseline tests, CT, bone scan, before chemo starts on March 31st.
Ironically the spot the breast MRI noted was present on the CT. I’ll come back to this later.
March 31st, first round of chemo. Chemo is every 2 weeks. It’s exhausting. I had decided to do cold capping and it worked for me. I didn’t lose my hair. For my kids it made it easier to believe mommy was going to be ok because mommy still looked the same even if she was really tired. I think it helped me keep a positive attitude as well because I still looked like myself when I looked in the mirror.
After chemo came 20 rounds of radiation.
All in all my last day of active treatment was September 5, 2023.
I had a repeat Breast MRI on October 13, 2023. That spot on my right breast that they couldn’t find with ultrasound but was present on CT? Yeah, it is now gone on my most recent MRI. When I asked the surgeon about it, he said “we’ll never know 100% if it was cancer because it was never biopsied, but we know the chemo worked”.
This breast cancer journey of mine has been crazy so far, but I have been incredibly blessed. My cancer was able to be caught early. I have access to incredible care. Not every woman can say that. But they should be able to say that. I have heard from so many women of their concerns being dismissed. Being told by their health care professionals that family history is the biggest risk factor. Or that only the family history on your mother’s side counts. It’s maddening the misinformation even with the medical community about women’s healthcare.