Timeline

Self-discovery of breast thickening

Washing in the shower, discovered an abnormal area several centimetres across, very firm, nipple recessed, not detected the day before. Normal mammogram 18-months prior.

Unable to book appointment with GP for six weeks

Primary care physician recommended that if I thought I needed to be seen sooner, I could go to an UPCC. I did eventually do so, although I now regret not being more insistent at the time, or marching straight to the UPCC.

Mum diagnosed with Br CA at BCCA Surrey

Coincidental diagnosis, different type, size and treatment program. She received her diagnosis in-person and was given a planned surgery date on the same day.

Seen at Downtown Victoria UPCC

Referred for urgent mammogram/ ultrasound/ biopsy. Started on antibiotics.

Mammogram & US done the following day, however biopsy not performed as only one day of antibiotics started. Skin is dimpled (“peau d’orange”), hot, and faint dusky purple.

GP phones with news that biopsy shows high grade cancer

Makes referral to the South Island Integrated Breast Cancer Program – Centralized Referral. (Never did have an in person appointment with my GP, locum only.)

MRI appointment

Around this time, skin begins to show signs of rash over the tumour area, advancing every couple of days.

Mum talks to BCCA in Surrey

Brings my case to the attention of her oncologist, including the speed of onset and tumour growth, and also the lack of oncology referral (only surgical). Mum’s oncologist recommended that I be referred immediately to BCCA Surrey.

First Chemotherapy treatment at BCCA Surrey

Just one week from when my parents brought my case to Mum’s oncologist in Surrey. Course of eight treatments, three weeks apart (six months total), starting with Doxorubicin.

Chemo treatment 6 of 8 results in four day ICU admission at SMH

Following an illness with RSV the previous week, treatment with Paclitaxel and Trastusamab (Herceptin) appears to have triggered acute pulmonitis requiring O2 support (but not intubation).

Rapid improvement in the first 24 hrs, discharged home on no meds but still quite SOBOE.

Admission to RJH 3S

Presented to ER and was found to have significant pleural effusion due to temporary CHF. EF reduced from 50% to 35%, now thought most likely due to Herceptin. Treated conservatively with Lasix.

EF likely to return to normal when Herceptin leaves the body, but initiated several cardiac meds to assist LVF during period leading up to surgery.

Mastectomy and lymph node removal, RJH in Victoria

Done using nerve blocks and sedation, since general anaesthetic was too risky given my heart failure status. Surgery went very well, margins were “clean”, and recovery was uneventful.

Radiation treatment, BCCA Victoria

Four weeks of radiation treatments, five days per week.

Begin targeted therapy

15 months of protective treatment with Trastuzumab/ Herceptin canceled due to cardiotoxicity.

TDM1 considered instead, but still a risk for heart failure. After consultation with cardiologist, case review and special funding approval, treatment goes ahead. 14 cycles of 3 weeks, or as tolerated.