Treatment


**with each recurrence there is a new therapy or procedure, hopefully this will help someone one day

10/4/2010: Diagnosis 1 Stage IIb Infiltrating Ductal Carcinoma
                  2.5 cm tumor L breast, 3/24 nodes +, ER+(95%)/PR+(10%), HER2-
7/29/2013: Diagnosis 2 - Stage 4 Metastatic Breast Cancer - 
                  Pleural Mets around Left Lung & in L chest cavity; 11th rib (ER/PR+; HER2-)
10/4/2014 - Recurrence 1 
                 Continued Pleural & Chest cavity, L Hip tumor, T4/T5 tumor, 10th rib disease
4/10/2014 - Recurrence 2
                  No improvement in Pleural Disease, confirmed disease in L/R Ovary, 
                  Omentum & Fallopian Tube post surgery, L Hip Tumor, growth of t4/t5 
                  tumor with fractured t3, T/6, and micro lesions on Liver
9/29/2015 - No improvement in disease after 5months on a clinical trial, changed    
                   therapy - pathology remained ER+,PR+,HER2- AND AR+
3/10/2016 - increased activity in bone metastasis on lumbar, sternum and spine - stayed on chemo and added radiation
7/16/2016 - new nodule on left pleura, changed to targeted hormone therapy
11/10/2016 - new nodule on left pleura, 3 lesions on liver and a 5cm tumor found in parietal lobe, changed therapy and added radiation and immunotherapies
11/14/16 - Brain MRI found 5cm tumor on Partial Lobe, which was removed by craniotomy, and 10 mm sized tumors through my lobe part of the brain
3/20/17 - Cancer EXPLOSION in Lungs and Peritoneum
5/24/17 - Cancer EXPLOSION in Lungs and Pleura
10/30/17 - Cancer in Clavicle and Neck Lymph nodes, Lungs, Right Pleural Effusions, Liver, Peritoneum & Large, drainable Ascites seen on CT
1/29/18 - Shrinkage of Lung tumors and No Pleural Effusions, Small diffuse Ascites due to Peritoneum Tumors with no change and growth of 3 liver tumors, Brain Stable with some regression since 11/2017
8/29/18 - Cancer has shrunk significantly in Lungs, No Pleural Effusions, Slight shrinkage of tumors in Liver, significant reduction of LARGE Peritoneum Tumors, return of large ascites likely due to shrinkage of Peritoneum Tumors, Complete resolution of Lymph Node Tumors, Brain has remained Stable with continued regression

BREAST SURGERIES
11/11/10 Bilateral Mastectomy with immediate Tissue Expanders & Axillary Node Dissection - 1 Lymph node positive out of 21
11/24/10 - 5/11/11Expander fills started: 
6/2/11: Exchange surgery: , Allergan High Profile 475cc Silicone Implants Style 20
4/26/12: Revision Surgery AKA THE RESET BUTTON:: Capsulotomy due to Capsular Contracture on Left Side, Placement of Aloderm matrix to create a natural breast fold, Placement of 500cc Allergan Extra High Profile Silicone Implants

MORE SURGERIES
3/18/15 - Laparoscopic Oophrectomy & Fallopian Tube removal to stop Lupron, disease found in both organs on L & R side
9/30/15 - VATS of L Pleural Cavity. Biopsy of L Pleural Cavity Placement of L PleruX Catheter for Pleural Metastasis. - removed 12/2015
11/14/15 - EMERGENCY CRANIOTOMY TO 5CM tumor in Partial Lobe - Brain Metastasis 
1/10/16 - Craniotomy Revision Surgery due to infection at Scarline - was on TeFlaro IV for 6 weeks due to Staph and Klebs bacteria in wound
9/7/17 - Tracheotomy - Placement of Trach due to ICU stay for 40days - removed 12/2017
9/21/17 - Placement of R PleurX Catheter for Pleural metastasis - removed 2/2018
9/2017 - 12/2017 - Outpatient Interventional Radiology Paracentesis weekly due to ascites from liver and peritoneal metastasis, was only able to drain 3L at maximum. Drainage stopped when no fluid could be safely accessed for proceedure due to organ and tumor placement. Stomach remained distended  but was less distended than it was before 10/2017

9/2018 - present - Outpatient Interventional Radiology Paracentesis weekly due to CT Scan noting large ascites, which were able to be safety according to the CT Scan Images on 8/29/18 and Interventional Radiology's assessment on 8/30/18. Maximum drainage was 2L and stomach has been flat after procedure.

MORE TESTING
9/2010: Core Biopsy on L Breast - Dx with Breast Cancer
10/2010: Had Breast MRI & PET Scan in  to confirm that diagnosis was 2.5cm breast tumor confined to L breast12/8/10Pelvic Ultrasound & Trans-vaginal Ultrasound - cyst on R ovary, benign. NED 3/17/11, NED 10/4/11, NED 4/2012, NED 10/2012, NED 10/2013
Abnormal Pap Smears from 9/2006 - 10/2012 - Paps every 6mo, Had 8 Colposcopies with Biopsies. NED on 10/2012, back to annual Paps

7/2012: BRCA1/2 & BART Genomic Testing - negative
7/2013: CT Scan of Chest, Abdomen & Pelvis every 3-4months. Brain MRI every year, Bone Scan every Year
9/2015-12/2015: Chest X-rays to monitor Pleural Effusion and Pleurx Catheter (ever 2-4weeks)
7/23/2013, 7/8/2015 & 8/102015: Thoracentisis
9/4/2013: Foundation One Report - studied Breast Tumor from 2010 for genetic mutations 

      ** FOUND ** CCDN1; CCDN3; FGF9; FGF11; FGF13; BRIP1 (BRCA1 VARIANT); Androgen Positive1
10/28/2015: Prescion Medicine & Genomic Testing of DNA and Pleura Tumor done at Weill Cornell - NY Presbryterian - found about 20 known genetic mutations for cancer
9/1/2016 - Went to sloan kettering to test all tissue for immunotherapies. Found out tumor is positive for Mesothelioma Protien, which is a new target for tCell therapy
11/14/16 - Resent Brain tumor to Weill Cornell's Genetics Department to get genetic code for more prescion medicine and get basic breast pathology 
10/25/2018 - Guardant 360 Genomic Testing done via lab-draw (aka blood and not a tumor biopsy genetic analysis of the tumor & known genes that increase cancer risk)


FERTILITY TREATMENTS- 
Started IV Hormonals @ UPENN (specialist works with ER+ Breast Cancer Patients) 12/15/10
12/13/10 - Fertility Doctor noted that cyst on R ovary was "blood filled" and a sign of ovulation
Egg Retrieval - 12/26/10
Cultivated 5 embryos & 3 eggs

CHEMOTHERAPY/TARGETED THERAPIES
1/3/11 - 2/14/11 : 4 rounds of Biweekly Dose Dense- Epirubicin & Cytoxan
2/28/11 - 5/16/11: 12 rounds of Weekly Dose Dense - Paciltaxol 
10/2014-4/2015 : Daily Afinitor 10mg (mTOR inhibitor) (combined with a hormonal therapy)
4/2015-10/2015 : Clinical trial on Lucitanib 15mg (FGRR & 11q chromosome inhibitor)
10/2015 - 7/2016: Xeloda 1,500mg 2xdaily every 14days with 7days off
7/2016 - 11/14/2016: Faslodex Injections Monthly with Ibrance every 21 days
11/29/2016 - 3/14/17: Carboplatin & Gemzar two weeks. with 1 week off (went on Chemotherapy Break from 1/1/17-2/7/17)
3/2017 - 5/2017: Halaven Chemotheray (2 weeks on 1 off)
5/2017 -7/2017:  Navelbine Chemotherapy (2 weeks on 1 off) 
7/2017 - 9/2017: Opdivo Immunotherapy (every 2 weeks)
9/2017 - 11/2017: Ixempra (every 3 weeks)
11/2017 - 2/2018: Ixempra with Xeloda oral therapy (14days on 7days off)
2/2018 - present: Xeloda oral therapy with weekly Abraxane and biweekly Avastin

RADIATION
 7/5/11 - 8/11/11: 28 Daily Radiation Sessions with use of Bolus for 5 sessions of Chest, Skin & Clavicle
4/28/15 - 5/9/15: 10 Daily Raditaion Sessions from t2-t4
4/11/16-4/21/16: 10 Daily Radiation Sessions to each area: sternum, left iliac wing and t11-l2
11/21/16: 5 sessions of SRS to 8 tumors & SBRT (5 sessions) to Crainiotomy wound
4/26/17 -5/2/17: 4 sessions of SRS to 2 tumors left from December 2016, 1 tumor that was missed on scans in 2016 and 1 baby met that was new in my brain
7/10/17 - More SRS brain radiation to another spot with targeted radiation. All prior radiated spots have shrunk, vanished or are turning into dead tissue.

HORMONAL THERAPY
6/7/11- 7/29/13 - Tamoxifen planned for 5yrs before my cancer spread beyond the breast 3yrs later. 
8/7/13 - Monthly Lupron Shot to turn off ovaries
9/4/13- Start Femara 2.5mg daily
10/5/14 - Start Aromasin 25mg with Affinitor (see Targeted Therapies above) 
3/18/15 - End Lupron due to Oophorectomy

BIOPHOSPHATE THERAPY
Zometa infusions every 6months - Start 8/17/11-7/2013
Zometa every 3 months - 7/2013-4/2015
Zometa every month - 4/2015 - 3/2016
Xgeva Monthly -  3/2016 - present


HOLISTIC THERAPY 
** I am not a doctor, I take these supplements based on recommendations from doctors & also based on reading I have done on holistic cancer therapies, which were discussed and approved by my doctor. The list was the most current list of supplements I have been taking, but I have taken other supplements in the past that are not on this list, but had to discontinue due to not needing the extra supplement or interaction with cancer treatments. I have added hyperlinks to each supplement to explain why I have taken them. **

Please note I have had to STOP all Supplements on 2/1/18 , but the Medical Cannabis (no known interactions with current cancer treatment) due to being on certain chemotherapy drugs. With every drug change, my doctors and I review supplements I have taken before & if I can restart them. We also do lab-work before I take new or restart an older supplement routine, so I am taking the right dose of vitamin etc that I need.  


1. Rainbow Light Vitamin D3 1,000IU - 1pill daily  for bone strength
2. Source Naturals Calcium D-Glucarate 500mg - 2 pills daily for estrogen management
3. Probiotics (PB8) - 2 pills daily for detox
4. Cannabis Oil Via Medical Card due to Brain Mets - 40mg daily of pure CBD oil and 25mg THC oil before Dinner due to having repeated bouts of nausea at 6:30pm from developing Anticipatory Vomiting & Nausea. Initially prescribed to reduce swelling of Brain tumors and reduce risk of seizures from Brain Radiation and/or Tumors. Increased dose over time and expanded use for chronic bone pain, nausea, sleep and continued reduction of swelling of radiated tumors. 
5. Digestive Enzymes - 2 pills twice a day to encourage a healthy immune response by providing proper gastrointestinal enzymes to break down food
6. Magnesium-Citrate 1,000mg at Bedtime as needed for muscle cramps & constipation