Day 39 | A Cancer Lesson: The Supraclavicular Lymph Nodes

Well...Taking the good with the bad 

In the (clear!) MRI of my spine, they saw a lymph node that needed extra scanning. Yesterday, I went to have more ultrasounds of my nodes. 

One of the nodes is 2cm. Anything over 1cm is considered suspicious for cancer, especially when it's positive in other nodes. 

It is possible this is a "nothing" swelling. They reviewed spine MRIs from 2015, and it seems there may(?) have been swelling in the same node back then...but they weren't MRI-ing my nodes. They were MRI-ing my spine. So, there isn't clear evidence one way or another.

Damn. What happens next?

So, before I start chemo, I will need another biopsy of the node in the supraclavicular region. Due to the location and size of the node, they will need to put me under again. Cue all the doctors. 

Wait, what the heck is the supraclavicular region?

It's the area above your clavicle.

So what if they found cancer there? No offense, but we already knew your lymph nodes were cancerous. 

While they found (and removed!) cancer in the axillary lymph nodes, finding cancer in other lymph nodes changes staging and possibly the prognosis and treatment. The overall impact on the: 

• Short-Term: It will likely not change anything in the short term (except pushing my first chemo treatment back a few days).
• Long-Term: They want to know if it's cancerous before starting treatment because it could/would change the long-term plan. A new plan may involve chemo, radiation, then chemo again. It may involve more surgery. We don't fully know yet how / if the bad node will change things. 
• Super Long-Term: The overall survival rate for stage three cancer was 77%, but that is from people that started treatment in the early 2000s. The survival rate for triple negative is a little lower than that of other types of breast cancer. ...but, there are NEW MEDS, NEW TREATMENTS every day.

Why do they need to know about your supraclavicular nodes now?

They want to identify the cancer now, before starting chemo, because chemo could shrink the node and/or rid it of cancer....which we all know is a good thing. However, they wouldn't know about where to radiate and/or if the area need targeted extra radiation. It's important to identify that now so they can get a clear idea of my overall treatment plan NOW, before I am cured forever :). Here is a good article on radiation for breast cancer.

What's next?

• If this node is cancerous, they will restage me at a 3C (more on node involvement and staging). Being a 3C sounds really bad (or worse than 2A or 3A). It's the last step before being a stage 4. ...But the cancer has not in the organs, bones, or lungs. This is still good news. 
• If the node is benign, they will start chemo sometime this week, and they will monitor the little/big node over time.

Let's not despair too much. It's possible that this is nothing. It's possible my anatomy is just wired to have one big lymph node in my supraclavicular region. Until we biopsy, we don't know. So, let's keep praying. I'll let you know as I know more.