[Aussie Girl]

Hi,

Just want to reassure you that your wife's cancer is still at an early stage and that the treatment plan you've been given is very good and similar to what many of us have had with good results. Every time a study comes out, the prognosis for early HER2 breast cancer seems to get better. I'd think >>98% for stage 1 cancer for your wife. Unfortunately the chemo is necessary to get these good results for this type of breast cancer.

It would be great if the surgeon can get a clear margin with a second op and not have to have radiation. Some ladies have breast tissue that extends a bit further than average, particularly laterally. If the second op doesn't get definite clearance, then radiation may still be needed, but it is worth trying. Definitely no need to have the left nipple removed. Risk of further problems there are very low. Similarly, the skin around the nipple should be fine. Unless the tumor lay right under the skin and was infiltrating it at the time of diagnosis, then the risk of recurrence is extremely low. (I'm a pathologist and it is very very rare to see skin recurrence in an early stage breast cancer after adequate local control and chemo).

I love my portacath (Power port) that sits just under the outer end of my collar bone. I don't know about ones in the neck - check where it is going in. Make sure she get a low profile one if she is thin, so the skin doesn't have to stretch too tight over it. The site may be quite tender for a few weeks, but after that - it makes chemo so much easier.

Use the site search function to find info on the various side effects of chemo. Make sure you have a little stock of the medications and remedies suggested. And try to keep moving - walking a little each day makes a difference.

Neulasta is very important as it minimizes the risk of low white cell counts resulting in infection. The lowest counts occur between about day 7 and day 11, but Neulasta has to be given day 2 before you know you have a low count.

I ended up in hospital with fever and no white cells in my first round because I didn't have access to Neulasta ($2000 a dose) for my first round. It was government funded after "it had been proved I needed it". Stupid really, as the hospitalization cost the government and my health fund tens of thousands of dollars.

You'll get through all this together and it sounds like you have a good team.

Chemo is hard - but it isn't a continuously devastatingly awful process like you imagine it from movies. There's a rhythm to it so you take extra care on the low days and welcome each day of improvement until the next cycle. Each cycle is a milestone towards the goal of beating the disease. Then heavy chemo is over and each day brings improvement.

Best wishes to you both.

Aussie Girl