An Evening in NYC

Hi Everyone,
Yesterday afternoon Jim and I headed into New York City. We don't usually go into the city on a week night, but we wanted to attend an information session on triple negative breast cancer, and it was a good excuse to go out for dinner.

There were two speakers at the conference; Dr Ira Bieiweiss, Professor of Pathology, Chief of Surgical Pathology and Director of the Division of Breast Pathology at The Mount Sinai Medical Center and Dr Serena Wong, Medical Director of The Life Center at the Cancer Institute of New Jersey. Both of these speakers were amazingly knowledgeable. Jim and I learned so much, but the most important thing that we learned is that Martha received the most up-to-date treatments currently available to triple negative breast cancer patients. This knowledge is reassuring to both of us. It is normal to second guess our decisions and to wonder if we could have done more. I now know we did all that we could.

Dr Bieiweiss explained, in great detail, the pathology that goes into diagnosing cancer. He explained that the breast has ducts, similar to the Lincoln Tunnel, and if a duct gets a leak the cancer spreads. He told us that invasive ductal cancer can be seen on a mammogram, while invasive lobular cancer can not be seen on a mammogram. I always wondered, why Martha's cancer didn't show and maybe this is the answer. I had never heard of breast cancer not showing on a mammogram before Martha's situation. Dr Bieiweiss showed us slides that showed cancer. He explained the more different the cells are increases the grade of cancer. When size and grade are combined it gives an indicator if the cancer has metastasized to the lymph system. It was amazing to see breast cancer on a cellular level, on an over-head projector.

Dr Wong was young and passionate about her career. She explained all sorts of stuff. She listed the drugs that are used to fight triple negative, and I think Martha had most/all of them. She explained the risk factors for getting triple negative breast cancer; early period, early births, no breast feeding, no physical activity, obesity, and alcohol use. Crazy, but Martha didn't have even one of these risks. Triple negative cancer only accounts for 15% of all breast cancers, and only 16% of white premenopausal women get triple negative breast cancer. Again, this is crazy. I didn't get an answer to why Martha got this type of cancer. Dr Wong did explain that a mutation in P53 equals an 82% chance of getting/having triple negative.

Both Doctors explained the clinical trials that are taking place using PARP Inhibitors and so far these clinical trials are showing promising results. Martha was on her game because this was one of the last things she asked Dr. Livingston. She was willing to participate in a clinical trial, but not were starting at that time. I say, damn, damn, damn. We need to keep fighting and searching for an anwer. We need to support the doctors who are capable and willing to do the work.  And one day they will have something to keep triple negative cancer at bay.

During the question and answer period, I asked if triple negative breast cancer can be detected at stage 1 and/or 2? They answered yes. I asked about the speed with which Martha's cancer seemed to appear and spread. How did this cancer go from nothing to stage IIIB so fast? They explained that this is such an aggressive cancer that it cannot appear at all and then a few months later be first diagnosed at a stage IV. I told them how Martha's cancer might have been IBC, but it was definitely triple negative. They told me that it was very likely that she had both.

Jim and I left the conference much more informed than when we arrived. They video taped the speakers and I requested that they put it on the web. People need access to this information.

As Jim and I walked, in search of a restaurant, I was sad, yet confident that all of us did absolutely everything humanly possible to help Martha. We didn't go down the wrong path and we left no rock unturned. I am confident that we need to keep fighting and talking about breast cancer. These doctors, and others like them, are smart enough to figure this out. They just need more time and more money.

Then Jim and I came upon a wonderful restaurant, Atlantic Grill. We made a toast in honor of Martha's life and then we enjoyed a delicious meal before heading home to New Jersey. I miss her so much. She would have enjoyed spending the evening with us, maybe she did.

xo,
Pam