Just the facts.

There were no big surprises during my appointment with the oncologist today. The worst of it was that in addition to the mets to my sternum, there are four small spots on my lungs.

I was very unhappy to hear this, although in truth it doesn't change my treatment. It just goes to my earlier statement that I can only receive bad or worse news. Jane tells me that my frame of reference for what constitutes good news will change (although she said it much more eloquently than that).

Here's the deal:

1. I have what is presumed to be breast cancer in my sternum, lungs, and the lymph nodes under my arm.
2. My first occurence of breast cancer was weakly estrogen receptor positive. ER+ means that the cancer likes estrogen. Even with people who have weakly ER+ breast cancer, the first line of treatment is hormonal -- essentially cutting off estrogen production, and also the body's ability to use estrogen. I have already started hormonal treatment.
3. In early August, I will have another CT scan. If at that time the cancer is stabilized or smaller, hormonal therapy will be said to be successful, and I will continue with it until it ceases to be effective.
4. If the cancer has grown, the hormonal therapy will be discontinued. At that point there would be decisions to make regarding chemotherapy treatment. Chemotherapy would be an option for me if hormonal therapy failed, but "quality of life" comes into play. I could decide to do chemotherapy immediately, later, or not at all.
5. On June 8th I will see a surgeon, who will get a sample of the enlarged lymph nodes. This is no-big-deal outpatient stuff.
6. A pathology report will be done on the sample. If the pathology shows that the cancer has become estrogen receptor negative (ER-), the hormonal therapy would be discontinued and I will be in the situation described in #4.
7. If the pathology report confirmed ER+ status, I would continue with the hormonal therapy at least until August, when the effectiveness would be assessed.

That's all the news fit to blog.