In 1992, at 57, I was diagnosed with a small Stage 1 infiltrating ductal carcinoma with one positive lymph node in the left breast. 22 out of 22 axilla nodes were negative. I had a lumpectomy, 30 sessions of radiation, and 6 chemotherapy sessions of CMF. Except for the nausea related to chemotherapy, I did relatively well during treatment. Prior to my treatment, I had been taking 0.625 mg Premarin. I was strongly advised to get off the estrogen immediately and I did over a two week period. The side effects of estrogen withdrawal were horrendous. Severe leg cramps at night kept me from sleeping and bizarre mood swings destroyed any peace I could hope for in my daily living. In addition, my libido went into the basement. Quality of life issues were part of every discussion with my doctor. Finally, when a testosterone test came back below detection limits, I decided the risk of taking estrogen and small amounts of testosterone were worth it given that I was seriously thinking of divorcing my husband so he could find someone else and have a better life than one I could give him. This decision came after a hellish year of feeling like my life was on hold. My oncologist agreed. I got on with my life.

In December 2007, I was once again diagnosed with breast cancer in the left breast. Whether it is a new cancer or a reoccurence is an unknown. This time, 15 years latter, it is a 2.1 cm Stage 3 cancer with 4 out of 4 positive lymph nodes. There was only one choice--a mastectomy followed by chemotherapy and radiation. I went off of premarin and testosterone over a six week period. I was grateful to find that I had no side effects from estrogen withdrawal.

The surgery went well with one exception. I developed a large persistent seroma which refused to heal. Now almost 5 months after surgery, I still have a drain. I had 4 sessions three weeks apart of TC (taxotare and cyclophosphomide). This time the nausea was kept under control by a regime of four drugs (zofram, decodron, compazine, and lorazapan). After the first session, I lost my hair. I took this opportunity to buy a blonde wig. Other side effects were minimal until after the third session when I began to lose my ability to respond to sexual stimulation. I wanted to have sex, but it was like my sexual organs were numb. My husband and I still have sex. I like the closeness and derive some happiness at feeling his response. Again, there are no definitive answers as to when or if I will get my sexual life back. It isn't fair.

Today, I have finished 18 out of 25 radiation treatments and the drainage from the seroma is about 45 cc/day which is about half of what it was when I started radiation. I have searched the internet for a way to accelerate the healing of seromas without success. Journal articles report on a variety of methods, but other articles show that none of them make a difference. My surgeon had the drainage analysed and found that there are malignant cells in the fluid. Apparently, this may be caused by micro cancers in the lymph system that interfere with healing. Since it is rare to analyze seroma fluid in breast cancer patients, no one knows how common this is. An article out of Harvard suggests that there is no relationship to the risk of metastasis, but the data base is limited. A PET scan and breast MRI were negative. I have had the drain replaced once when it malfunctioned and the system is working well, but the psychological stress of carrying this around with me is grim.

My next decision is whether I will take tamoxifen or an aromoatase inhibitor (AI) for five years. I have a lot of muscle and joint pain from arthritis so there is concern that taking the AI will make the pain even worse. In addition AI's generally cause a lower libido than Tamoxifen. My onocologist has suggested that I take Tamoxifen for two years and then switch to an AI if there is nothing better on the horizen at that time. Although some women take an AI and suffer no side effects, others are devastated. There is no free lunch. 

So here I am, almost five months after surgery with no left breast, a seroma that refuses to heal, a non-existent sex drive, no hair, and aches and pains of various sorts that I didn't have before. But it could be worse. To be continued...