The Journey

A chronological record of the patient's journey from diagnosis through treatment, with medical information translated into understandable terms.

1
diagnosis

The Diagnostic Days: Tests, Scans, and Questions

First consultation with the surgeon on Friday afternoon, followed by whirlwind of diagnostic imaging - mammogram, ultrasound, core biopsies. MRI scan the following week completes the picture. From reassuring examination to mounting concerns.

  • • Initial physical examination suggested lump might not be cancer
  • • Mammogram, ultrasound, and core biopsies performed same afternoon (Friday)
  • • Radiologist expressed concerns during examination
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2
diagnosis

The Results: Diagnosis, Complete Picture, and the Path to pCR

A week after the diagnostic tests, all results are in: HER2-positive invasive ductal carcinoma with lymph node involvement. The surgeon presents the complete diagnostic picture and outlines the NACT strategy with a clear goal - pathological Complete Response.

  • • Pathology confirmed: Invasive ductal carcinoma, Grade 3, HER2-positive
  • • Lymph node involvement confirmed in right axilla
  • • MRI mapped full extent of disease - approximately 25mm primary tumour
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3
consultation

The Treatment Plan and the Cardiac Pause

PET/CT scan reveals no distant disease - cancer is localized (huge relief!). Meeting the oncologist at Royal Marsden, receiving the treatment plan with pCR as the goal. But an unexpected finding on the PET/CT leads to an urgent cardiac referral and a pause before treatment can begin.

  • • PET/CT scan: whole-body imaging to check for distant metastases
  • • Results: No distant spread - cancer is localized (excellent news!)
  • • Extensive local lymph nodes identified (axilla, subpectoral, lower neck to C7)
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4
scan

The Neck Scan: Mapping Every Node

Following the PET/CT findings showing lymph nodes extending up to C7 vertebra in the lower neck, a specialist neck radiologist is brought in for precise ultrasound mapping. Another scan, but this one is about optimization - getting millimeter-accurate information for the most effective treatment planning.

  • • PET/CT revealed lymph nodes extending to C7 vertebra level in lower neck
  • • Specialist neck radiologist referral for precision mapping
  • • Ultrasound of neck/thyroid scheduled with possible needle aspiration (FNA)
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5
consultation

The Heart of the Matter: Assessment and Clearance

Six days of cardiac testing and anxiety. From coronary calcification concerns to discovering excellent heart function. The relief of receiving clearance to proceed with the preferred chemotherapy regimen.

  • • Comprehensive cardiac workup: echo, CT coronary angiogram, blood tests, ECG
  • • Started Atorvastatin 40mg for cholesterol and potential cardioprotection
  • • Results: LVEF 71% (excellent heart function), non-obstructive coronary disease
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6
milestone

The Roadmap: Ready to Begin

With cardiac clearance received, the complete treatment roadmap is finalized. Genetics testing initiated. Consent forms ready to sign. After weeks of preparation, assessment, and planning, treatment is ready to commence with a clear path to pCR.

  • • Treatment roadmap hand-drawn by oncologist - visual journey from now to pCR
  • • EC x4 cycles (every 2 weeks) → Weekly Taxol x12 weeks → Surgery → Radiation
  • • Phesgo throughout and beyond - approximately 18 cycles total
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