San Diego, CA

It is a calm and beautiful San Diego Sunday morning and there is much to enjoy. We went to see the head of breast oncology at UCSD on Friday and she was quite delightful and spent ample time with us and again went through the decision making process in determining Ann's optimal treatment going forward.

She recommended an aromatase inhibitor as the most effective way to block estrogen as the tumour is hormone sensitive. This will continue for at least five years. She also mentioned an alternative to external beam radiotherapy, namely a technique called partial breast irradiation which I had not heard of before. I will have to research it further to be sure that it it is at least as effective as the standard treatment. This method has some significant advantages in that it takes only one week instead of six weeks and can be given immediately following lumpectomy instead of waiting until after chemo if indicated. 

She really did not think that the option of subcutaneous mastectomy either bilateral or on one side in order to prevent recurrence or diminish the risk of new disease was reasonable.

We also discussed the $64,000 question regarding adjuvent chemotherapy and as we surmised we will not get the answer to that for  another two weeks while the Oncotype DX gene test is being done.

This is a little frustrating as neither of is very good at waiting but there is little choice. At least,we can look into getting an opinion on partial breast irradiation and we will try to get to visit with the radiation oncologist at UCSD next week.

In the mean time we will take advantage of all that San Diego has to offer.