After losing so much hair in one day (not counting the mess that was in the shower drain as well), I decided to take a pair of scissors and just whack away at my hair.  Even though I had shortened it already, the weight of it was really hurting my scalp.  I had no thought to style . . . just to lightening the load.  Not bad, eh?  Tossed a wee bit of gel in it to remove the "pouf."  We'll see how long this remains in.

I also went back to the hospital today for another blood check.  I went mid-afternoon and there were very few people there.  I was able to speak with the senior technician and tell him a bit more about my situation.  He asked if I took any medicine to increase my numbers and I told him that I didn't (although, I guess the shot I took the day after chemo helps with that).  He did the test and gave me the results almost immediately (he had no one else in the queue).  The numbers were great!  Even better than my pre-chemo numbers!  Both he and I were relieved.

God is good . . . all the time!  I am so incredibly grateful.  This will keep my chemo cycle on schedule for next week.

What in the world does the money of China have to do with a chef's hat?  Let's just say that food costs money!

I've only been out once since my first chemo session and that was to go to the hospital for the blood check.  I've been "playing things safe" by staying in during my low white cell counts . . . and I've been keeping busy at home.

However, I went out yesterday!  Woo hoo!  I met with a group of friends for "Sundae Club" (that's what we call "church" here) and had a great time with them.  I wore my mask when I was with the group and while walking outside.  I reminded everyone to wash their hands and unfortunately, I had to stay away from the babies as they had the sniffles.  However, it was wonderful to be with everyone again.

After Club, we went out to eat.  I'm sad that one of the side effects of chemo is that the lining of the esophagus is thinned, thus eating more "intense" foods more difficult.  I'm a gal who loves her spices and now I can't eat them.  I can literally feel spicy food burning its way down my throat, so I stay away from it.  Fortunately, there's still enough variety in the foods of our area to keep me happy.

After lunch, I dragged Art to the meat market.  We normally buy two/three pounds of beef at a time.  However, since I'm heading back to Hong Kong next week and probably won't feel like shopping for food when I return, I bought ahead.  I bought nine pounds of beef, separated into three different "roasts."  Art's eyes went wide . . . "Are you sure we need all that?"  I reminded him of his schedule in that he won't be getting home from work until 7:30 three nights a week and that I won't be able to run out and pick something up.  I reminded him how I wouldn't be here for three days and that food would need to be available for the kids once they got home from school.  He just kind of shook his head in wonder about how could we possibly eat all that food.  I think he was also in sticker shock over how much I spent on meat!  (Recipes include beef stew; BBQ beef and fajitas.)

I also bought ten chicken breasts.  When I got home, I froze the beef and six of the breasts.  I chopped up the remaining four, as well as some broccoli, cauliflower, onion and green pepper.  I put some rice in the rice cooker and stir fried the meat and veggies.  Everything was done at the same time (that's a miracle!) and dinner was served! 

While I won't be teaching this semester, I will be doing my best to care for my family.  This morning, the kids went back to school after their long semester break and I got up and made them scrambled egg and cheese pizza.  Michael fussed at me a bit . . . he was anxious to leave for school to see all of his friends . . . but broke down and said, "I think I'll have a piece after all!" 

I was an instant fan when the first Toy Story came out in 1995.  I could relate to everything about it . . . headless, legless, hairless dolls included.  Unfortunately, with four siblings, toy mutilation was a known activity in our house.

Remember the little aliens?  Remember their line?  "You have saved our lives!  We are eternally grateful!"  They repeated this every time they saw Mr. Potato Head.

Fast forward to 2010 and Toy Story 3.  What a bittersweet film!  It made me laugh and it made me cry.  Once again, I could relate to everything . . . toys that didn't make the cut (Bo Peep), toys to be donated and toys to be kept.  I still have several of my childhood dolls in storage, that unfortunately, due to life circumstances (moving to China), that my daughter never got to play with.  However, I do look forward to showing them to her one day.

The aliens remained a part of the scene.  Fifteen years later, they were still enthusiastically saying to Mr. Potato Head, "You have saved our lives!  We are eternally grateful!"  Their consistent refrain really made me think about my own life.  It's been over 40 years since I made a personal choice to follow Jesus . . . am I still "eternally grateful?" Am I still as enthusiastic as I was way back when?

I went on a hunt to buy some aliens.  The Toy Story marketing machine was in full motion, but let me tell you . . . it was hard to find just the little aliens!  Or, if I did find an alien, it would be much bigger than I wanted.  I finally found a kit that had the miniature figures of Woody, Buzz and the aliens.  I purchased it and started carrying an alien in my pocket and and the other two in my purse.

The aliens were reminders (symbolism!) to me to be grateful.  I used them to tell others about an "attitude of gratitude."  I quit carrying them in my pocket and my purse after about a year and moved them to a desk in the house. 

The other day, a friend of mine contacted me telling me that one of her daughters still remembered my story of the "Alien in my Pocket."  The daughter recently told her Sunday School class about it . . . a year-and-a-half after I told her the story.  It prompted me to take my aliens off the shelf and to start carrying them around again. 

God has saved my life . . . I am eternally grateful!

Today's post is a bit more of a rant than other posts.  It has nothing to do with any organization, but is a reflection of my personal views on a particular topic.

There's just something about having a symbol for something that makes people either relate to the concept or to keep a memory or event fresh in our minds.  It kind of goes with the "a picture is worth a thousand words" idea.

Some common symbols include:

Wedding rings.  Such small things, in and of themselves, but ones that invoke powerful emotions.  Wedding rings make a statement of commitment . . . of love without a beginning or end . . . of a "happily ever after."  An inexpensive wedding ring (mine was less than $100 at Target!) doesn't mean a lesser amount of love, because love doesn't have a price tag.

A physical symbol of faith seems to be important to almost every religious participant.  Those symbols vary from faith to faith and vary quite a bit even within a faith.  Faith . . . "our handle on what we can't see" (The Message) . . . is something that everyone has, regardless of their belief in God or not.  It takes faith merely to walk out of our doors each day.

It's such a simple design, isn't it?  One sees a red cross and immediately, one's thoughts go to health care and humanitarian aid.  The International Red Cross organization gives us a way to respond to those in great need after disasters of many kinds.  For many who have received such aid, the sight of the red cross can bring back strong memories of key points in their lives.

And that brings us to the ubiquitous pink ribbon.  Sigh.  I've been known to wear a pink ribbon in the past . . . and even cross-stitched a pink ribbon in memory of my mom who died of breast cancer.  However, I long ago, abandoned the pink ribbon campaign because it seemed (to me) to be more about itself than about the disease it supposedly represented.

Cancer isn't pretty.  It's not soft and cuddly and it most certainly isn't pink!  Many products that sport the pink ribbon often contain cancer-causing products!  (Gals, do we really know what's in our make-up?)  I literally gasped out loud when I saw KFC's pink "Buckets for the Cure."  Seriously?  A huge bucket of fried chicken being used to support breast cancer research?  What about the research that is going on for obesity related diseases?  I would more likely use the bucket to barf into than to support breast cancer research by buying it.  The money "donated" to breast cancer research is so miniscule compared to the amount of money made from sales of pink ribbon products. 

(Side note . . . most women who die of breast cancer, die of its metastases . . . its spread to other organs.  Most of the pink ribbon campaign is about early detection (which is very needed) and most of the research continues to be in the realm of early detection and treatment of early cancer.  There needs to be a much larger infusion of money into research on how to cure already existing/reoccurring breast cancer.  If you really want to support the research cause, do so by making a direct donation to a research facility (not a charity) working on the specific project.  Additionally, if you know of someone who cannot afford a mammogram, then offer to pay for it for her!  The money spent on such a thing will go a lot further than purchasing pink ribbon items.)

I never wanted to be a member of the cancer club.  I didn't ask to join and I most certainly won't wear a membership pin!  When people see me, I don't want them to see another pink ribbon.  I would much rather people think of me as an individual.  It is my hope and prayer that my journey be identified by my walk with Christ rather than by a marketing machine gone awry.

So, please . . . no matter what your desire and no matter how "cute" something is . . . please don't send me anything pink!  No pink caps or hats; no pink pens, no pink tee-shirts, no pink sweats, no pink cups, no pink whatever.  I'm not someone who wears a lot of pink to begin with (although, I do own two or three pink tops!) and I'm certainly not going to start wearing it now, just because I have breast cancer.  I understand the need and desire for symbolism (as shown above) and I can't completely "bash" the pink ribbon.  Breast cancer awareness has grown by leaps and bounds over the past twenty years and I'm most definitely benefiting from research that has gone on during that time.  The pink ribbon gave a name to a disease that people were previously ashamed to talk about.  However, I don't want anything to do with pink ribbons and all the broo-ha-ha accompanying them.

One of the most common side effects of chemotherapy is a lowered white cell count.   White cells are what help you fight infection, so when your white cell count is low, your immune system is more easily compromised.  The key is to be aware of when you low point is and to take measures to protect yourself.  The lowest point is called "nadir" (pronounced "nay-der" by North Americans and "nah-deer" by my British-English-speaking Chinese doctor.)  When you are at nadir, you should limit your contact with large groups of people, wear a face mask if you are around anyone with a cold (and have them wear a face mask, too) and wash your hands quite frequently.  You have to monitor your temperature and keep a close eye on any health changes so that you can take immediate action, if necessary.  Knowing the low point is more of a precautionary thing than something that requires action as it gives me an awareness of when to be "extra careful" in my interactions with people.

My regular white cell count is on the low side of normal to begin with.  We were expecting to see very low numbers and we were prepared for them.  However, the lab was not prepared!

I had my 7-day post chemo blood draw and it was interesting, to say the least.  We went to the local hospital across the street from our university.  Registered, paid for the blood test and went upstairs to the lab.  The technician said we needed a doctor's order.  Went to the "blood tumor doctor" who looked at me in my mask and asked, "Are you sick?"  I replied, "No, I just want a blood test."  She immediately took my card, went to the computer, saw it in the system and printed out the order slip.  No questions asked!

The technician pricked my finger (I *hate* finger pricks!) and sent me downstairs for 15 minutes to wait for the results.  After ten or so minutes, the phone (red, of course) at the info desk rang.  The attendant called out, "杨胜利在马？"  (Is Vickie here?)  They wanted to see me back up at the lab!  I wasn't  too surprised.  I looked at Art and said, "They're freaking out!"

We went back upstairs and an older technician was with the young guy who had drawn my blood.  He told us that my numbers were so low that he wasn't sure his machines were working.  I told him the situation and that relieved him a bit.  However, he pricked another finger so that he could run the test again.  (Repeating what the young tech did!)

I went to the bathroom and while I was there, the results were given to Art with an adamant, "She needs to see the doctor!"  Art, being the nice guy he is, wanted me to go down the hall to see the doctor.  I told him, "I *am* seeing a doctor . . . my own!"  I had no desire to get into an argument with a local doctor about needing to be in a hospital.  I just wanted to get out of there.

We came home and scanned the results and sent them to my doctor in Hong Kong and to the American doctor here in our city (my first line of contact should I need medical treatment here).  I've been told by my doctors that the numbers are "fine" and very much expected for this stage of chemo.  I have already been keeping myself relatively isolated, wearing face masks around people and washing my hands every time I turn around.  There's not much else I can do.  I don't plan on going out in public until Sunday.  There's enough to keep me busy here at home.  Also, people are coming to see me on a limited basis, so I'm not spending a lot of time alone.  In fact, I'm finding I have very little alone time! 

My counts will now be on the rise.  I'll get another blood draw on day 14 to check them and yet another one just before my next chemo.  If the counts aren't high enough at chemo time, I'll have to wait until they are for the next chemo session.

It's a good thing I'm not needle-phobic.  My poor son is and he is so very sympathetic about all the needles being stuck in me.  

How did we end up making our decision to commute to Hong Kong?  It has taken quite some time to write this.  Most of it was written the week of February5.
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This is a difficult post to write because it has so many twists and turns to it.  It's hard to understand because so much of it reflects Art's and my personal time with God.  With that being said, I'll just post it . . . be warned, though, it's long!

My second core needle biopsy (testing for drug sensitivities and for the FISH test), was done on Friday, February 3.  It was a minimum five-day wait for the results, so we decided to return to our home city in China on
Saturday.  We met with our sundae club (that's our name for "church") the next morning. 

In the meantime, we needed to make some important decisions on how and where to pursue treatment.  We had options of Hong Kong or the US, with the Hong Kong option having sub-options of my commuting back and forth (minimum 6 hours, sometimes more) or my staying in HK with friends or by myself.  Additional option would be to move the entire family to HK.

We laid down before our Father our desire for clear vision on which direction to go.  At one point in time, we had decided to go to the US.  We looked up material on premature departure from the field and started working on some of the suggestions included in that material.  The agony in making that decision was so overwhelming from every point of view . . . physically, spiritually and  emotionally.  We sent out a prayer email to all of our supporters, asking them to pray *immediately* for clarity on our parts as we navigated the next steps.  We let them know that we were being strongly encouraged to return to the US and how difficult that decision was for us.  We mentioned the option of my commuting to HK and how no one felt this was viable except for the believing doctor who was treating me.  We briefly mentioned a possibility of our staying in HK for the duration of treatment.

I couldn't eat.  (BTW, I always thought I was a stress eater.  Perhaps I never really knew what stress was before . . . because right now?  It's hard for me to eat!  I have no appetite and I eat because I need to not because I want to.)  Before we went to sleep, we asked God to speak to us even in our sleep to make things clear, claiming Psalms 16:7  "The wise counsel God gives when I'm awake is confirmed by my sleeping heart."

I had an interesting night's sleep that night, waking up at one point, saying, "Oh, shoot!"  I was loud enough to awaken both myself and Art, but I had no recollection of whatever prompted that.  I was very fuzzy-headed and could only say, "I can't wrap my brain around this." I was able to immediately go back to sleep.

I dreamed.  I'm still trying to discern if this dream is from God, but after discussing it with Art and after several days of reflection and prayer, I am  inclined to believe it was a message for us. (I'll tell the dream at another time.)

Art went for a run Monday morning.  His heart cried out to hear from God.  On Sunday night, he gave up everything here in LZ and began to mentally prepare to return to the US.  However, on Monday morning, as he ran and listened, he began to hear that this was not necessary.

While he was out, I was processing and praying over my dream.  I began to read the myriad of emails that came in through the night . . . responses to our prayer requests and affirmation that people had been praying for us while we slept.

All the emails were very touching and supportive and prayerful.  Most people "got it" in understanding the need for a rapid decision rather than being about the cancer itself.

One completely surprising email came in.  A woman from my small group of years ago who had moved to another state, wrote of her and her family's current location . . . Hong Kong!  They moved there seven months ago.   Both Art and I were absolutely floored by this . . . they are the last family we would have ever suspected of moving to Asia.  Her email reflected God's grace and goodness.  They have a daughter, Rachel's age and a son, Michael's age.

On Monday, we received phone calls from three doctor friends.  While we had emailed two of these doctors (M.D.s), we had not personally spoken with them since this journey began.  The first doctor, Art’s brother, ended up his conversation with saying that he didn’t think traveling to Hong Kong for treatment was unreasonable.  Although Art’s brother’s practice doesn’t involve treatment of cancer patients, he had several helpful pointers and questions for us to consider.

The second doctor, internal medicine, had lived in HK for eleven years when his son was diagnosed with lymphoma.  He and his wife had no choice but to go to the US as the HK doctors at that time didn't know how to treat children with lymphoma.  They also agonized over leaving HK, but had separately received word and peace from God releasing them to do so with free hearts.  He and his wife (also on the phone) are now the directors of the organization we are with, completely and heartfelt-fully, understood our struggle.  As we discussed the option of commuting, they both understood that we had not received the same “release” that they had received in the same situation.  They asked some key medical questions that they felt needed to be addressed, but agreed that we should follow what we believed God to be telling us.

The third doctor is a breast cancer specialist/oncologist and a life-long friend of mine. She initiated the call on her own and I was able to talk to her in-depth about side effects, infections, etc.  I asked the questions that our director had asked and she was able to easily answer them.  She has reviewed the recommended treatment (chemo first, surgery second) and agrees with it 100%.  I gave her the details of the commute, as well as the run-down on the medical situation in our city.  At the end of the 30-minute phone call, she said that she would have no problems if I were her patient and did such a commute for treatments.  She has patients who commute just as far (or farther) to get to her.  {Update:  the recommended drug protocol for my chemotherapy is the exact protocol she would use for her patients in the same situation.}

In between these other calls, a call went out to the American doctor here in LZ.  She is still in HK with her husband, but will return tomorrow.  I asked her about her concerns and most of them were centered in how I would manage my work schedule and chemo schedule. As soon as she heard that I was not planning to teach, she immediately said, "I have no problems with that and I think you could commute."  She sent key questions for me to ask the doctor on recommended treatments should problems occur.

We made a call to our university and they have graciously released me from my contract with strong words of encouragement to "get better." They have made no demands upon us.  God has since miraculously provided a teacher to take my classes this semester . . . he will arrive in LZ on Wednesday, the 22nd.  The provincial government is allowing him to come in on a tourist visa which they will change to a work visa in-country.  This is *not* a standard procedure! 

In the course of 24 hours, we went from an agonizing "we're returning to the US" to "Vickie's going to commute."  We are going to try to have Art accompany me whenever possible.  We do have peace about this.  We understand this doesn't mean it's necessarily going to be easy, but we do feel we're moving in the right direction.  It's imperative that treatment starts as soon as possible, so we returned to HK on Wednesday to put things in motion.

If the commute becomes too difficult (especially with the cumulative fatigue), then I will stay in HK for the remainder of the treatments, or even go the US, if necessary.

We have not made a decision on where to have the surgery following chemotherapy.

We realize that this does not make sense in a worldly fashion.  We understand that this is hard for many people who love us so very much.  We do honestly believe that we are following God’s leading in this.  We have given this cancer to Him and we fully expect Him to heal me through His chosen methods.  His ways are not our ways (Isaiah 55:8).  

These plans are tent pegs.  Just as Abraham and Lot traveled about, following God’s leading, so are we are willing to do the same thing.  We are willing to change paths.  We are not trying to be stubborn.  We are keeping our hearts and ears open.  We covet your continued prayers as this journey continues.  We are on this journey, asking for humility along with the way.  We don't feel "heroic" at all.  We are really trying to just depend upon our heavenly father for guidance.

The faith in healing can’t just be in medical science, nor can it be just in location.  Just as God brought us through Art’s head injury, He will bring us through this.  We feel in some ways that this is similar to Gideon's story.  Gideon's victory over the Midianites had nothing to do with the size of his army (reduced from 30,000+ to a mere 300 soldiers), but had everything to do with God.  We are believing that my healing MUST point the way to God every step of the way. 

We trust that since we feel this is God’s plan, that it is the best plan for now.  If this is truly from God as we believe it to be, then His grace and strength will be sufficient to see us through.  We can’t trust Him just halfway in this . . . we have to trust Him all the way. 

We continue to ask for your prayers and support, even if you don't agree with or even understand our decision. 

May HIS glory be revealed!

The artwork on this page is licensed under a Creative Commons Attribution-Noncommercial-Share Alike 3.0 License. Please attribute legal copies of this work to “Andrea Gilbert (www.clickmazes.com)".

How do you go about solving a maze?  Since I work with kids a lot, most of the mazes I use in lessons have a clear beginning and end (unlike the maze above).  And you know what?  Without fail, whenever there is a clear beginning and end, I head straight to the end and work backwards.  I really don't know why that is so . . . it's just the way I think, I guess.

As I process this cancer journey, I realize that I need to do the same thing . . . look at the end of the story.  The end isn't whether or not I'm cured of cancer.  The end is God's glory.  If I start there, then I can't go wrong. 

Same goes for if I don't even know where the beginning or end is (as illustrated above).  Starting with God's glory is always the best place to begin, no matter where you are in your story.  In other words, the beginning and end are interchangeable.

Psalm 29 is all about God's glory.  Verse 11 is especially applicable to my life and to others around me:  "God makes his people strong.  God gives his people peace."  Amen.

(Oh, and let me know if you solve the maze!)

I had my first chemotherapy treatment on Valentine's Day . . . and my husband was with me the entire time.  I still need to write my thoughts and reflections on "true love," but let me tell you . . . it's not about chocolates and paper hearts!

At any rate, the day you receive chemo is known as Day 0.  I received a shot on Day 1 (24 hours post chemo) to help boost my white cell counts.  We started our journey back to our home city the same afternoon.  While I felt a bit queasy, there was nothing to difficult to deal with (other than greatly reduced appetite).

Day 2 was a bit more challenging.  Brushing my teeth triggered a gag reflex and I vomited a bit before leaving for the airport.  I tried to eat a cracker, but that too, caused vomiting.  I immediately took the anti-nausea meds that were given to me.  Fortunately, they were quick acting and quite effective . . . no more vomiting.

The most noticeable and most irritating side effect for me has been an increased sense of smell.  I'm not one who typically has a strong sense of smell, so for me to now be smelling everything to a high degree is quite troubling.  The food on the airplane (fish pasta!) was quite challenging!  I had my face mask on, so I literally just reached up and plugged my nose while people were eating. 

The three hour flight was quite uneventful and the ride home from the airport was equally uneventful.  I ate a package of crackers then and it stayed down.  I wasn't able to eat much for dinner, but I did manage some chicken and green beans.

Day 3 was much easier!  While I was still a bit queasy, I was able to twice as much as the day before.  I did take a nap, but overall, felt "okay."

Day 4 was even better!  I did some housework and made it through the day without a nap.  I cooked for my family for the first time in a month and we all felt like it was a homecoming.

Day 5 has been great!  The smell factor is still quite irritating, but hopefully, I'll adjust to that as time goes on.  I can literally smell the meds coming from my pores!  No one else can, but I am certainly aware of them. 

In two days, I will get my blood counts checked, so we can be aware of how low they will go.  We're hoping the hospital folks don't "freak out" over the low numbers.   Art will let them know the situation ahead of time.

In preparation for chemotherapy, I decided to take the plunge and get my hair cut.  The above photos show the "before and after."  (Sorry about the bad lighting in the second photo . . . didn't use the flash.)  I've never been one to be too hyper about my hair, so long hair, short hair or no hair . . . makes no difference to me!  God knows the exact number of hairs on my head anyway . . . that's a mighty thing!

For those of you who like details . . . here they are!

First core biopsy results:
Estrogen Receptor Score:  8 -- Positive
Progesterone Receptor Score: 6 -- Positive
Ki-67 Proliferative Index:  45% -- High
c-erbB2 overexpression:  2 -- Equivocal
Immuohistochemistry:  E-cadherin stain is positive, thus excluding lobular expression.  The p63 stain shows all tumor clusters in this biopsy are invasive rather than in situ.

Final diagnosis:  Invasive ductal carcinoma, provisional grade II (modified Bloom and Richardson).  (NOTE:  Grade II is an intermediate growth rate.  It is not the same thing as staging.)

PET scan results (summed up):  Large lesion spanning 5:00 - 9:00.  No local invasion of underlying right pectoralis major muscle, right chest wall or ribs is noted.  No other tumors noted.  Few lymph nodes affected (level I, level II) suggesting regional nodal metasteses.  No evidence of distant metastasis to the brain, lungs, liver, adrenal glads, distant nodes or bone is found.  (This means that the cancer has not spread to distant organs.)

TNM rating:
T3/T4 -- This would usually be a single number.  The tumor is more than 5 cm across.  That makes it a definite T3.  However, I am presenting with some skin redness, even though the cancer does not appear to be in the skin at this time.  If it were present in the skin, the rating would be a T4.  Therefore, I have a "/" between the two.  Definite T3 with some characteristics of T4.
N2 -- Cancer has spread to 4 to 9 lymph nodes under the arm
M0 -- No distant spread is found

SUMMARY:  Locally advanced breast cancer (LABC), Stage IIIb, T3/T4, N2, M0 -- The tumer is larger than 5 cm across and may be growing into the skin.  It has spread to 4-9 axillary lymph nodes.  It has not spread to distant sites.

Grade II -- Intermediate rate of growth.

ADDITIONAL TESTING:  Fluorescence in situ hybridization (FISH) is a test that “maps” the genetic material in a person’s cells. This test can be used to visualize specific genes or portions of genes. FISH testing is done on breast cancer tissue removed during biopsy to determine whether the cells have extra copies of the HER2 gene. The more copies of the HER2 gene that are present, the more HER2 receptors the cells have. These HER2 receptors receive signals that stimulate the growth of breast cancer cells.  (http://www.breastcancer.org/symptoms/testing/types/fish.jsp )

A positive result would mean an additional drug would be added to chemotherapy to stop the growth of the cancer cells.  A negative result means that drug would not be added.  My test results (two now) keep showing up as "equivocal" . . . meaning my tumor is neither strongly positive or negative.  (My doctor says that my tumor is "strange" in that it has degenerative cells not responding in a "normal" way. )  A third pathologist is now doing additional testing, hoping for a definitive answer.  There are possible risks to taking the drug when not needed, so we, along with the doctors, are hoping for a clear direction! 

TREATMENT:  Due to the size of the tumor and the intermediate rate of growth, chemotherapy is recommended first.  (I like to call this a "search and destroy" mission.)  Surgery will follow chemotherapy.  (I like to call that the "total evacuation!")  Additional chemotherapy or radiation may be needed following surgery.  This will depend upon how I respond the first round of chemotherapy.

TYPE OF CHEMOTHERAPY:  Four cycles of AC, doxorubicin (Adriamycin), and cyclophosphamide (Cytoxan).  This will be followed by four cycles of a different drug combo, depending upon the final results of the Her2 testing.  The "A" part of this "chemo cocktail" both blocks DNA production in your cells, and also inhibits the enzymes responsible for repairing DNA. Cells can't live without DNA; thus when they're deprived of it, they die (in fact, some even kill themselves when their DNA is damaged). "A" can't distinguish between cancer cells and normal cells; but because cancer cells are dividing so rapidly, it has a greater negative effect on them than on your normal cells. The "C" part of this chemo combo stops cancer cells from replicating. So between them, you have some pretty powerful agents working to destroy those cancer cells.  http://www.healthcentral.com/breast-cancer/c/78/10889/chemo-faqs-ac