DX & Treatment Timeline

Diagnosed Denovo Metastatic Stage 4 Breast Cancer to Bones AUGUST 2019

ER+ (90%) PR+ (60%) HER2 negative


April, 2019 Back and hip began to hurt – sharp pains in each but not debilitating

May, 2019 Back and hip continued to hurt – started Advil each morning

June 14, 2019 Saw GP for yearly checkup, X-ray, referred to Chiropractor

June 25, 2019 Yearly regularly scheduled GYN appt (no lump detected on breast exam)

July, 2019 6 sessions with Chiropractor with no relief – referred to orthopedic doctor.

July, 2019 Back to GP – given pain medication for seizing in back

July 25, 2019 To local orthopedic doctor who told me to go to physical therapy

July 31, 2019 Regularly scheduled mammogram (47 years old – I’ve been getting regular mammograms since before I was 40 due to family history so big deal – really didn’t think much of it)

Aug 1, 2019 First MRI on my back. Finally convinced the local orthopedic doctor to call in an MRI. Chiropractor shared the report and results showed a compression fracture at T9. I was told I would have to have surgery on my back to repair. The orthopedic doctor who called in the MRI NEVER contacted me.

Aug, 2, 2019 Call from hospital (NOT GYN–still waiting to hear from her two years later) about needing a follow up because the mammogram showed “something suspicious”

Aug, 6, 2019 Appointment with different orthopaedic doctor at Duke Medical Center who reviewed MRI and an ordered an X-Ray of my hip (the other doctor’s would say, “let’s get your back straight and then we will look into what is going on with your hip” He called in multiple other tests and scans for later in the week.

Aug, 7, 2019 Blood testing

Aug 8, 2019 Follow up mammogram & ultrasound – call that night from GP with results of Bi-Rad 5 and 3 cm tumor in right breast

Aug 9, 2019 First BONE SCAN

Aug. 12, 2019 GP called with BONE SCAN results – metastasis in shoulder, skull, hips, and vertebrae

Aug. 13, 2019 MORNING – Breast biopsy, appointment with breast surgeon who scheduled an appointment with oncologist for that afternoon

Aug. 13, 2019 AFTERNOON – First oncologist apointment and admitted into hospital for multiple scans and testing, back pain unbearable at this point

Aug. 14-18, 2019 IN HOSPITAL – OFFICIAL DIAGNOSIS of Metastatic Breast Cancer to my bones (about 8 different places), CT scan, Brain MRI, Echo test, KYPHOPLASTY on T9, bone biopsy on T9

August – September, 2019 4 Treaments (every other week) AC chemotherapy (aka THE RED DEVIL Adriamycin and Cytoxan)

October, 2019 – January, 2020 12 Treatments TAXOL Chemotheraphy

February, 2020 Lumpectomy – Lymph nodes clean

March, 2020 – April, 2020 Radiation on Breast

May, 2020 – Feb, 2021 Kisqali/Letrozole with treatment breaks & dose reductions due to rising liver enzymes blood counts

Lupron every two months & Xgeva every three months – Lupron and Xgeva started out in smaller intervals – monthly and every other month, respectively

May, 2020 – July, 2020 Physical Therapy for back and lymphatic massage/physical therapy for lymphodema

Jan 2021 Started seeing a licensed counselor/therapist every two weeks to start and at present time, once a month

March 2021 Verzenio/Letrozole with treatment breaks and dose reductions due to GI issues, loss of appetite, nausea, head aches

Started on 150 twice a day, moved to 150 once a day, and now 50 twice a day

December 2021-January 4, 2022 Verzenio treatment break after stable Brain MRI from vertigo, confusion, dizziness, headaches, and nausea

Feb 2022 Switched from XGeva injection (bone strengthener) every three months to Zometa infusion due to change in insurance.

March 2022 OOPHORECTOMY – ovaries removed – No more Lupron injections

April 2022 PET SCAN – STABLE!

June 2022 CT SCAN due to bloating, pressure, GI issues – STABLE

July 2022 – Aug 1, 2022 – Verzenio treatment break

October, 2022 My first progression since diagnosis to L5 vertebra and sacrum – switched from Verzenio to Xeloda and stopped Letrozole

November, 2022 Bone biopsy to check for mutations and recheck of subtype

ER+ (30% now), PR+ (3%) and still HER – negative

December, 2022 Severe headaches getting used to Xeloda – BRAIN MRI clear!

February, 2023 PET SCAN – L5 and sacrum with much lower SUV , new progression to acetabulum. Switch to Zometa once a month and discussion of adding Faslodex

March, 2023 5 rounds of radiation to acetabulum & switching to new medication just FDA approved in Jan, 2023 as soon as insurance goes through and we can get it

March, 2023 Discussing switching to newly approved Orserdu but denied from insurance due to not having the ESR1 mutation

**SCANS every 3 months (CT/Bone Scan or PET) –

**Monthly labs & oncology appointments**

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