My name is Tricia, and I have been living with Stage IV breast cancer since I was first diagnosed in October, 1999, at the age of 26. Juts last month I celebrated my 30th birthday. Most women don''t look forward to turning 30, but I couldn''t wait. It was such an accomplishment for me. As I always say, growing older and turning 30 sure beats the alternative--which is NOT having the oppporutnity to grow older.

I first felt the lump when I was 25. I had it checked by an ARNP at a doctor''s appointment. I had previously had two small pea size lumps aspirated in the left breast, and she told me this much larger lump on my right breast was probably the same, and a mammogram really wouldn''t tell us much. I went another four months undiagnosed, while cancer raged inside of me. When I started to experience pain in the breast, which would shoot up into my neck and arm, I returned to a doctor, who immediately sent me for testing. The ultrasound revealed it was not fluid (hence not likely a cyst), and the mammogram was inconclusive. Next stop, a surgeon, who sent me for a fine needle aspiration. This showed no cancerous cells, but there were a few abnormal cells. The pathologist told me "in his heart of hearts, he did not think it was breast cancer" but my surgeon might want to follow up. Thank goodness the surgeon insisted on that follow up. When I awoke form the biopsy I learned I had breast cancer. Three days later, when I returned to her office, I learned more about how bad it was. She had removed 4.5 cm x 4 cm and had not gotten clean margins--the tumor was bigger than that!

Within days I was at the leading cancer center in Florida, meeting with my surgical oncologist and medical oncologist. They could feel the swollen lymph nodes under my arm, a sign the breast cancer had spread beyond the breast, making me a Stage IIB at least. When the medical oncologist was pushing around my clavicle, she popped some swollen lymph nodes up--a good indication the cancer had spread to there as well. I was going to be in for a tough fight. I began chemo that week (neoadjuvant chemo--prior to mastectomy) and learned that the two nodes on my collarbone had cancer, making me Stage IV. Fortunately, the cancer had not spread anywhere else in my body. I did 3 rounds of Adriamycin every 2 weeks, followed by weekly Taxol and Herceptin, once a week for 13 weeks. After 5 months of chemo, the tumors were unable to be palpated, meaning the chemo was working, and maybe had eliminated the cancer.

Well, that hope didn''t last long. The mastectomy and lymph node removal showed a 1.5 cm tumor remaining in the breast, and of 27 lymph nodes taken, 21 still had cancer in them. Onto the next plan. I then did Taxotere with Herceptin every week for 8 weeks. By the end of this, I had no hair, eyebrows, or eyelashes, my fingernails were falling off, I had some neuropathy, and my eyes constantly teared like I was crying. But I was able to do a lot and felt relatively good, though to look at me you''d never know it. But my toughest treatment was yet to come.

I next prepared for high dose chemotherapy with stem cell rescue. The pre-high dose treatments were so bad, I almost didn''''t go through with the high-dose chemo. For 5 days after the preparation chemo I could barely walk, and the pain felt like someone had sawed my legs off. And I got sick for the very first time from the chemo. Plus the stem cell collection took a bit longer than anticipated--6 days of collecting stem cells in order to have enough.

I thought the high-dose chemo couldn''t be any worse than the preparation dose, but I was wrong again. I entered the hospital for the high dose chemo and by day 5, my mouth was so swollen and deteriorated that I couldn''t eat and had to go on IV nutrition. I basically slept all day long--thank goodness for morphine, though it made me hallucinate like crazy. I remained in the hospital for 3 1/2 weeks. For one stretch of time, I had a fever of 104 degrees which they couldn''t break for 8 days; finally, with the last antibiotic they had, the fever went down. At the same time, my grandfather died, and I told my dad (although I don''t remember) that it was supposed to be me, but he went in my place. I truly believe he would have done that for me!

When I left the hospital, I was still very weak, hardly able to walk, only eating maybe 500 calories a day (popsicles mostly) and needing IV fluids. But slowly, my strength and energy returned. By October, my platelets were above 50 and I could begin radiation. But after 19 of the planned 30 radiation treatments, my platelets had plummeted and I had to stop radiation and receive platelet transfusions. This went on for the next 3 months, until my platelets stabilized again. Then I finished the radiation with e-beam radiation. By the end of February, 2001, my treatments were over--1 1/2 years from my initial diagnosis. Some days I never thought I''d get to the light at the end of the tunnel, but I had a very suppportive family, friends and workplace, all of whom I owe so much. I began tamoxifen. I continued to get stronger and better, and hoped against hope that I''d beat the statistics. I had been working full-time and even began playing tennis again. In Sept. 2001 I did the Avon 3-day 60 mile walk in NY. I basically did all I did before, only a little slower and with quite a few more pounds on me! I even returned to playing soccer, playing in 3 games before I went out for my DIEP flap reconstruction surgery in August 2002. Scans prior to my DIEP flap revealed some mark on my rib and on my forehead, but follow up X-rays seemed to indicate there was nothing to worry about. I had the reconstruction done, but a glitch there lead to a follow-up revision surgery on the abdomen. After I returned home, I had more scans, and the spot on the forehead seemed to have gotten larger. Follow up scans this time revealed a small spot most likely consistent with metastatic disease. No biopsy could be performed on this small spot on my skull, but it had a high probability of being cancer, so I began treatments for mets to the bone in October, 2002, my three year mark. I get a monthly 15 minute IV of Zometa. I also switched to Femara and take Celebrex and Tetracycline, drugs which I researched and found might have some cancer fighting potential. I also had the area where the spot was radiated with e-beam radiation. These treatments are very easy, non-toxic, and are working to keep me alive and well. You''d never know I had cancer if you met me for the first time today. I still play tennis, fish, run, swim, and work hard as an attorney.

Living with stage IV breast cancer is tough, because you are living knowing that statistically, you are probably dying. But when things are going well, and I am stable, I tend to be able to put this out of my mind for most of the day, and only think about it with passing thoughts. But I can never put it out of my mind completely, It is a part of who I am and my life''s journey. I just keep tretaing my cancer as aggressively as I can, based on the knowledge I gain and advice from my doctor, who I thank for being open to trying things within the realm of reason. I am certain the therapy I have done thus far has kept me not only alive, but thriving, despite my original diagnosis. I bet the doctors didn''t anticipate I''d do as well as I am doing, all things considered. And with each new drug, and ongoing research, there is hope. Metastatic breast cancer is much more treatable today then what the statistics of yesterday present. And each new drug adds the possibility of more time and years. And maybe I''ll be able to benefit long enough from each new discovery, and turn this cancer into something chronic. And should it ever be too late for me, I hope it is not too late for the woman diagnosed tomorrow.

Everyone thought I was too young for breast cancer, but we all know that''s not true. Had I or that ARNP been more vigilant, maybe we could have caught it earlier, but I''ll never be able to know. Instead, I focus on the fact I am here and doing so incredibly well. I dread the day this may progress further and become debilitating, as I have seen this beast take lives from friends I have made, but until then, I will fight with all my might, and prayers.

Living with Stage IV breast cancer is possible, and for me, it is as though I don''t even have cancer. I am lucky in that, and we have to focus on those positive aspects of whatever we encounter with our own personal breast cancer journey. You are all amazing women, and I know I am too.