Name: Kirstin Spencer

Age: 48

Region: Gloucestershire

Diagnosis: Primary DX – January 2018, Zurich. MBC DX – March 2021 Cheltenham. Lobular breast cancer ER+ PR+ HER2-

Breast Cancer grew in mastectomy scar unchecked, so it metastasised to skin, lymph nodes and most bones.

Age at diagnosis: 45 (primary breast cancer) and 48 (metastatic breast cancer)

Hi, my name is Kirstin and I live near Cheltenham with my husband, daughter and cat. 

I lost two of my best school friends to cancer, my roommate died of metastatic breast cancer when she was only 30. After visiting her parents years later, I thought I would get myself checked out as I had always had difficult to check dense breasts, which I understood heightened the risk of cancer.

I was shocked to find that I had multifocal lobular breast cancer in both breasts. Lobular breast cancer can often grow in several places at once in the breast (multi-focal) and can form in sheets hiding in dense breast tissue rather than making a lump. As this can make it difficult see the extent of disease I was advised to have a double mastectomy. Very quickly I had a double mastectomy and immediate DIEP reconstruction which went extremely well and I recovered quickly from surgery with full mobility. 

I was warned that with my type of lobular breast cancer, the number of tumours and with close margins, despite being stage 2 with no metastasis, the lobular cancer may recur in mastectomy scars or near the operation site.  I was told to not worry as if it returned locally and caught early, it could still be managed as a chronic disease.

However to catch it early depended on vigilant follow up which should take place every 6 months for the next 5 years. This would include an ultrasound twice a year and a mammography in a year (a mammography is used even after autologous breast reconstruction to look at and assess any abnormalities, or if you have a high chance of local recurrence, or if it is difficult to assess by palpation – as lobular cancer could be). Then it will be decided whether follow up mammographies or MRI’s are indicated.

I then returned to the U.K. from Zurich and was unlucky. By the end of 2018 my scar had thickened, an ever growing hard area developed underneath it and I had unusually red and raised scars accompanied by a faint but persistent rash.

Despite being armed with the advice of the Doctors who had actually treated my initial disease, my symptoms were dismissed as not serious in the U.K., were not further investigated and therefore my disease was not followed up with any scans or blood tests or in any meaningful way for almost three years. 

I moved from the London area to Gloucestershire in 2020 and in January 2021, refusing to give up trying to get help (the rash and growth had now taken over a quarter of my breast), my GP helped me get an appointment at the local breast centre in Cheltenham. Here they performed an ultrasound scan which led immediately to a punch biopsy of the extensive lump in my breast scar and skin area.

They found very extensive lobular cancer tumours over my reconstructed breast which had spread into the subcutaneous skin. This led to further investigative scans which confirmed the cancer was throughout the skin, there was lymph node involvement, perineurial invasion and further metastasis throughout my skeleton, so I was now left with extensive incurable disease.

Since my metastatic diagnosis and because of my strong ER+ histology, depriving my body of oestrogen has been the first line of defence. I have been put into the menopause with Zoladex. My diseased bones are being helped by Denosumab, I take an Aromatase Inhibitor called Letrozole and targeted therapy – a cdk 4/6 inhibitor called Palbociclib. It is relatively early days of treatment for me.

I am so very grateful to my oncologist, Dr Elyan for both finding and helping me along an excellent treatment pathway. No doubt we all owe a great debt to all the people who researched and worked to get these drugs available for patients such as myself. The success of such work is certainly enabling me to be around for my 8 year old daughter for as long as possible and I very much hope more medical feats may yet come to pass.

Why you wanted to be involved with the MetUpUK campaign: Metastatic breast cancer can be a very frightening diagnosis and the drugs that you take to manage it can be very challenging. We metastatic breast cancer patients don’t always have obvious physical impediments so many people wouldn’t know we were ill or understand what warriors we have to be both mentally and physically on a daily basis. We are often living from scan to scan as Doctors look for signs of cancer progression. We are only safe as long as the medications we take work – and we all know that they do stop working, we just don’t know when that will be. This can lead to terrible feelings of isolation and helplessness. We are all hoping for further research and development of medication that helps control metastatic breast disease with tolerable side effects.

MetUpUK understands and raises awareness of the metastatic cancer plight – which can often be found hiding in plain sight.

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