CONTACTS 

SUBJECTS
CA 15-3 Blood Tests Show 36 Significant Drop into 30s
CA 15-3 Trend Rising from 33 to 41 Will be Reviewed During Follow Up

1304 -
1304 -    ..
1305 - Summary/Objective
1306 -
130601 - Follow up ref SDS 41 0000, ref SDS 40 0000.
130602 -
130603 - The doctor advanced the schedule for a PET scan test to 021218, and
130604 - ordered another blood test to evaluate recovery following completion
130605 - of chemotherapy.  Tests will be reviewed during a meeting with the
130606 - doctor on 030109 to assess further treatment decisions based on trends
130607 - in CA 15-3. ref SDS 0 KVDE  Swelling under the arm, ref SDS 0 KW5F,
130608 - and firmness in the breast appear to be normal side effects of
130609 - treatment. ref SDS 0 SG7J  A blood test for diabetes was taken based
130610 - on increased urination. ref SDS 0 KV6F
130611 -
130612 -
130613 -
130614 -
130615 -
130617 -  ..
1307 -
1308 -
1309 - Progress
1310 -
131001 - Schedule Evaluation Meeting for 030117
131002 - Recovery Progress CA 15-3 Cancer Marker Rises Above Target Level
131003 - CA 15-3 Cancer Marker Above Target Level Progress Toward Recovery
131004 -
131005 - Follow up ref SDS 41 SQ5I, ref SDS 40 SQ5I.
131006 -
131007 - The doctor advised that cancer treatment concluded on 021204 with
131008 - completion of phase II using Taxotere, ref SDS 41 0001, following
131009 - radiation, and phase I treatment that began in April, reported on
131010 - 020423. ref SDS 20 0001
131012 -  ..
131013 - Millie asked about the trend of CA 15-3 test results over the past
131014 - three months that increased from 33 to 41. ref SDS 41 F48G
131015 -
131016 -          021202......... 41 H?............ 021204, ref SDS 41 SP5G
131017 -          021102......... 36 H?............ 021113, ref SDS 40 Y65I
131018 -          021023......... 33 H?............ 021023, ref SDS 39 SQ5I
131019 -       *  020930......... 33 H?..29........ 021002, ref SDS 38 SQ5I
131020 -          020917......... 36 H?............ 020924, ref SDS 37 SQ5I
131021 -          020717......... 59 H?............ 020726, ref SDS 36 YN5K
131022 -          020629......... 75 H ............ 020705, ref SDS 34 UX6I
131023 -          020608........  67 H ............ 020614, ref SDS 30 0001
131024 -          020603........ 108 H ............ 020607, ref SDS 28 X67F
131025 -          020511........ 117 H ............ 020603, ref SDS 27 PJ4J
131026 -          020419......... 81 H ............ 020430, ref SDS 23 7N5H
131027 -          020321......... 85 H ............ 020405, ref SDS 13 6T8K
131029 -  ..
131030 - The doctor said he would be disturbed by a trend upward, and indicated
131031 - the current results over the past two months rising in two reports
131032 - from an all-time low for Millie of 33 to now 41 does not show a trend.
131033 - He explained that CA 15-3 varies in the body, so variance is not
131034 - disturbing.
131035 -
131036 -      [On 030109 CA 15-3 dropped to 37 showing improvement on reversing
131037 -      the trend over the past 2 months. ref SDS 44 SM6M
131039 -       ..
131040 -      [On 030508 the doctor submits ASCO guidance showing CA 15-3 not
131041 -      recommended to diagnose cancer, applied for guidance showing
131042 -      recurrence when treatment fails. ref SDS 45 M28G
131044 -       ..
131045 -      [On 030606 patient concerned about rising trend of CA 15-3.
131046 -      ref SDS 46 NE7L
131048 -       ..
131049 -      [On 050729 doctor orders additional chemotherapy treatments based
131050 -      on sudden 25% rise of CA 15-3, after reaching all-time low.
131051 -      ref SDS 48 Y44G
131053 -  ..
131054 - Millie explained having injured a toe recently, and asked if that
131055 - could influence variance in CA 1503?
131057 -  ..
131058 - The doctor said that trauma to a toe is not typically associated with
131059 - variance in CA 15-3.
131061 -  ..
131062 - Millie advised that recently there have been small ridges or bumps
131063 - appearing on her finger nails; she asked if this could account for
131064 - variance in CA 15-3?
131065 -
131066 -     [On 050809 save side effect occurs after 5th cycle of treatment
131067 -     with Taxotere and capecitiabine (Xeloda). ref SDS 49 6X81
131069 -  ..
131070 - The doctor said that this condition is often a side effect from
131071 - chemotherapy with Taxotere, and does not influence variance in CA
131072 - 15-3.
131074 -  ..
131075 - The doctor looked at the Kaiser computer in the examination room and
131076 - printed additional information showing Kaiser changed the method of
131077 - computing CA 15-3 a few months ago that now gives slightly higher
131078 - readings.  He noted the report that several months ago on 020930, when
131079 - Millie had a CA 15-3 test result of 33, under the prior system the
131080 - reading would have been 29, well below the target level of 31 that
131081 - indicates normal.
131083 -  ..
131084 - The doctor indicated more tests are needed to establish a trend.
131086 -  ..
131087 - The doctor scheduled a PET scan, and scheduled a meeting with Millie
131088 - for 030109 to review results of the test, per below. ref SDS 0 LK5L
131090 -  ..
131091 - Prior to the meeting, Millie will have another blood test to obtain
131092 - another CA 15-3 level that can be discussed during the meeting on
131093 - 030109.
131094 -
131095 -      [On 030109 CA 15-3 dropped to 37 showing improvement on reversing
131096 -      the trend over the past 2 months. ref SDS 44 SM6M
131097 -
131098 -
131099 -
131100 -
1312 -

SUBJECTS
PET Scan Planned to Evaluate Condition Following Completion of Phase
PET Scan Scheduled for 030110 to Evaluate Condition Following Phase 2

1504 -
150501 -  ..
150502 - PET Scan Scheduled for January
150503 -
150504 - Millie asked about scheduling a Pet Scan which was planned during the
150505 - meeting on 020924? ref SDS 37 IF4J.
150507 -  ..
150508 - The doctor said that in light of rising CA 15-3 test results, per
150509 - above, ref SDS 0 SM6M, he feels that the PET scan test schedule should
150510 - be advanced from January.  He wants this done as soon as possible.
150512 -  ..
150513 - After meeting with the doctor, Millie went to the nuclear medicine
150514 - department downstairs in the hospital and submitted documents received
150515 - from the doctor for scheduling the PET scan test so that results are
150516 - available for a follow up meeting with the doctor next month on
150517 - 030117.
150518 -
150519 -     [On 021210 PET scan test scheduled for 021218. ref SDS 42 0001
150520 -
150521 -
150522 -
150523 -
150524 -
150525 -
1506 -

SUBJECTS
Urination Increased Frequency Side Effect Chemotherapy May Indicate D

1603 -
160401 -  ..
160402 - Urination Frequency Side Effect Chemotherapy, Indication of Diabetes
160403 -
160404 - Millie reported increased urination and loss of control,
160405 - incontenance.
160407 -  ..
160408 - The doctor said this is a side effect of chemotherapy; it can also
160409 - indicate diabetes.
160411 -  ..
160412 - The doctor schedule a blood test for diabetes.
160413 -
160414 -     [On 050729 same urinary problem reported after 5 cycles of
160415 -     treatment with Taxotere and capecitabine (Xeloda). ref SDS 48 VT3O
160417 -  ..
160418 - After the meeting we went to the labatory and a blood test sample was
160419 - taken.
160420 -
160421 -
160422 -
1605 -

SUBJECTS
Swelling Left Side Under Left Arm Likely Caused by Draining Lymph Nod

1803 -
180401 -  ..
180402 - Swelling Along Left Side Below Arm Area Likely Lymph Node Drainage
180403 -
180404 - Millie reported some occassional mild discomfort from new swelling
180405 - below the left arm pit where lymph nodes were removed during surgery
180406 - on 020312. ref SDS 8 7V61  This is a new development since the report
180407 - on 020726 that swelling and discomfort had ended after treatment with
180408 - Taxotere. ref SDS 36 YO52
180410 -  ..
180411 - The doctor examined Millie.  He advised that some swelling is expected
180412 - at this time from lymph drainage to this area as a result of removal
180413 - of cancerous lymph nodes during surgery on 020312. ref SDS 8 Q78M
180415 -  ..
180416 - The doctor commented that the degree of swelling is very minor, barely
180417 - detectable by sight and by feel comparing the left side with the right
180418 - side.  He indicated this condition does not show more than is expected
180419 - following surgery to remove lymph nodes.
180421 -  ..
180422 - The doctor feels continued rise in CA 15-3, per above, ref SDS 0 5E6L,
180423 - and the return of lumps under the arm requires monitoring now that the
180424 - 2nd phase of cheomotherapy ended a few days ago on 021204. ref SDS 41
180425 - 0001
180427 -  ..
180428 - The doctor indicated that overall, treatment with Taxotere seems to
180429 - have improved Millie's condition, and that the PET scan test in a few
180430 - weeks will provide further evidence on deciding whether more
180431 - treatment is required.
180433 -  ..
180434 - Millie said she feels great; she is back on the job and maintaining a
180435 - normal exercise schedule of hikng and workouts at the gym.  Even
180436 - though treatment has ended, Millie will continue to get CA 15-3
180437 - testing and other tests to evaluate response to treatment.
180438 -
180439 -     [On 030109 findings of PET test on 021218 seems to indicate
180440 -     favorably that swelling under left arm reported on 020520 is no
180441 -     longer visible. ref SDS 44 GJ55
180443 -      ..
180444 -     [On 030109 findings of PET test on 021228 citing evidence of "new
180445 -     mild diffuse increased uptakes at the region of the left axilla"
180446 -     may reflect reports today of occassional mild discomfort from new
180447 -     swelling under the left arm, ref SDS 44 L66M, which analyst's
180448 -     "impression" says are likely secondary to post-radiation changes,
180449 -     suggesting not cancerous. ref SDS 44 GJ69
180450 -
180451 -
180452 -
180453 -
180454 -
1805 -

SUBJECTS
Breast Firmness About Surgery and Radiation Area Typical Result
Radiation Treatment Completed Chemotherapy Schedule Phase II Called L

2004 -
200501 -  ..
200502 - Breast Firmness Results from Surgery Scar Tissue and Radiation
200503 -
200504 - Follow up ref SDS 37 0J7H.
200505 -
200506 - The doctor examined the surgery and radiation areas on the breast and
200507 - observed firmness from thickened, stiff skin following completion of
200508 - radiation treatment on 020910, reported in the record on 020924.
200509 - ref SDS 37 0J7H  These conditions were not reported during
200510 - examination at that time on 020924.
200512 -  ..
200513 - He feels today that this new condition reflects scar tissue from
200514 - surgery 9 months ago on 020312, ref SDS 8 0001, and reaction to
200515 - radiation treatments that ended 3 months ago on 020910.  The doctor
200516 - noted that in some women the entire breast becomes firm.  In Millie's
200517 - case firmness is localized to the area of surgery and radiation
200518 - treatment.
200519 -
200520 -     [On 021218 Millie met with radiologist for examination following
200521 -     completion of radiation treatments. ref SDS 43 0001
200523 -      ..
200524 -     [On 030109 PET scan test on 021218 received from the doctor and
200525 -     describes new mild diffuse increased uptakes at the region of the
200526 -     left axilla, left upper chest wall, and left supraclavicular
200527 -     regions. ref SDS 44 L66M
200529 -      ..
200530 -     [On 030109 the doctor observed red rash and stiff skin on left
200531 -     breast. ref SDS 44 KW5F
200533 -      ..
200534 -     [On 030606 patient requests emergency meeting for doctor to
200535 -     examine sudden severe inflammation and rash on left breast; a
200536 -     week later the doctor finds rash has subsided, ref SDS 46 7C6W,
200537 -     but observed skin firmness in the left breast, attributed to
200538 -     side effects of surgery and radiation treatments. ref SDS 46
200539 -     O16M
200541 -      ..
200542 -     [On 030710 CT test reports similar findings of skin thickening
200543 -     on left breast may be side effects of radiation therapy, and
200544 -     also notes that the same symptoms occur with "known breast
200545 -     cancer," ref SDS 47 VM7I; patient requests further testing with
200546 -     biopsy; Kaiser defers testing for cancer on grounds symptoms
200547 -     are most likely side effects of radiation treatment in 2002.
200548 -     ref SDS 47 T64L
200549 -
200550 -
200551 -
200552 -
200553 -
200554 -
200555 -
2006 -