Munira Premji



Breast Cancer 101

It’s been a tough couple of weeks since I was diagnosed with breast cancer.  In that time, I have shed tears, asked questions, experienced a myriad of emotions and generally have been overwhelmed. It has also been an amazing time of learning about this cancer so that we can be active participants and advocates when we meet with the medical team at North York General Hospital next week to discuss my treatment plan.

So here is an executive summary of what I have learned so far. Warning:  the information below may contain technical information that puts readers to sleep!

Breast cancer starts in the cells of the breast.  Normally, healthy breast cells grow, divide and die in an orderly way.  Cancer cells are wayward and mischievous.  They multiply in a uncontrolled fashion and create a lump or tumour, or damage healthy tissue.

There are many types of breast cancer.  These include:

  • Ductal carcinoma in situ (in situ is good; it means that the cancer is contained within the milk ducts and has not spread)
  • Lobular carcinoma in situ (this just means that there are changes to the cells in the breast. Most women who have this condition never develop progressive cancer disease)
  • Invasive ductal breast cancer (invasive is not good. It means that the cancer cells have spread from the milk ducts to the surrounding breast tissue). This is the most common type of breast cancer and the one I have been diagnosed with.
  • Invasive lobular breast cancer (this means that the cancer cells have developed in the lobules and spread to the surrounding breast tissue)
  • Then there are less common breast cancers called inflammatory breast cancer and Paget disease of the nipple.  They sound just plain scary.

The most common cancer treatments are surgery, radiation therapy, chemotherapy, hormonal therapy and biological therapy.  The treatment depends on many factors including the type of cancer as well as the stage of the cancer (the size of the tumour and how much it has spread) and the grade of the cancer (how the cancer cells look and behave).

The treatment also depends on the hormone receptor status which is whether the cancer cells have receptors for the hormones estrogen and progesterone.  Ideally you want the hormone receptor test to be negative because it simplifies the treatment.  Unfortunately, my biopsy results came back estrogen positive.

The other test that is done is something called HER2/neu status.  HER2 is a protein that promotes cancer growth.  Ideally you want this test to come back negative.  Unfortunately, my biopsy showed that I am HER2 positive.

This week, I had two additional tests: a full CT scan and a bone scan.  I am hoping that these tests will show that my cancer has not spread beyond the one or two lymph nodes in my under arm.  If it has, I am in deep trouble.  The plan is for me to meet my new oncologist on Friday next week to get the results of my CT scan and bone scan and to finalize a treatment plan.  Unfortunately, based on preliminary discussions, it appears that this will include chemo, surgery and radiation.

In the meantime, I have an appointment on Thursday to inject markers (in the form of titanium clips) in the area of the tumour and affected lymph node.  The reason for this is that if the chemo works so well that the doctors can no longer find the cancer, they need a marker to show them where the tumour was.  I just find this the funniest thing ever!  I guess after Thursday, I will be a bionic woman!

Also the medical team has “strongly recommended” and “highly suggest” that I see a psychiatrist who specializes in oncology.  I don’t know if they do this for all their patients who are going through breast cancer, or figure I need one based on the fact that I am a “complex case” who is going through “more stuff than any person should go through”.   I am keeping an open mind and will go to at least one appointment scheduled in January.

All in all it has been an eventful week.  Next week is important as the oncologist shares the results of my CT scan and bone scan and discusses the treatment plan.  My knowledge of breast cancer has grown, as has my vocabulary.   In situ? Receptor status? Ductal carcinoma?  HER2?  lobular?  Biological therapy?  What?!

Thank you so much for your emails, phone calls and facebook messages.  I am so grateful for your love and support.  I am only able to read a couple of messages at a time – – they make me laugh, they make me cry, they make me feel incredibly special.  You are my true heroes and I love you all very much.



  • Anonymous , January 11, 2016

    Dearest Mukhianima
    I have been reading your blogs in their entirety each time but was having a hard time finding words to console you or encourage you or send prayers for you. Then I said to myself, you are already a fighter, an optimistically optimistic person, you are already an example of encouragement, a source of comfort, a giver of love and a truely courageous, happy, lovely individual. How can I be comforting to you or your family. All four of you have been amazingly supportive to each other and trust me all these qualities are most definitely going to carry you thru this.
    The only thing I can offer is tons and tons of prayers for you, loads of good wishes and lots of positive yellow energy your way.
    Love you forever and prayers for you every moment of my existence.

  • Nargis Hajee , December 22, 2015

    Dear Mmaa Munira,
    Our prayers are always with you. Stay strong and brave with confidence that you will pull through this one too!!
    We are always there for you.
    Take care and love you very much.

  • Mary , December 16, 2015

    Hi Munira,
    I was very sad to hear the news…you are a strong person and can beat this too! You were just in my office to say goodbye…your hugs really give out positive spirit. You and I have chatted several times about this horrible disease and how it affects people and families…but as you know, I too know of a close survivor who has had 3 bouts of cancer and all that comes with it…now approaching 10 years he is still with us. You need to stay strong not only for you but for your beautiful family…Sabrina in particular who is engaged and you want to celebrate that special day with her…just like Tony did when he walked down the aisle with our daughter 3 years ago on her wedding day after a tough battle. Munira…keep that Angel close to you who will guide you every step of the way. Never give up! I’ll be thinking of you.

  • Anonymous , December 15, 2015

    Stay strong and positive

    You can fight this.

  • vicki cotter , December 15, 2015

    my grandma, mom, sister and cousin are/were all breast cancer survivors. Thank you for sharing your journey, and your love, with us.

    • Anonymous , December 15, 2015

      Wow Vicki. I had no idea. I like the word survivor. It denotes coming out victorious after a battle. And thank you for connecting!

  • SUNIL GOKANI , December 15, 2015


    We were shocked when we read about this. Aarti is not able to call you at present but will call you as soon as she gets free from her exams. I do not know if you are aware but she has joined full time course to become RMT & concentrating on her studies but was shocked when I told her about you.

    I just want to salute you. You are really brave & always praying to god to give you & your family strength to come out of this situation at the earliest. Let us know if we can be of any help to you


    Sunil & Aarti

    • Anonymous , December 15, 2015

      Thanks Sunil and Aarti! Sorry that you had to find out about this through the blog. I would so love to come for a treatment when Aarti is available. Please wish her all the best in her exams. You know i love her dearly and she and I have planned to go to India together. So we need to make this happen! I’m doing ok under the circumstances so please don’t worry about me!

  • Rashida Tejani , December 14, 2015

    Warm thoughts and prayers always …Bless you for being so strong

  • Shaney , December 14, 2015

    Hey Munira…..forever smiling!
    Your positive attitude will once again conquer this nasty cancer.
    It is amazing to see how you have managed to give us your big hugs with that contagious smile.
    Our prayers are with you and your family as you deal with this.

    (Sarah was quite sad when she heard, big hug from her).

  • Shyrose , December 14, 2015

    Dear Mukhiani Maa
    I don’t know what to say or do for you. You’ve been great inspirational for me from day one I met you. You’re a fighter and an awesome person who always finds ways to encourage others and see good in others. May Allah grant you the strength for full recovery. Ameen

  • Anonymous , December 14, 2015

    Hey my Mukhiani, you are my inspiration! Was so nice talking to you. You will fight this unwanted guest in your life and will soon have a get together with the Golden Jubilee Mks. Looking forward to our outing soon! You are always in my prayers and my family’s prayers! Love Ya!

  • shellina haji , December 14, 2015

    Munira you are in my prayers. This is unfortunate. I hope and pray for full recovery

    • Anonymous , December 15, 2015

      Can’t seem to help it! I have so much to live for!

  • Anonymous , December 14, 2015

    So much to learn from you. In spite of all this, you are SO POSITIVE

  • Parin Sunderji , December 14, 2015

    I seem to sound like a broken record but you really, truly are an amazing person – in all ways! You are a shining light to all of us wimpy people. Through all this period, you continue to display a sense of humour that lets your inner strength show through.

    You have managed to bring down to the level of an uninformed, lay person, the knowledge that you have gleaned over this short period.

    We all know that you – and your family – have gone through more than your share of trials and tribulations. May Allah grant you all the strength to bear this new burden with fortitude and may his blessings help see you through this difficult time.

  • Farzana Esmail , December 14, 2015

    Positive cells can kill cancer cells. Keep that going and visualize everyday that the cancer cells are being killed one by one but something more powerful from above. Best of luck and try not
    To get wrapped up in your prognosis and diagnosis…. You looked gorgeous on Friday in your white sari. Love, Farzana Esmail.

  • Anonymous , December 14, 2015

    Our thoughts and prayers continue to be with you.

  • Carmela Ciotti-Hooper , December 14, 2015

    My dear Munira! You are my HERO!

    I have always admired you long before circumstances started to unfold in your life.

    Should you just ever want to talk please don’t hesitate.

    I will have you in my prayers this week.

    Love Carmela

    Carmela Ciotti-Hooper, CPCC, PCC Professional Certified Coach HR Consultant

    CCH Coaching C – 905 978-3492 B – 905 304-2913 Skype – coachcarmela Twitter – cchcoachcarmela


    • Anonymous , December 14, 2015

      Thanks so much Carmelita for keeping me in your prayers. I promise to call you if I need to chat or vent or cry or need someone to listen to me…

  • shahnaz suteria , December 14, 2015

    Salgirah Mubarak to you and your amazing family.

    Be well and be blessed Shahnaz Suteria, M.O.M.Sc., R.M.T., Dip. H.R. Osteopathic Manual Therapist 416-830-2022 “Let the beauty of what you love be what you do” ??? Rumi “When your work speaks for itself, don’t interrupt.”- Henry J. Kaiser


  • shahnaz suteria , December 14, 2015

    You looked absolutely stunning today, my dear.

    Be well and be blessed Shahnaz Suteria, M.O.M.Sc., R.M.T., Dip. H.R. Osteopathic Manual Therapist 416-830-2022 “Let the beauty of what you love be what you do” ??? Rumi “When your work speaks for itself, don’t interrupt.”- Henry J. Kaiser


  • Elizabeth Lancaster , December 13, 2015

    Thinking of you Munira as you undertake another flipping cancer journey. Man, I wish life were easier – way easier – for you. And I wish you the continued strength and love of your spirit, faith, friends, family as well as awesomely powerful doctors, drugs, surgery and healing.

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