Monday, October 13, 2008

FROM TIME OF DIAGNOSIS OF BREAST CANCER (DCIS- (DCIS - DUCTAL CARCINOMA IN SITU, STAGE O, NON-INVASIVE)

• On 23.10.08, I felt like my breasts were making milk. My nipples felt wet but there was no discharge. I don’t know why, but I just squeezed my right nipple intuitively and out came dark-iodine-serum-looking fluid.

• On 27.10.08, the mammographer injected iodine into the breast duct that had secreted the altered blood. A mammogram and ultrasound was then done on both breasts. The mammogram showed that a breast duct in the right breast had a stricture (narrowing) in it, as well as microcalcification around the duct.

• The mammographer said she wanted to remove the breast duct by making a 3 cm long incision in the top part of my right breast. She would have sent this away to be biopsied.

• At that point, cancer was so far from my mind, and I said I did not want a 3cm long scar in the middle of my breast and that I wanted the plastic surgeon who did my breast implants to do remove the breast duct. In hind site, I should have interfered with the experts!

• On 29.10.08, the plastic surgeon removed the affected breast duct as well as an area around the duct. He made an incision where the nipple areola meets the breast skin and the scar was almost invisible. I was happy and thought this was the end of it. Little did I know it was just the beginning!

• Because this was not something that this plastic surgeon does every day, he did not put markers into my right breast tissue to demarcate the area he had removed. He also did not have a pathologist in theatre with him so he did not get a 1cm clear tissue margin around the tissue he removed. I should have had a breast surgeon do this op/biopsy/lumpectomy.

• On 3.11.08, the plastic surgeon gave me the biopsy results: DCIS - ductal carcinoma in situ, non-invasive cancer, stage0, but high grade and aggressive. I was in shock! When I asked about the treatment, he suggested a double mastectomy. I could not believe this but knew that he was a plastic surgeon and so saw end case scenarios of failed previous treatments.

• On 5.11.08, we met with the 1st breast surgeon who the plastic surgeon worked with. He suggested a lumpectomy and radiation or a right side mastectomy. He was a man and I just felt he could not relate although he tried very hard to. I asked him how he would feel about having his testicals cut off one by one. He flinched!

• On 10.11.08, I met with the 2nd breast surgeon, Dr Carol Benn. She was a woman which was better to start with although she was still very surgical in approach. I could see knew her field well, and judging by the number of women in her waiting room, she saw a lot of abnormal breast tissue.

• Although the removed breast duct and surrounding tissue showed non-invasive cancer, Carol needed to determine whether or not any invasive cancer had missed and had made it’s way into the right sentinel node (main node that drains the breast) in the axilla.

• Carol also wanted to check the new lumpy tissue that had appeared after the duct removal op with ultra sound. She did not know if these lumps were just scar tissue or whether they were cancerous.

• On 17.11.08, an ultrasound was done on both breasts.

• The ultrasound showed that my right breast tissue was hyperplasic (definition at end of this post). An ultrasound cannot show whether or not there is cancer in the breast tissue conclusively. It can only show that the tissue is abnormal. A needle biopsy would need to be done to determine whether or not the lumps are cancerous (non-invasive or invasive) or just scar tissue. This is booked for next Tuesday (2.12.08).

• There could be other areas within the right breast that contain non-invasive or invasive cancer but the scanning methods currently available (ultrasound, mammograms, MRI) cannot show this.

• What I am realising is that the only way for a breast doctor to be certain of the true status of breast tissue is to have all the breast tissue taken out of the body and analyzed. Whatever the needle biopsy shows, it will not change the fact that I need to have a right-sided mastectomy. The needle biopsy is more for my peace of mind to see whether or not there is invasive cancer there or not in case I decide to wait until January before I do the mastectomy/ies.

• On 19.11.08, Carol removed my right sentinel lymph node and an enlarged lymph node near by. She had felt this node during a physical exam in her rooms but said it could have been enlarged because I had just had surgery (after 1st op: removal of the milk duct).

• On 21.11.08, results showed that my right sentinel lymph node and the other node were clear of cancer. YEAH!! This meant that I did not have to have chemotherapy. Chemotherapy is usually used if the cancer has spread to rest of the body.

• The pathology lab that examined the breast duct did not do hormone marker tests on the tissue. This test determines whether or not the tumour is hormone sensitive. Carol does not usually use this lab but as she had not done the breast duct removal op, she had to work with what she had. Carol requested that the lab did hormone marker tests a week later (not sure how this works) and the results came back saying: the tumor was estrogen-sensitive and only slightly progesterone-sensitive.

LiveHeidi

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