Monthly Archives: January 2011

The DCIS Booklet

I read the booklet on DCIS and am blown away by the presentation of the data on treatment outcomes, in which 🙂  symbol is used to represent survival and
😦 symbol to represent death. I think, well I guess you would be a bit sad if you die!

A week after my surgery I visit my surgeon to get my pathology results. I’m confident everything will be okay. My surgeon blasts through my confident exterior when she says I’ll need more surgery. I don’t have clear margins. She’ll need to take a bit more. She draws me another diagram illustrating how she’ll just need to take a slightly larger incision.

She operates two weeks later. It is frustrating knowing that my healing breast will be again be cut into. I know the nurses and the drill. Although I hate having an anaesthetic it all goes well and I’m back home that night tucking into a delicious dinner.

I attend my follow-up appointment curious to see whether I will need to have radiotherapy. My daughter insists on coming with me even though I told her I don’t need her as it will be just be a standard follow up. The nurse checks my wound and says its healing well. I still haven’t seen my scar as I have had dressings on it all the time. I’m curious to see how I will look. I guess I can get a false nipple to wear; I’d seen an episode of “Sex in the City” in which one of the characters had worn one to attract men.

We wait in the room for the surgeon, eventually she walks in her expression as inscrutable as ever. She sits down and says, “it is totally unexpected but we still didn’t get clear margins. We will need to take the whole breast off to ensure you are clear. It has been growing so stealthily without being picked up by any of our tests, we would never know what was happening.” You will have to have a mastectomy. I was in complete shock! Here I have been worrying so much about how I would be without a nipple and now I am going to have my breast cut off! Suddenly the aesthetics seem so less important than living or dying.

The day before my operation I have another appointment with my surgeon. The nurse shows me different prosthesis I could use and gives me a free Berlie mastectomy bra.  It finally hits me there in her office. By this time tomorrow I will no longer have my left breast. My surgeon asked me what sort of mastectomy I want. Whether a clean cut to the chest wall or one that entailed a smaller incision and retained some skin so that I could have a reconstruction later. I don’t know! Part of me would like to have a clean excision to my chest wall and proudly bear my scar. But another part of me would like to keep the option of having a breast reconstruction later. She then asks me whether I want to have the lymph nodes that the breast drains into removed. I DON”T KNOW! This is all too much.

For the first time she doesn’t sound so confident that the pathology will be clear after my breast is removed. I guess her confidence is dented as well. The prospect of me having invasive cancer now seems like an option. For the first time I am scared! I don’t want to die! Not yet! When is a right time to die? My previous concerns about losing a nipple seem less significant and my concerns about having slightly sagging breasts now appear truly trivial.  I walk out of the clinic with my nice pink Berlie gift bag. I feel others compassionate glances as they know this means I’m having a mastectomy.

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Diagnosis

Microscopic image of breast cancer cells dividing (image downloaded from www.wellcomeimages.org)

I was diagnosed with DCIS in my left breast during my regular annual breast screen and review in September 2008. I had been having annual reviews at a breast clinic as my sister died of breast cancer at 35 years of age and I had a number of problems with my breast. The cancer was detected in the ultra sound scan and confirmed through a biopsy. The cancerous cells were located just behind my nipple.