So the next week after my diagnosis, I had an MRI of my breasts to see if the other side had any cancer, and thank god there wasn't. It also takes a better look at your lymph nodes and I had one questionable lymph node in the left, on the side of the tumor. So when I went in for my second set of biopsies, they also biopsied my questionably enlarged lymph node. Well after they poked what seemed like a million holes in my left breast and armpit, the results came back DCIS again and my lymph node was negative, good news again! Although this was promising, my oncologist and breast surgeon was still skeptical, think that this is really invasive cancer that we keep missing because it is common to have both DCIS and IDC together. Who knew!
By the way, I am a doctor, but had to learn all of this just like any other patient. I think being a doctor made me understand things easier, but also probably made me worry more because I think it inherently made me more pessimistic because of all the sad stories I see all day as a doctor. I really didn't ask why me, because in my profession I have seen horrible accidents and diseases happen to the nicest people and I understand that these things can happen to anyone and no one person is immune. I wasn't ready to have a pity party for myself yet, why not me?
I should take a moment to explain the difference between DCIS and invasive cancer (IDC). DCIS is ductal cancer that is still within the duct, which means that it has not had the opportunity to spread because it has had no access to the blood or lymph system- I'd say best case scenario and considered Stage 0. IDS is invasive ductal cancer, which means that it has broken itself out of the duct and is now free to rome to other places via the blood or lymphatic system.
So the next step was to go straight to surgery, because they had no reason to do chemo first without being able to prove that I have IDC, which is the indication for chemo first, even though they really thought that is what I had. The only way to know exactly what I had was to take the entire tumor out and do a lymph node biopsy to confirm my type of cancer and the stage that I was in. I had to decide if I wanted a single mastectomy or a double mastectomy. A lumpectomy for me was not really an option because the tumor was about 4-5 cm on palpation and as seen on ultrasound. Well I really didn't think about this for very long, take them both! I'm 31, its aggressive, no need to worry about it coming back into the other breast (although there is still a small risk of breast cancer even with bilateral mastectomy, I felt that I should clarify that, the risk isn't zero, but its reduced by about 90%), and for symmetry purposes, its better to take them both. The other consideration into single vs double also depends on genetic testing with BRCA 1 and 2 (yes the Angelina Jolie gene), of course so many other people have it, but she is the most recognizable face of this genetic mutation that predisposes you to breast, ovarian, prostate and pancreatic cancers. So if you are positive for this gene mutation, you are gonna want a bilateral mastectomy, I chose the bilateral before I even got the results and I was negative for the gene, another thank god moment!
So I was off to the plastic surgeon to decide what kind of reconstruction I will choose to have...
No comments:
Post a Comment