Tuesday, April 7, 2009

one lump or two?

The logistics of this cancer thing can be overwhelming. After the diagnosis there is research to be done, and doctors to be chosen, and appointments to get to. And sometimes, there are difficult choices to be made. 

My diagnosis came after my first mammogram. A mammogram, mind you, that I really didn't believe I needed. With no maternal family history of cancer to speak of, certainly not among my closest relatives, I really didn't think it was an issue. I expected heart problems, diabetes, vascular issues. But not cancer. I went for the mammogram because I turned 40 last July and my doctor told me to. For good or bad, I tend to do what authority figures tell me to do. In this case, if it hasn't saved my life, it has almost certainly saved me a good deal of pain and trauma. 

I was diagnosed with multifocal microinvasive ductal carcinoma in situ (DCIS) in my left breast. The microinvasive means that it has just started to move out of the ducts, which is not a good thing, but it could be worse. The multifocal means that it has started in a number of distinct areas, which means that it isn't really feasible to treat it by removing just an area of my breast. The whole thing has to go. If the cancer hasn't reached the lymph nodes, which we will know after surgery, then I won't need radiation or chemotherapy. I'll take an estrogen blocking pill for five years, and hopefully leave this nightmare behind me. 

So I got the news about the one breast and promptly made an appointment with Dana Farber Cancer Institute in Boston. My surgeon told me during the first appointment that she and the radiologist at Dana Farber were concerned about an area on my right breast as well. By this time, I had more or less absorbed the news; the new concern threw me into turmoil once more. I did not immediately realize that I could simply elect to have bilateral mastectomies, which is what I am considering now that I know it is an option. Though it seems a bit drastic, I really, really don't want to go through this again. Even now, after I've had a mammogram on my right in Boston and the result was that there is no cause for immediate alarm, I'm not sure I want to wait and see. 

So that is one choice that I need to make, and the other is whether to have breast reconstruction. Very interesting to me as I have asked for thoughts from my friends is the difference between the male view and the female view. This is by no means a comprehensive study, or even a study at all, especially since the male views are really just from a handful of fellows. The women have had varied opinions, though tending toward a vote for reconstruction. But without exception, the men have been less equivocal. They are supportive of me whatever I choose, but they believe, as one of them said, that "breasts are overrated." I found this somewhat surprising, and I'm sorry guys, but my breasts are not overrated. At least not to me. Expendable perhaps. But not overrated. I am very fond of them, and will miss one (or both) of them. Enough so that I probably will elect to replace whatever we remove, however inferior to the originals the new ones may prove to be. 


1 comment:

  1. ok...these are my thoughts...take them, leave them...understand that they come with the deepest love and respect for the woman I'm proud to call my daughter. This is what I would do, if, indeed, this were my decision...please keep in mind that I am 60, not 40 and that, although I'm attached to them as a part of me, I have never been absolutely over the moon in love with my breasts..... I would have both breasts removed, I would probably go for the silcone...(besides the longer surgery time and the healing time there is also the issue of surgery on another part of my body)...another "site" that will have to heal...and I'm also a bit confused...does this mean that, with your own tissue could this cause a cancer to reappear in the "new" breasts? (please forgive my ignorance..as well as my really bad spelling!) These are a few of my thoughts on the matter: I don't think the breasts would "feel" the same if one was the "original" equipment and the other was manufactured; I'm not sure they would look alike; I would not want to have to hear "breast cancer" in my life ever again; Sounds easy I know but, as I told you before, it's not me, not my body, not my decisions to make...exactly how would I react to this news? Can't say for sure but I know that whatever decision you make will be the best one for you...please know that I'm behind you 100 percent.. I have the week of the 21st off from work so wherever you want/need me to be I'll be there...I love you...Mom