Ductal Carcinoma In Situ
Yesterday morning, I had my first consult with a surgeon. I felt immediately comfortable with her. What a relief to have a surgeon I trust to help me make wise decisions about my treatment. She’s warm and caring, has a sense of humor, and is intelligent and knowledgeable, and explained in detail what the results of my biopsy mean. Here’s the scoop.
(Note: I’m not a doctor, so take my layman’s understanding of DCIS and my particular situation with a grain of salt and talk to your doctor to get professional advice.)
Cancer is a big, scary word, and getting an unexpected diagnosis is terrifying. I have zero symptoms, and no family history of cancer, with the exception of my maternal aunt who had early stage breast cancer in her mid 50s. That such a tiny, invisible thing, of little immediate consequence to me now can be upending my life seems hardly fair. Still, if I’ve got to be saddled with breast cancer, I’m doing it right: I’m keenly aware that I’m very fortunate to have an excellent prognosis. With treatment, I’m expected to make a full recovery.
Ductal carcinoma in situ (DCIS) is presence of early stage cancer cells in the milk ducts. There’s some debate over whether these contained, early lesions should even be called cancerous, but the tendency is for them, left unchecked, to turn into something more insidious. Therefore, the currently accepted treatment protocol is to treat DCIS with surgery, radiation and several years of hormone blocking or reducing medication to help prevent growth or recurrence.
All cells have calcium in them, and at the end of the cells’ lifespan, they leave calcium behind in the body. In a mammogram, a cluster of these deposits can be an early sign of cancerous cells, which is why biopsies are done for women who present with this on their mammogram. There’s about an 80% chance that a biopsy will indicate that all’s well, but the other 20% of the time, they’ll uncover cancerous lesions. As someone prone to calcifications, and with all my bitching and worry about the pain and hassle of dealing with mammograms and biopsies, I’m sure as hell glad to have caught this early.
An MRI yesterday confirmed that my cancer is limited to the centimeter-sized area indicated in my mammogram. Over the next week, I’ll be hearing from schedulers to set up consults with a medical oncologist and a radiology oncologist, and will get my surgery date on the calendar. My surgeon will remove the cancerous area and surrounding tissue, and a couple weeks later I’ll start daily radiation treatments, five days a week, for 5-6 weeks.
Then, with the most disruptive part of my treatment regimen behind me, I’ll start about five years of hormone therapy, since my cancer cells have receptors for estrogen and progesterone (not all cancers do) that could cause more cancer growth in the future. Because the aromatase inhibitors commonly prescribed to post-menopausal women (I’m 51 and stopped menstruating at 49) can decrease bone density, I’ll also have a bone density scan to get a baseline.
Top concerns at the moment are:
bone density: my mother’s severe osteoporosis and osteoarthritis and how aromatase inhibitor meds will impact my bone density
my history of systemic lupus erythematosus (SLE, in remission for many years): SLE is known to cause more profound radiation side effects
weight gain: aromatase inhibitors can also cause major weight gain, and honestly it’s bad enough just being a once-slim menopausal woman who’s put on 30 pounds in the last four years
post-op appearance: what the heck is my breast going to look like when my lumpectomy heals, after removing, what, like a square inch of tissue?
hot flashes: I’ve been relatively lucky with this, but cancer meds can make this much worse
Well, time will tell.
Long time no see, Tumblr! New blog about some bullshit I’m dealing with. Also at @piscesgotcancer on Twitter, so I can escape my own feed and all the news of the world for a while. #selfcare
