It is with a heavy and once again hopeful heart that I tell those of you who don't already know: I have been re-diagnosed with breast cancer.
On my most recent followup mammogram, on Thursday, September 11, they found microcalcifications of a sort and in a formation that were concerning. These could result from fat necrosis from the trauma of surgery, they told me, or they could be evidence of the return of cancer. The usual timeline for surgery-related calcifications is 1-2 years, of recurrence 3-5 years. It had been two years and 9 months since my surgery, almost to the day, making it difficult to tell where I was likely to fall. They ordered a biopsy for Monday.
I was nervous about this procedure, which was guided by mammogram rather than by ultrasound. If you just imagine the concept of a mammogram you can understand why the idea of poking me with things while I hung out in this machine was not exciting. I had also had a difficult time the last time they did anything remotely similar, which was when they were placing the markers that tell the surgeon where to go, right before my first surgery. As it turned out, though, with the glorious modern invention of lidocane and the fact that you lie down for this instead of sitting, it was not that bad at all.
I wasn't sure how much to worry about the results, but I had the feeling they would not be good. The range of possibility for malignancy was very wide--a useless 5-95%--but with my history and the looks I was getting around the clinic, I was not surprised when I got the call.
What they found was the presence of ductal carcinoma in situ (DCIS), the localized cancer that they had discovered under what had once been my invasive disease when I had my first surgery, along with a very small segment--just 2mm--of invasive ductal carcinoma (IDC).
Because of the presence of invasive disease, they will be doing the battery of staging tests that they did the first time: MRI and CT at least. All to see whether there is evidence of invasive disease elsewhere, especially in the other breast (what they found is on the left, as it was before) and in the place my lymph nodes used to be, since I had it there already, but also bones and other places breast cancer is mostly likely to do its dirty deed. As was the case last time, this waiting period is the hardest part, although I am optimistic that we are dealing with a localized recurrence. It was obviously an early catch. That will all happen in the next couple of weeks.
If they find nothing in the way of other cancer, and my little smidge of invasive disease is it, then I most likely won't have chemo. I am going to have surgery no matter what, probably in October, and it will be a mastectomy of at least the left side and possibly a bilateral. I am no longer eligible for lumpectomy on the affected breast, because lumpectomy is paired with radiation and I can't have radiation again there. There is a threshold beyond which they are just giving you different cancer, so that's a one time deal. The pathology report from surgery will also go into the question of whether I will have chemo, as will whether or not this is a recurrence, which is most likely, or another process, which they will be able to tell when the more detailed analysis of the biopsy come in.
I plan to write more later about the impact of this and how I am dealing with it, but for now I just need to get the word out. There are several people who should have heard this from me in person who haven't. I'm sorry. I can only hope that you understand and forgive me.
As you can imagine, this is an emotional time but also a practical one, because that's how I am. I will get over whatever treatment takes, eventually, as long as it works. So none of this third time's a charm BS. A second time is more than enough, thank you. Though some people do deal with it over and over and many still go on to live long lives, so anything is possible.
People often wonder what to say in these situations. Anything you say is fine--I'm not easily offended! :) And not saying anything about it is perfectly acceptable, too. Some of you are probably already wondering if there's anything you can do, and I'm grateful for your kindness. Patience and good cheer are all I need for now. Those of you who saw me through this last time know I have both of those things in droves, but a little extra can't hurt. Also, you can hug someone for me! Anyone will do, and pets totally count. And remember that life is short. Eat delicious food, smell a flower, feel the breeze, go to a show, take on that hobby! It's fine to have the long view, but you can still enjoy today.
xxoo
