When we get an ache or pain in our house the last thing we do is call the doctor. Our motto is "let's wait and see if it goes away in a day or two."
When I felt a pain in my breast, however, neither my husband nor I wanted to wait that long. Nor did the doctor who saw me first thing that Monday morning. His exam did not reveal anything unusual, but an immediate mammogram was ordered. I called the radiologist whom my doctor recommended and his office squeezed me in that very afternoon for a mammogram. Everyone was so helpful.
Since I had had a mammogram 4 years earlier at 35, when all women are recommended to get a "baseline" mammogram, I knew what to expect. I waited in my jeans and blue plastic chest cover-up until the mammographer came. She was friendly as she adjusted my breasts onto the machine then mashed them hard (ouch) for X-ray clarity.
Next I went to the examining room to wait for the radiologist to analyze the x-rays and report the results. I waited for the verdict. There was the knock. The door opened. Thankfully, my radiologist did not mince words. "It looks like breast cancer."
There was no tumor. I had a lesser known form of breast cancer which is made up of "microcalcifications." This kind of breast cancer can only be detected by having a base line mammogram with which to compare. My first baseline mammogram showed the darkness of healthy breasts. My second mammogram showed my left breast with scattered white particles dotting the darkness and my right breast looked like it was smeared white.
The radiologist advised me to see a surgeon and get biopsies to confirm his diagnosis.
Boy, does your To-Do List change when you find out you that you might have breast cancer! As a professional free-lance writer, I first canceled all my assignments. Then I cleared my social calendar. Only then did I take out a clean notebook to figure out what I needed to do next. There are doctor appointments to make and family and friends to fill in. There is medical research to review, insurance issues to sort out, and form after form to complete in each doctor's waiting rooms. It is a real crash course in medicine. Patient side.
Breast cancer based on microcalcifications is not like a tumor-based breast cancer. Surgical treatment for a tumor is often a lumpectomy. This operation removes the tumor and surrounding tissue so that margins of clean tissue untouched by disease are clearly visible. Microcalcifications, however, are scattered in such a way that it is difficult to get clear margins and know for sure if you have removed all of it. Thus all of the breast tissue is removed as well as the nipple. In both kinds of breast cancer, a gateway lymph node is also removed to see if the cancer has spread into the lymphatic system.
Outpatient surgical biopsies revealed Ductal Carcinoma In Situ (DCIS), a precancerous formation. Using the standard Van Nuys breast cancer index, my right breast ranked a 9 out of 10; my left was a 4. Clearly I needed a mastectomy on my right breast immediately. My left breast, rating 4 out of 10, showed less indications of cancer so doctor said I could conceivably wait and watch it cautiously. But did I want to wait? Did I want to go around wondering if the left breast would become cancerous? And then what? Another trauma for the whole family to endure? No way.
So the decision was made. I would do all the surgeries but one breast at a time, the right side first. I went to the pre-surgery mammogram so for my surgeon and the hospital radiologist could review it one last time. After their consultation, my surgeon confirmed that I still needed a mastectomy but wanted to know if I had considered breast reconstruction. He noted that many women have the general surgeon remove the breast and then while still on the operating table have a plastic surgeon come in afterwards to do the reconstruction.