My best friend, age 46, went in for a routine checkup back in December. Her doctor did a breast palpation along with everything else, and gave her a clean bill of health. She said, “So, then, all I need to do is schedule my mammogram now, right?” He said, “Well, your baseline was clear, and your last one was clear, and you really don’t have any risk factors except your age, so you really don’t need to have one EVERY year.”
She said, “You know, my insurance pays for one every year anyway, and my best friend’s Mom died from breast cancer last year, so why don’t we go ahead and do it anyway, just to put my mind at ease?”
During the mammogram, they found micro-calcifications in her left breast. They explained that such things are not uncommon, and could indicate some minor tissue trauma - perhaps getting thrown against her seatbelt, even. “Come back in six months, and we’ll do a follow-up,” they said.
Fast forward to late June of this year. A new mammogram showed that the micro-calcifications have doubled in size and number, and there appears to be a weird little shadow under the grouping. “Come back in six months,” they said again, “and if it’s still there, we’ll do a needle biopsy.” She said, “You know, I am here, I’m already not wearing deodorant, and you’re making me nervous, so why don’t we do that needle biopsy now?”
Her initial diagnosis was DCIS, or Ductal Carcinoma In Situ - scary sounding, but it turns out that is a contained tumor that doesn’t leave the milk duct it’s in, so won’t metastasize or anything. Sure, it IS cancer, and she’ll be talking to an oncologist, but it’s really nothing to get alarmed about.They tell her she can have a lumpectomy, probably outpatient even, and it’ll probably never come back. Then they send her for an MRI.
After the MRI, her oncologist meets with her and asks her if she has given any thought to reconstruction after the surgery. She is baffled - thought this was a simple in-and-out removal of DCIS? He blinks, and refers back to the report in his hand.
"Noooo… " he says. “I cannot save that breast. You do not have a DCIS. You have cancer. The tumor is several inches across, it has tendrils and satellites - you will be having a mastectomy and chemotherapy. And we’re going to check your sentinel nodes and run some genetic tests too, because we need to know if we can save your other breast.”
The sentinel nodes are clean, and she tested negative for the genetic marker, but Monday, she is having her left breast removed. They will start the reconstruction process right away, and will be lifting and doing a reduction on her right breast too. She will have to undergo chemo, as well.
Please remember that doctors don’t always know everything. Stand up for yourselves - if you have questions or concerns, keep talking until someone listens.
