Monday 9/8 - Visiting the Surgeon

We were lucky enough to get an appointment with the surgeon one business day after the diagnosis. I cannot express enough how important this was to us. The uncertainty was making us crazy. Rather than repeat all the detail again, I'm including an email I sent to our many friends and family members:

Dear Friends and Family,

For most of you, this is an update and for some of you, this will be the first news you will hear about this. Last Friday, I was diagnosed with ductal carcinoma of the left breast (DCIS). I was lucky to get an appointment with the surgeon today and David and I spent 3 hours with her. Dr. Lauren Schnaper, at GBMC, explained very thoroughly how very lucky I am that the cancer is NOT invasive, is a VERY LOW grade and it's about the best scenario you could hope for, if you have breast cancer. I'll be having an MRI before the surgery, since Dr. Schnaper noticed an area on the mammogram that she did not like, and I'll most likely end up with another biopsy before the surgery scheduled for Wednesday, October 1. Yes, it is the second day of Rosh Hashanah, but it is the first appointment I could get since she wanted lead time for the biopsy, if it was needed.

Based on the results of the MRI, if everything is a go and the pathology doesn't change, I'll be having a lumpectomy. After that, I have an appointment with a medical oncologist. Apparently, this kind of cancer and the fact that the biopsy was reactive to estrogen and progesterone responds very well to an oral hormone therapy drug, Tamoxifen. You take it for five years, if you can put up with the side effects, and it reduces your risk of a second episode is reduced by 50% according to the latest studies.

In some cases, women with this diagnosis also have radiation, but the surgeon says it's a one shot deal and you have to weigh whether you would take that route now or save it in case the cancer did return, and you really needed it for a more invasive cancer. Because there hasn't been a lot of research years focusing on DCIS, since it has only become a diagnosis since mammograms came on the scene (approximately 1989, according to the surgeon), they don't have a lot of filtered research. Meaning, that they haven't taken the time yet to determine if women with my low stage of cancer would do just as well without hormone therapy and without radiation as someone who has a more complex grade of DCIS. Those studies are yet to come. In the meantime, you have to look at what's out there and make decisions and the surgeon says it's really tough to know how much is just enough but not too much. Considering my mother was diagnosed at 55, a little more than one year older than me and with an invasive cancer (she had node involvement), and that my maternal grandmother had uterine cancer and her sisters had female-related cancers, I've requested a genetics counselor follow-up, which I'll set up when the dust settles.

Otherwise, David and I are very encouraged that we are very very lucky and in good hands! My angel is watching over me once again! Thanks, as always, for caring and being wonderful family and friends. It makes it so much easier to have those you trust and care about to share these moments with.

Love, Jo Ann