Since I have posted many of my blogs back-to-back I figured I would wait a day or so to post the results of my double mastectomy. So before that here is just a little bit of background for those just reading this blog for the first time: I was diagnosed in May 2014 just 10 days after I had an elected breast reduction surgery with Ductal Carcinoma In Situ (DCIS) in my right breast. Since my surgery was not one where they were actually looking for cancer, the specimens were just grossly labeled Left and Right breast and sent off to the lab for pathology. It was discovered that I had (2) DCIS the sizes of 2mm and 5mm that had randomly been removed from my right breast. I was told it was considered Stage 0 which is awesome, but that I would need radiation and medication therapy to my entire right breast and that I should take a hormone suppressant for 5 years. I basically said heck no to both and at the time of diagnosis asked if it was crazy to just take off my breasts and be done with this whole breast cancer business. I was told that was very reasonable by many doctors, but my husband, family and some friends just thought that I might be being a little too extreme.
Four days after surgery I received a phone call from Dr. Fox with my final pathology results. She said a whole bunch of really big words and I reminded her that I was still pretty drugged up and had no idea what she was saying. :) She reassured me that my left breast was cancer free! They found a Proliferative fibrocystic change which she basically described to me as being like an internal pimple in the breast. In some instances the hyperplastic cells have features bearing some resemblance to ductal carcinoma in situ which raise a concern if found on a mammogram. In my case, since all of my breast tissue was being removed there was no additional concern for me.
My right breast presented a few more items of concern. Ductal carcinoma in situ (DCIS), nuclear grade 2 was found in a chain leading right to my nipple. Therefore, my right nipple with also found to have DCIS in deep lactiferous ducts. The good new is that no Paget's disease was seen. There are different ways to describe the nuclear grade of DCIS: these are all how the DCIS looks under the microscope. When DCIS is high grade, is nuclear grade 3, or has a high mitotic rate, it is more likely to come back (recur) after it is removed completely with surgery as compared to DCIS that is low grade, is nuclear grade 1, or has a low mitotic rate. Patients with higher grade DCIS may need additional treatment.Since I am a nuclear grade 2 I am right in the middle - obviously. I will meet with my Oncologist in a few weeks to discuss his suggestions of additional treatment if he feels necessary. At this point the additional treatments would mean Tamoxafin for five years (which you know I will turn down) and/or radiation to my right breast.
In addition to my DCIS being officially graded, it was also finally staged at a Stage #0 - which is awesome! I basically have beaten breast cancer before it got a real strong hold on me! However, they did find Atypical lobular hyperplasia (ALH) AND a breast with proliferative fibrocystic change and fibroadenoma, which could potentially turn into something invasive if left in the breast long-term, but was not a risk factor at this particular time. But it is good that that too was removed so that I no longer have to worry about that down the road!
Overall, I am very happy that I listened to my body earlier this year and had a breast reduction. Without having that surgery it likely would have been several years before my DCIS was large enough to be detected on a Mammogram and by that point it could have been stage 2, 3 or 4. I am so fortunate that this was caught super early and now I begin my journey through reconstruction using expanders.
More to come on that whole process.....