DCIS - In THREE Places!

Yesterday, while Dawn Ann was trying to get a shower, her bandage got wet, and began to peel away from her body. Since it was wet inside, we took off the dressing to keep the warm, moist, dark area under the dressing from being a breeding ground for bacteria.

We had to make a special trip to Walgreen’s to get some gauze bandages and tape. We put on some gauze strips and taped everything down. Dawn Ann’s post-mastectomy camisole, which gently squeezes things together, helped to hold the new dressing in place.

In the process of changing the bandages, I got my first look at the incision and the results of the mastectomy. I knew what was coming, but I have to admit it that it caught my breath for a moment. Obviously what once was there, was there no more.

There appeared to be some skin tucked into a fold for future use, possibly to cover the implant when that time comes. I tried my best to not show shock or surprise on my face as I re-wrapped her dressing. My shock was only for a moment.

She asked me if it was grotesque, or hard to look at. I told her it was all right. As of yet, she has not had the opportunity herself to see a full frontal view of the results of the surgery. She could only look down to see, without the aid of a mirror when we changed the dressings.

When Dawn Ann finally does behold everything for the first time, I want to be there for her.

Today we had our first follow-up visit with Dr. R (the breast surgeon) since the surgery. Dr. R peeked at the incision and stitches. The skin looked good, with no sign of infection. She just left our home made dressing in place. Tomorrow we will visit with the plastic surgeon. We will probably get a new dressing then.

Dr R. reviewed the final pathology report with us. Both sentinel lymph nodes came back clear of any metastases, as the preliminary tests had shown. The cancer has not spread into the lymphatic system. They identified both sites that were previously biopsied, and both of them were truly “In Situ” – which means that the cancer had remained in place, or localized. The cancer had not spread to any of the adjacent breast tissue.

The big surprise in the final pathology report was that there was a third cancer location found! It was in the upper, outside quadrant of the breast, and was found in a random tissue examination by the pathologist. This cancer was undetected by mammogram, sonogram, and MRI – and it was a very aggressive form of cancer too! Fortunately, it too was “In Situ”, or localized.

The finding of the third cancer spot re-confirms the decision to have a mastectomy. This third cancer spot was found by a random sample of the remaining breast tissue – after the known cancer sites had been examined. Who knows, if every section of the breast tissue had been examined there might have been yet more cancer found. The doctor confirmed that there was something about the right breast, know one knows why, that was causing the cancer to form. Even if we had done two lumpectomies now, sooner or later we would have needed to do a mastectomy as other cancer spots would eventually come to light.

Now we have to really watch the other breast carefully. Dr. R. wants to see Dawn Ann in 6 weeks for another follow-up to the surgery. From that point on, we will see her once every 6 months – forever. This will be to check the left breast, and to make sure that no further cancer occurs in any remaining breast tissue from the right side. Even with the mastectomy, there are still some microscopic particles of breast tissue that remain. In theory, (but not likely) it is possible that cancer could return in those remaining particles of breast tissue.

For now, we are glad that all of the cancer that we know of has been removed from Dawn Ann’s body. She will not need chemotherapy or radiation. The only remaining question is whether or not to have Dawn Ann start taking tamoxifen. Dr. R. recommended that we see a medical oncologist for further consultation. Tamoxifen is an anti-estrogen drug, that could potentially lessen the risk of cancer in the left breast. However, tamoxifen also has some serious side effects, including: blood clots, stroke, memory loss, vision changes and liver cancer.

Since Dawn Ann has had a hysterectomy, with ovary removal, there is not that much estrogen in her system to begin with. Right now Dawn Ann is leaning against taking tamoxifen.

Dr. R. presented Dawn Ann’s case to a “cancer board” last Thursday. Apparently there is peer review of cancer cases. Some doctors recommended that Dawn Ann take tamoxifen, and others were indifferent about it. All agree that chemo and radiation are not necessary at this time.

We will make an appointment with an oncologist, and make a final decision on tamoxifen after that consultation.

We also plan to meet with a genetics counselor in the next few weeks as well.