Ch. 2 - My IDC Diagnosis

CHAPTER 2 - My Diagnosis

In early June 2007 while I was applying lotion I felt a small lump in my right breast. I was fairly confident that I had not felt the lump before, but I could not be sure. A few days later, I noticed that the lump was still there. It was not painful to touch or with movement, but I could feel it. I had my husband check it out over the next few days. He confirmed that there was something there and said I should make an appointment to have it checked out. The next day I called to schedule an appointment. My regular physician, Dr. Spencer-Smith was out-of-town, so instead of waiting for his return, his office recommended that I see one of his partners, Dr. Reese. On June 14, 2007 I visited the MD and he performed a breast exam. He asked if the lump had been noticed upon the breast exam and I explained that it had only been felt about 2 weeks ago for the first time. He reassured me that it was probably something benign, but that we needed to have it checked further by an ultrasound. He ordered for an ultrasound and sent in the request for my insurance company, an EPO. The ultrasound was then scheduled for July 18, 2007. I had this procedure performed at White Memorial Medical Center. The ultrasound technician stated that most problematic "cysts" are painful. She could not give any ultrasound results, but this made me feel at ease since I was not experiencing any pain. The ultrasound results however came back abnormal. Dr. Spencer-Smith's office called me with these results and scheduled me for an appointment with him on August 2, 2007. At this point, I became nervous. He stated that the results were abnormal and showed "something" that looked suspicious. He stated that even if it were CANCER, it would be treatable, and encouraged by husband and I to stay positive and not to worry. He sent us over to the hospital that SAME day for a mammogram and a fine needle biopsy with vacuum. They were able to do the mammogram, but I had to wait until the following Wednesday, August 8, 2007 for the fine needle biopsy with vacuum. On this date, I had the fine needle biopsy performed. I was so nervous... #1 because I had never had one done before and I thought it would hurt and #2 becauase I also have breast implants which could be punctured during this procedure. I also knew that this procedure would give us definitive results of what was growing in my right breast, at this point I knew I needed to know, but did not know if I was quite ready. When the biopsy was completed, the MD inserted a small metal clip that would show the location of the biopsy when follow-up mammograms are performed. This procedure was then followed by a mammogram to make sure the clip could be seen. At this point, I was happy that all of this was behind me, but very nervous in regards to waiting for the results. On August 10, 2007, my MD called with the preliminary results. He stated that he would not know the final results until August 13, but that the initial results look good, a benign problem that could simply be removed with a simple surgery. My husband and I were relieved, but the MD did caution us that the final results would give the final answer. The pathologist needed to wait for the completion of 2 more of the stains. On August 13, 2007 we received the final results. Dr. Spencer-Smith's office called me at work and stated the MD wanted to see me in his office @ 3:00 pm and he also wanted my husband to be with me. I knew at this point, that the results were not good, but I really did not know what to expect. The MD explained to us that the final results showed a form of cancer known as invasive or infiltrating ductal carcinoma, otherwise known as IDC. He did explain that it was treatable with surgery, radiation, and chemotherapy and that my chances were good. He continued to explain to us that although the cancer is malignant, it does not mean that it is fatal and that treatment options have come a long way in recent years. He shared statistics with us and stated that 1 in 8 women today are diagnosed with some form of breast cancer during their lifetime. We had many questions for him. It seems so strange for me to have cancer... young... no history of cancer of any form in my family, except skin... an active, healthy female. He simply stated that it was just bad luck. He encouraged us to not over-analyze the whys and hows, but now focus on being positive and support each other during this time. On this visit, we were told so much information. He had already contacted a surgeon, Dr. Sharazi, who came to his office around 3:30 pm to meet with me and my husband. She briefly went over the anticipated treatment course with us and proceeded to perform a breast exam. She stated that my left breast also felt a little odd and reported that she would not move forward with surgery until after an MRI of both breasts. This sent panic through my mind. It was hard enough to be positive regarding having cancer in one breast, but PLEASE, not two!! After the breast exam, Dr. Spencer-Smith returned and informed me that he also needed to remove my IUD. I had only had the IUD since November 2006. He explained that this was necessary because my IUD (Mirena) is a progesterone secreting type which is not good for someone with breast cancer because the cancer could contain be progesterone receptor positive which would actually help the tumor grow and spread. He gave us the choice of condom usage or having another IUD inserted that does not secrete hormones. He said that until ALL of my treatment was completed, we could NOT get pregnant. We chose for a copper IUD to be inserted after the other IUD had been removed. This was SO PAINFUL!!! But in retrospect, I lived. I did have severe cramps and vomiting from the pain for about 24 hours, but only occasional afterwards for about 1 week. At the end of our office visit, we still had many questions. We did have a trip planned for Catalina Island for 3 days. We asked it we should cancel the trip, but both MDs stated it would be good for both of us to get away and let everything settle in a little bit. In the meantime, I had mentioned that I had been considering having my implants removed. I felt that this may turn out to be the best time, especially if it were necessary due to my newly diagnosed breast cancer. Dr. Spencer-Smith stated that while away on our trip, he would call a plastic surgeon for us and brief him on my case. We were to get in touch with him the follwing day to schedule an appointment. His name being Dr. Allan Perry out of Pasadena. We were also instructed to call Huntington MRI center on August 15, 2007 because Dr. Shirazi wanted me to have an MRI done at this center on both breasts just to make sure the left breast was clear and she wanted a clearer idea of the extent and size of the cancer in the right breast before surgery. We did as instructed. I had a MRI done on both breasts on August 17, 2007. This MRI was done with contrast and took about an hour. On August 20, 2007, I received a call from Dr. Shirazi. She stated that the invasion in the right breast appeared small on MRI and that the left breast was negative for cancer. YEAH!!! Later this same day, we met with the plastic surgeon in his office. He explained to my husband and I that my implants felt healthy and he did not recommend any action at this time. He stated that without the implants he would need to be present during the operation to insert a tissue spreader in the right breast. This would keep the skin and underlying tissue from shortening after surgery and throughout radiation. The spacer would remain in until reconstruction surgery could be performed. Oh yeah, this would only be necessary if I chose a partial mastectomy. If I chose a total mastectomy, the reconstruction would be done at the time of surgery since this type of surgery did not require follow-up radiation, only chemotherapy. At this point I decided to have a partial mastectomy performed because all the physicians explained that with the partials, the outcomes are good, and I liked that fact of saving any healthy breast tissue that I could. Due to this fact, he said that during the recovery period, there would be no need for the tissue spreader because I already have one, my implant. The surgeon consulted with one of her radiation colleagues and he informed her that the radiation would not damage the implant and that the implant would not cause any harm during this period. So... with all this in mind, the conclusive plan was decided after my visit with the plastic surgeon and consulting with my general surgeon. The operation will be a partial mastectomy of the right breast with sentinal node biopsy. The surgery date was scheduled for August 24, 2007. After surgery, I was informed that I would need chemotherapy (IV vs. pill) and radiation and that the intensity and duration of the treatment would depend on the stage and grade of the cancer. And, since I do not need a plastic surgeon at this point, I only have to follow-up with him in 6 months to a year after everything has settled and I have completed chemotherapy and radiation. Surgical options would be determined, if any, at that time. There was one question regarding the need to harvest my eggs. This issue will be discussed further with my OBGYN after the surgery is behind us. During the time between the MD visits and consultations on Monday, the 20th and the surgery date of Friday, the 24th, I sent emails to many of my friends and family explaining my current health condition and asking for their support. The responses were overwhelming, greatly needed and greatly appreciated. It was very conforting to know that I have so many people who love and care for me and who are willing to do whatever I need during this difficult time.