Wednesday, September 13, 2006

In a nutshell:

The doctor called me last night w/ the results of the biopsy. It showed that the area had DCIS, which is Ductal Carcinoma in Situ, or precancerous, non-invasive cells within the breast ducts. He also called it high grade. Combined with the other tumor, his answer is mastectomy. He said other surgeons might be more aggressive w/ the breast conservation approach, but his is more comfortable w/ the mastectomy approach.

I wonder how comfortable he would be with "lose all of your penis vs. lose part of your penis"??

I'm very VERY angry right now with both the surgeon and the oncologist for ignoring this area of microcalcifications until the end. I feel they should have been biopsied in the beginning, before a lumpectomy was offered. He told me he couldn't recall the "thought process" that lead to taking the approach that was taken. I think the "thought process" was lack of communication between doctors and not reading notes very well.

Had I not said "what about the calcification spots?" at my appointment w/ the surgeon at the conclusion of my chemotherapy, we would have merrily gone on our way with the lumpectomy. I DID repeatedly ask my oncologist about the calcifications and he kept saying it would be ok, that they would get it with lumpectomy, that I wouldn't lose my nipple area, that I could do a lumpectomy. I haven't decided whether to call him and yell at him or wait until next Friday when I have an appointment with him. Frankly, as much as I liked him, I'm thinking of changing oncologists as well.

I am going to get a second opinion. The surgeon gave me the name of another surgeon who he knows personally and says is more aggressive w/breast conservation. I also got the name of the surgeon a lady in my ward used who is a very big on breast conservation attempts. She had three masses, in the same general area, and he was still willing to do lumpectomy.

The surgeon's assistant is supposed to call me with names of some plastic surgeons I can consult with and see pictures of their work. Goodie. I plan to tell her to have the doctor go through is notes and find that "thought process", as he said he would have to do to remember what it was. I do think I finally made him understand last night how angry I was about spending 16 weeks thinking one thing, lumpectomy, when that was false hope, and that now I feel the same emotional upheaval I felt when I found out I HAD cancer, all over again.

So, I guess my next step is to retrieve all my films from North Scottsdale ( they insisted on keeping everything after the biopsy, which upset me), getting copies of all my radiology and pathology reports, and talking to other surgeons. I don't relish the idea, but my plan B is to insist on just the lumpectomy of the main tumor, and refuse anything to do with the DCIS, which would have been the actual course of action had I kept my mouth shut at my last appointment, and take my chances.

Here's a thought...if an area of DCIS is non-invasive, doesn't poking holes in it with a biopsy let it OUT of its duct?? I'm not happy. But at least angry keeps me from bawling.

Opinions welcome.

Ok, that was a BIG nutshell...