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January 18

Saturday night, still have the zing in the right breast, still have the little clip in place.  What the hell, let's have friends over for dinner!

My phone was on silent, but I happened to see the screen light up.  Why was my radiologist calling me at home at 8:36 p.m. on a Saturday night?  Oh yes!!  To tell me that my biopsy was malignant, that's why!

I had DCIS, which is ductal carcinoma in situ (means "in its original place).  It was extensive, and it was considered high grade, which is fast growing.  It was estrogen positive, progesterone positive, but HER-2 negative.  Whatever.

For someone under forty who finds herself with this, there are two basic choices:
1) lumpectomy with radiation and tamoxifen
2) mastectomy

Here's the rub:  for someone my age with high grade DCIS, there is a very high percentage (something like 40%) that it could come back, either in the same breast or in the contralateral (opposite) side.  It will also become invasive, probably within a year.  (When did this window open?  Today, the day of diagnosis?   Three hundred days ago?)  I don't know about you, but I am not willing to go about my life wondering every single day if it's come back.  I want my chances of recurrence after any type of surgery to hover right around the 0-1% mark.

So I chose mastectomy.  Bilateral.  Screw this.  I had already researched this to pieces, and I had seen probably every slide and image posted from American/UK/Australian medical journals.  I wanted it out.  I have too much going on to worry about this, too.  I reviewed my plan with Dr. Goodwin that night during that phone call, and I asked his opinion.  He agreed with my decision.

In this moment, I felt relief.  I knew what it was, and I had a plan.  Dr. Goodwin told me that he was going to call the surgeon on Monday morning to try to get me in, because that would be faster.  I also had to have an MRI to rule out invasive disease.

This short phone call changed my life.

I think this is when I went out and got the notebook, actually.  Well, after dinner.





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