Wednesday, December 4, 2013

Decision Trees

I like to be prepared. Turns out during my previous stay in Cancerland, I had minutes to make life changing decisions even without having all the facts at hand.  I think this time I will have the luxury of time.

And all of this could be a false alarm

Repeat: all this worrying for nothing.

Last week and over the weekend I was good at keeping this way back in my mind. But yesterday I couldn't stop myself from having bleak thoughts and feeling sorry for myself. The smallest setback would put me on the verge of crying. I couldn't find a parking spot that wasn't 5 blocks away for my Livestrong class, I couldn't do some of these silly roller exercises without being in pain, I found out that an important appointment for Naomi was the same time as mine so I couldn't be at hers and Steve couldn't take me to mine..all little things but I couldn't handle it gracefully. I kept it to myself however.

And I started my reading. So this thing of mine probably is NOT a local recurrence. For TNBC, local recurrences occur in less than a year from diagnosis though I don't know how they can distinguish that from residual disease. As said before, distal recurrences (the scariest of the scary) rarely occur after three years, the exception being bone mets which can occur up to 6 years ( in estrogen positive disease, all this can happen 15 years out though at a much lessened frequency). But what to do if this is DCIS? Well depends if it is TNBC or not. If it is, I vote for double mastectomy. I must have some special proclivity for cancer.If it is low grade, then simple removal should be enough. I do not want to take anti-estrogens.

Recently they have decided not to count those with DCIS as patients with cancer. DCIS is thought not to be invasive. But studies show that the cells are no different from invasive cells. Maybe they haven't had a chance to invade yet or maybe there is some factor stopping them from invading. It is a very common condition. Random testing of women who have died of other causes show it 16% of the time. It could hang around for years and never turn into cancer. But then again, it could. I went to a funeral 3 years ago for a woman who was diagnosed with DCIS at the same time I had my full blown cancer. She was told if they just removed it, there was a 98% chance she wouldn't ever have to deal with it again. It showed up in her liver 2 years later. She died while being treated.

This is all assuming I have DCIS but the truth is that it is probably fat necrosis. Probably..or some silly artifact left over from my exploded seroma which was still leaking in the middle of the mammogram. I had this huge (6? 8? cm) seroma for 4 years that formed after surgery. On a mammogram, it looks like a giant tumor and felt like a hard lump. But ultrasound showed it to contain liquid (breast cancers are solid). I assumed after it exploded, it would no longer be visible on this month's scan. I certainly can't feel it through the skin anymore (but I do feel all sorts of creepy scar tissue) But there it was looking like it has for the past few years. Gross as this sounds, it drains through my nipple. But what happens if this stuff drained through the rest of my duct work? Could that be what they are seeing?

Today it is unseasonably warm. As I am not supposed to do anything that causes jiggling (maybe that's why I have a seroma in the first place) for 48 hours I tried to do 2 workouts today though I can't see the harm in biking (except the cold front is coming through tomorrow). Part of my instructions was to make sure I wore a bra to the appointment. Who with one D cup breast (and the other being a B cup) would show up without a bra?

I am not so weepy today but I bet I won't sleep tonight. Please send me some positive energy.

And one of the Moms became a first time Grandma late last night.


Anonymous said...

Sending positive energy your way. Kris

Holly said...

Sue - having just gone through a similar scare last month, I am totally with you. Holding positive thoughts for negative results!!

Anonymous said...

Hi Sue, I'm thinking good positive thoughts for you. If I lived closer i'd come introduce myself and take you out for a glass on wine! hugs....


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