Ready to pick over the breast cancer minefield?

Here we are, four months or so since my last post. I am writing an article about my DCIS, because I think there are important things to say about it that would help other women. There are so many different angles I could take, however, and I'm having trouble getting started. There seems so much to say, and I don't know how to say it. I'm going to start with a little bit at a time, here, and see where the writing takes me.

Picture this: you've got your Sunday paper. You've pulled out the magazine to browse through while you drink your coffee. The headline is something like: Do you feel lucky? (Dirty Harry somehow doesn't seem appropriate when talking about breasts, I know. I'm working on it.) 

In December 2009, I was diagnosed with DCIS: ductal carcinoma in situ, an early form of breast cancer. The same form, as it happens, as Martina Navratilova, although there I stop making comparisons. There is an incredible range of diagnoses and individual risk factors affecting the likelihood of it turning into full-blown invasive disease. In many women, it never does. In others, it’s highly likely. The key here is that we have an opportunity to prevent (for some) later stage breast cancer, to catch it nice and early before it’s had a chance to eat away at our bodies. Hurrah! The problem is, we don’t know which cases are going to mutate, and when. Bollocks.

DCIS, let alone the whole category of breast cancer, is dreadfully misunderstood. DCIS isn’t a one-size-fits-all disease. There are three different grades, for starters. 1 is low, 3 is high. If you have grade 1 DCIS, and you’re getting on in years, there’s a minimal chance of it turning invasive. My surgeon puts it like this: if you're an older woman with grade 1 DCIS, you may not need to have breast surgery. You may not need any treatment at all. You're more likely to die of old age first. If you have grade 3 (which mine was), if it’s extensive (mine was 9 cm) and you’re pretty young (I was 38), your chances of getting invasive cancer, and soon, skyrocket. I had a mastectomy. Every doctor must make an assessment of risk and advise on appropriate treatment based on the individual patient. So don't hit the panic button. Well, not without being informed properly. Unfortunately, some people aren't - but it's not necessarily anyone's fault. The subject is a minefield and difficult to navigate, even for doctors...

You still here? More soon!

(Photo by "joxin" at http://www.flickr.com; creative commons)