Treatment Options & Genetic Testing

So, here we are on 01/25/17....I was diagnosed yesterday with Stage 0 DCIS in my left breast.  Today I am heading to the Breast Center to meet with the Patient Navigator and the Genetics Nurse for Genetic Testing........

In the Breast Center:

A mastectomy pillow (goes under your arm) given
to me at the Breast Center.

I arrived at the Breast Center and was greeted by the Breast Center Patient Navigator, "A". She was very sweet and very knowledgeable.  Please be sure to check with your facility to see if they offer this assistance.  It is very helpful, especially in the beginning to have someone who knows the ropes to guide you through all of the information, appointments, and help you choose the best physicians for your treatment.

"A" started by going over my biopsy results in detail and discussing what it meant.  I had researched some online the night before based on our previous telephone conversation, so by the end of our talk, I felt like I had a thorough understanding.  We discussed my treatment options next.

For me, Stage 0 DCIS, does not require chemotherapy.  No chemo...this was good news.
It does require surgical intervention though because left untreated, DCIS becomes invasive and can spread.  "A" assured me that all 3 of my surgical options were good and produced positive outcomes for patients.  

Here's how my options were laid out:

Option 1: Lumpectomy followed by 5 days/week x 6 weeks of radiation and 5 yrs of hormone suppression medication (leading to menopause symptoms).

Option 2: Left (unilateral) mastectomy and reconstruction followed by 5 yrs of hormone suppression....no radiation.

Option 3: Double mastectomy and reconstruction ....no radiation, no meds

Additionally, if the latter two, there is implant vs natural tissue reconstruction.

All of these would be discussed in further detail with the Surgical Oncologist. My Surgical Oncologist would be the one to provide the statistics on the options, but "A" said that none of them would be "wrong".  This is most definitely a personal choice.  

We also discussed the physicians in the area and the ones that the Breast Center recommends.  I had already been told by several friends and coworkers that Dr. K was the absolute best for Surgical Oncology. "A" confirmed this and started working on setting me up with an appointment the following Monday.  "A" told me that I would hear from her or Dr. K's office to confirm my appointment.  She also recommended a Plastic Surgeon (from the group I had already heard about from friends) who works closely with Dr. K and is excellent with the natural tissue reconstruction option.  She would work on getting me an appointment with his office, as well.  She was anticipating that I could have surgery in just under a month...around Feb. 23rd.

I was then introduced to the Genetics Nurse, "E".  "E" explained the testing process and had several charts to show me how it worked and what the results would entail.  Most people have heard of BRCA 1 & 2 testing (thanks to Angelina Jolie), but my test would cover 28 genes.  The genes being tested would cover not only my genetic predisposition for breast cancer, but for 8 different cancers.  This was the one I took:

It was a simple saliva test...basically spitting into a test tube....a lot of spitting!  
We discussed what the findings would mean for my family....like the fact that regardless of the results, my niece should start getting routine mammograms at age 30 (instead of 40) just because she now has an Aunt with breast cancer.  Results would be available in 7-10 days.

I left the office with a ton of information swirling around in my head!  So many numbers and details.  This is one of those times, you want to have something to write things down on (or another person to take notes/listen).

It's all a bit overwhelming, but I felt good after my appointment.  Again, for me, this all signified a working, active, plan...things were moving in a positive direction.  I spent the rest of the day and evening updating family and friends and reading about the surgical options online.

I encourage you to be proactive if you have received a breast cancer diagnosis. 
Arm yourself with information and don't hesitate to advocate for yourself.  
Ask lots of questions!  
Write everything down and start a folder or file to keep all of the paperwork you will gather along the way...there is a bunch!  

Please feel free to comment or to ask questions if there is something you'd like to know more about.  I'm happy to share anything that might help you in your journey.

MY TIMELINE:

12/22/16  Routine Screening Mammogram

01/18/17  Repeat Imaging and US of left breast; LUMP found.
01/20/17  Core Needle Biopsy
01/24/17  Biopsy results postive...Stage 0 DCIS, left breast
01/25/17  Meeting with Breast Center Navigator and Genetic Testing