Good news!?

I've been a wreck for the past few hours. I've been holding back tears and wiping my nose and telling all of my clients it's allergies. Yeah, I don't have allergies - I'm just on the verge of a breakdown, that's all. The surgeon called. Well, she said in her low, calm voice. I have good news. The final path report was Atypical Ductal Hyperplasia. They went back and looked at the first path slides as well and changed the initial diagnosis to match that of the surgical path slides. That means you don't have cancer and you can cancel all of your appointments (radiation, oncologist, genetic counselor). You do have an increased risk (3-6 times normal) of developing breast cancer in the future, so you need to be seen every six months for follow up. I'll see you on Monday for your post-surgical appointment. I didn't even know what to say, bumbling idiot that I am.

Of course, I have been researching ADH for the past 24 hours, and I know it's a step below DCIS on the breast cancer spectrum. It is easy for pathologists to call ADH DCIS and vice versa. It's just that ADH doesn't have the word cancer associated with it. So why am I upset? Actually, I've held it together for 9 weeks. Nine weeks of testing and procedures and surgery and uncertainty and anxiety. I was bound to have a breakdown at some point. Why not now?

First, you don't give someone a cancer diagnosis and have them sit with that for a month and come to terms with it and steel themselves against it and then tell them they don't have cancer and not expect there to be some emotional repercussions. I'm sorry. I'm human.

Also, for those of you who are reading, don't tell someone who is going through the above emotions, for the previously stated reasons, that they should be happy. Because then they feel even worse for feeling not-so-happy.

I'll be fine. I am a strong person but I need this time. For what? To grieve the lost 9 weeks. To re-formulate my near future that doesn't involve daily radiation appointments and doctor exams. To face the fact that I will forever be known as a high-risk patient, with (I calculated) a 44% chance of developing breast cancer at some point in my life. To figure out my next project, since this one has abruptly come to a close.

Let's play Monday morning quarterback for a minute, shall we? What if I never had that mammogram? The calcifications may have been perfectly happy staying as ADH for years, and I could have postponed this episode. One of the reasons yearly mammograms are not recommended for women under 50 is the high percentage of false positives. And the anxiety and expense that is incurred because of it. I guess it's not really a false positive, since I do have a diagnosis of atypical precancerous cells, but they may have never amounted to anything. Also, what if a different pathologist had read out the initial slides? Maybe it would have been ADH. Although they were read by two pathologists who agreed. Or, what if I had decided to go with the surgical biopsy instead of the second stereotactic biopsy? The surgical biopsy is more accurate and they probably would have read that one out as ADH and I would have known it 5 weeks ago. I went to Hawaii thinking I had cancer! I read the whole 700 page breast book! I had people praying for me, and healing rituals, and I told my kids all about breast cancer.

At least I didn't have an unncessary surgery - I believe that removal is still recommended in cases of ADH. Just not radiation (and as I said in an earlier post, radiation may not be indicated in mild forms of DCIS either).

I am not mad at anyone in particular. No mistakes were made. Everything was done according to protocol. We all (me, my family, the healthcare team) did their jobs. These things happen. (Heck, I've read about women who have complete mastectomies only to find out later that they didn't have DCIS either. Yes, it could be worse.)  I'm not even mad, really. I am just emotional. It's crazy. Sort of like (I imagine), war veterans must feel when they come home. They are supposed to be all happy because they are no longer in a stressful environment, but it's hard to adjust from that to normalcy in a short period of time. Maybe I have PTSD?

So I may need a few days. If you try to call me tonight, I may not be able to talk without bursting into tears. I need some time to debrief. Is that what it's called? Then I can celebrate my new diagnosis as a cancer-free person.