5. April 2021 - Results Day

I got a call yesterday to say my Consultant wanted to see me today so that I had some clear information prior to the Easter break. Miss D is just amazing - such a kind, compassionate and caring doctor - she took so much time explaining my diagnosis which is as follows:

I have a Grade 2 invasive 20mm Ductal Carcinoma in Situ (DCIS) which has an oestrogen receptor that is both ER+ and HER2+ - with no spread to my lymph nodes.

I will try to explain what this means - but one of my coping mechanisms has been to not do too much research - Google holds a lot of information - but not necessarily the type you need!

Cancer is graded as follows:

Grade 1 - Cancer cells that resemble normal cells and aren't growing rapidly.

Grade 2 - Cancer cells that don't look like normal cells and are growing faster than normal cells.

Grade 3 - Cancer cells that look abnormal and may grow or spread more aggressively.

This is different to staging of cancer which is graded as follows:

Stage 1 - the cancer is small and hasn't spread anywhere else

Stage 2 - the cancer has grown but hasn't spread

Stage 3 - the cancer is larger and may have spread to the surrounding tissues and/or the lymph nodes

Stage 4 - the Cancer has spread from where it started to at least one other body organ also known as secondary or metastatic cancer

Some breast cancers have too much of a protein called HER2 (human epidermal growth factor receptor 2) on the surface of their cells. This is called HER2+ breast cancer. The extra HER2 protein encourages the cancer cells to divide and grow. Breast cancer that has receptors for the hormone oestrogen is called oestrogen receptor positive (ER+) breast cancer. I have both receptors which is why my HRT had to be stopped immediately as the oestrogen was just feeding the receptors daily.

So the good thing is it hasn’t spread to my lymph nodes and Miss D goes to great lengths to reassure me that, although the treatment is harsh, my cancer is treatable. She writes it in big letters on my information sheet - she draws diagrams to explain my diagnosis and just generally goes out of her way to ensure I am fully informed and take away the most important message - I WILL recover.

I try to be reassured but my head is saying ‘what if it isn’t?’

I know I caught it early, it hasn’t spread - but still……. What if?

My initial treatment will be determined following an MRI which will accurately measure Tilly - if she is under 25mm I will proceed to having a Lumpectomy - Miss D will surgically remove her under General Anaesthetic (GA) and then I will be referred to Oncology for a decision to be made on further treatment. If she is bigger than 25mm I will need a course of Chemotherapy to shrink her before the Lumpectomy can be performed. The MRI is booked for 6th March, and the results will be discussed in the MDT (Multi Disciplinary Meeting) on the 7th - all ready for my appointment with Miss D on the 8th.

Miss D anticipates that I will need a course of Chemotherapy whatever happens - this visibly upsets me and she is so compassionate. Having chemo marks you out as a cancer victim, it's a nasty poison they put in you, with so many terrible side effects including hair loss which is the big ‘I’ve got Cancer’ sign it puts above your head - and I'm scared. So many thoughts and emotions are flying through my brain and I do realise my concerns are the same as everyone facing this situation, but Miss D never made me feel ridiculous - she totally understood and spoke to me calmly and with authority - she will be with me every step of the way - I will get through this.

I left the hospital scared but thankful that I was in such good hands - to be honest I’m still quite numb - it all seems so surreal - I’m sure the enormity will hit me at some point - in the meantime I just keep putting one foot in front of the other.

When I get home I compose a text to send to the rest of my family - I can’t face speaking to everyone, and going over the same information again and again. I gave them as much information as I could, apologised for breaking the news this way and explained that I wasn’t ready to talk to anyone just yet. It was so hard to write down - it made it more real - although in all honesty, I still feel so disconnected from it all.

I was inundated with shocked but loving and supportive messages. I knew everyone just wanted to rush over and envelop me in love, but they all respected my wishes - I’m sure there were a million conversations going on between everyone - but they all gave me some space.

The recurring comment in all the texts was that they all consider me ‘the strongest woman they know’ - what worries me is what if I’m not? What if I’m actually a little weakling who has been play acting being strong for years? Could be very awkward……

I was so worried about telling everyone but I have been blown away by the loving support that has been shown to me by everyone. I have never felt alone - I feel cocooned in a warm blanket of love - it is almost tangible - I am very lucky to have such wonderful family and friends. And life carries on.