Breast Cancer and Reconstruction Shock

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A frightening experience to hear the words "breast...

A frightening experience to hear the words "breast cancer". Dr. Nicole Walker, and her team are compassionate, informative and "matched" me with Dr. Meininger. I had heard of wonderful outcomes from his skill and hope to have the same. His empathy and availability are reassuring and supportive. I learned of my DCIS while on vacation. I was scheduled within days to see Dr. Walker and her team. I met with the surgeon, nurse navigator, radiologist, hematologist, social worker and medical oncologist all in one morning. The 2mm DCIS was initially going to be a lumpectomy with whole breast radiation as there were multiple calcifications throughout the breast. The astute radiologist was particularly concerned about 2 other areas in the same breast so I had two additional biopsies 3 days later. These, too, were DCIS and the area now spread to 6cm, too large to get clean margins. I asked for the tumor board to give their opinion and all 5 agreed that mastectomy was the only reasonable way to be sure all cancer cells were removed. Radiating the breast after taking such a large lumpectomy would only make reconstruction extremely difficult if not impossible and would not ensure that the nipple and areola were not affected by stray cells. Skin sparing mastectomy was recommended. I was devasted and pretty much shut down. After seeing the medical oncologist, because my cancer is hormone receptor positive and all HRT had to be stopped, an MRI was ordered, bilateral. Two questionable areas were found in the other breast, one was biopsied and found to be atypical hyperplasia, which is how this DCIS started 10 years ago. My sister had stage 2 breast cancer which was found 1 year after a prior mammogram showed nothing. She just finished her bilateral mastectomy, chemo, radiation and reconstruction in August. Dr. Meininger was her plastic surgeon. My mother has had 4 occurences of breast cancer, radiation, and a unilateral mastectomy. My aunt, maternal side, has had breast cancer. Though my genetic testing came back negative, the strong family history made me very leary of not doing something decisive about this awful situation/disease.
Ironically, October is my surgery and breast cancer awareness month. While I have been very aware for years, have donated, participated in the Race for The Cure five times, it is different to be the patient rather than the support person. It is upsetting, scary, and I wish it weren't happening, not just to me but to anyone. I alternate between being the warrior and being an emotional mess who just can't stop the tears. I am not vain about my breasts, I just don't want to go through this process and I don't want to look at myself every day for the rest of my life and see that part of me is replaced, with scars, by something not real. I get the whole survive/thrive, "we are talking about your life", "scars are a sign of survival", etc. but I really just don't want to do this. I am very familiar with chronic pain, so it's not the pain, it's not the vain, it's just the plain......I don't want TO DO THIS. And yet I will, because I have to.
Bloomfield Hills Plastic Surgeon

Dr. Nicole Walker is the breast surgeon whose knowledge and ability to be informative and direct make me feel more comfortable with my decisions. We have already progressed from a small lumpectomy, due to multiple sites, to mastectomy. That was very hard to absorb yet she was patient, explanatory and supportive. My choice to have a bilateral mastectomy, due to atypical cells being found in the other breast was also supported. My nurse navigator, Allison, and Dr. Walker team very well and each is informed of conversations, concerns, questions and trepidations. I had several days of just wanting to do nothing about any of it and let nature take its course. There was no pressure, no judgement, just listening and explaining and allowing me time to absorb information. I, of course, came back around and realized that doing nothing was not a viable option. While every effort would be made to save one breast, there would need to be two lumpectomies in that breast and reduction, while the other breast would need a mastectomy and reconstruction. Common sense, and certainly never wanting to have to go through this surgical/reconstruction process twice, made the decision to have a bilateral mastectomy not easier, but just a wiser choice. Reconstruction will begin on the day of surgery. The questions I have in my head just keep coming and each doctor and my nurse have shown nothing but genuine concern and patience in answering them. Dr. Meininger has been direct, humerous, compassionate, empathetic and informative. I will be seeing him again this week as many more questions have occurred to me about the aftermath of the surgery and the process of the reconstruction. There are so many decisions to be made and while Dr. Meininger assured me there is no "wrong" decision, I had to base my personal decision on my family history

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