DCIS Timeline

I was 36 when I was diagnosed with DCIS - Ductal Carcinoma In Situ. I don't have a history of cancer in my family, and my insurance told me that I shouldn't even be screened until after I turn 40. I had never had a mammogram before. I'm in relatively good health. This is my medical timeline for Ductal Carcinoma In Situ - early stage breast cancer - and a bilateral mastectomy with immediate reconstruction.

• February 2015 - I found a lump in my left breast. It felt like a grape under my skin to my left side of my areola. It was new and definitely felt different than before. I knew I had to get it checked out, so I called my doctor's office. When I called to make an appointment I learned that it would be a month before I could see my doctor, so I took an appointment with the nurse practitioner at the OB/GYN office to get in faster.

• April 8, 2015 - Annual exam with my doctor's office. The nurse practitioner was calm about things and recommended that I get my first mammogram. When I checked out, I got instructions on how to schedule the mammogram. I called to make that appointment from my car in the parking lot. The earliest appointment was May 1, 2015, but they told me that I could call back to see if there had been any cancellations. I called back a few times and finally spoke to an operator who agreed to put me on her list to call if there were any cancellations.

• April 22, 2015 - I received a call that an earlier appointment was available. I took it instantly.

• April 27, 2015 - My first mammogram - a diagnostic mammogram - followed by ultrasound images. The ultrasound technician told me that she or the radiologist would come speak to me about the results. I knew it wasn't great when they took me back to see the radiologist. The radiologist sat in a dark room with a line of nurses waiting for him. When it was my turn, he showed me the lump and explained that it wasn't fluid-filled. He recommended a vacuum-assisted needle biopsy. Later the nurse told me that 80% of these biopsies come back as benign. She also scheduled me for a surgical consult. When asked which surgeon I preferred I told her the first available. I got an appointment for the next day.

• April 28, 2015 - Surgical consult with Dr. Philip Woodworth. Dr. Woodworth was again calm and very kind. He told me we could perform the needle biopsy, or we could do a surgical biopsy that would mean I would never have to worry about the lump again. I wouldn't have to explain it to doctors every year for the rest of my life, and that if it were his wife, he would recommend removing it. I agreed. When I asked him how soon I could be scheduled, he asked me how the next day would work for me. I was relieved that I had found a doctor that would match my sense of urgency. His nurse scheduled my pre-op appointment at the hospital for that same day at 3 p.m.

• April 29, 2015 - Surgery #1 - Surgical biopsy (lumpectomy) was performed as an outpatient surgery. The IV being placed in my hand was the worst part. It was very quick. And I got to go home only an hour after waking up. I used ice on the surgery site, and I didn't have much pain at all. The nurses gave me a "get well" card with Disney princess stickers on the front. It was really good to be treated like a princess at home. The nurse told me that the pathology results are usually back in 3 to 4 business days. Dr. Woodworth said he would call me with the results no matter what they were. Waiting and dreading was the worst. It was extremely hard to wait.

• May 5, 2015 - On the sixth day post surgery, Dr. Woodworth called me at 1:51 p.m. to share my pathology results. The call only lasted 2 minutes. Doctors know the best ways to deliver this kind of news. He knew I wouldn't remember much of the conversation, and he knew I'd need to process the information before we could have a thorough and productive conversation about it. He told me the results showed "very early stages of cancer." He told me that we had lots of time, and that it wasn’t like putting out a forest fire. I was stunned. Dr. Woodworth told me the next step was to do an MRI. It was scheduled for the next day.

• May 6, 2015 - MRI. The MRI was uncomfortable and scary. It was hard to wait for the test results, but the wait from May 5 to May 12 was the absolute worst for me. The MRI procedure was about 30 minutes. I was placed in the machine face-down and clamped in. It was uncomfortable. I was scared and very emotional. There's no crying in the MRI. You're instructed to be very still, and you definitely can't wipe away tears, and trust me, you'll want to if you're face down. I told myself to pull it together, and managed to do so. Being in an MRI, knowing it's "early stage cancer" but not knowing how bad it is or what the MRI will show, is terrifying. I had an IV during the MRI for contrast. When the contrast was released, I felt a bit woozy. I was so glad when it was over.

• May 12, 2015 - MRI and pathology results discussed in greater detail with Dr. Woodworth. I was diagnosed with Ductal Carcinoma In Situ. Stage 0. Low grade. HR+ and ER+ = very early stage breast cancer. Early detection, and acting quickly had made this quite possibly the best pathology report I could ever receive. Although the lump was removed, margins were not clear. I had a complete list of questions assembled. We discussed my treatment options - either a second surgery to remove more of the tissue to get clear margins, and a sentinel node biopsy to be certain that nothing had spread, followed by 6 weeks of radiation therapy, or a skin-sparing bilateral mastectomy with immediate reconstruction, with the sentinel node biopsy. To assist with my decision, genetic testing was performed. I was also assigned a nurse navigator who went over material on breast cancer in great detail. After my appointment that same day, I had a consult with Dr. Ken Gardner, radiation oncologist, to discuss what radiation treatments would be like. Dr. Gardner said he would recommend 6 weeks of radiation, 5 days a week, after surgery if I chose to do a lumpectomy. He also told me that with either course of treatment (mastectomy or lumpectomy with radiation) that I couldn't make a wrong decision. Both would be effective treatments.

• May 13, 2015 - Consult with Dr. Robert Taylor, plastic surgeon, to discuss bilateral mastectomy with immediate reconstruction. I already knew in my gut that this was the route that I wanted to go, because there's no doubt in my mind that I do NOT want to go through the same waiting, worrying and stressing that I had gone through with this medical event. I wanted to do whatever I could to to minimize the chances that this would happen to me again.

• May 20, 2015 - Pre op appointment with Dr. Taylor. I couldn't believe I was scheduled for surgery in 11 days. I received all my do's and don'ts prior to surgery along with my prescriptions to get filled in advance and post-op instructions to review.

• May 26, 2015 - Pre op testing at Mercy Hospital. I had blood drawn for testing and was asked to remove my polish from my toes and my acrylic nails.

• May 30, 2015 - Foot massage and nail polish removal.

• June 1, 2015 - Surgery #2 - 6:30 a.m. Bilateral mastectomy, sentinel lymph node tracer injection for biopsy of nodes. Tissue expanders placed to begin my immediate reconstruction. Mercy Hospital. Rogers, AR. I had two lymph nodes removed and biopsied that both came back as clear. I also had 400cc's of saline immediately placed in each of my tissue expanders. My surgeon wanted to get me to 900 cc's before the second stage of reconstruction. No clue what size that'll make me. I had two drains, one on each side, coming out of my sides. I also had two On-Q pain pumps, one on each side, to help with my pain for the first 4 days. I stayed in the hospital for one very long, very unrestful night.

• June 2, 2015 - Around 4 p.m. I was released from the hospital to come home.

• June 5, 2015 - Pain pumps removed in my surgeon's office. The tubes were very thin, and didn't hurt, but it felt really odd to have the long tubing pulled from my body. The tubes were placed on the tops of where my breasts were, so they weren't under any of my bandages or binder. I was glad to have fewer things hanging out of me.

• June 15, 2015 - Drain tubes removed in my surgeon's office. I DREADED the removal SO much. But it didn't hurt. The drain tubes were sore, and hurt every time I bumped them. The nurse clipped the sutures holding the drain tubes in place, told me to take a breath, and then removed them and tossed them in the trash. I instantly felt better. The nurse placed a normal sized Band-Aid where each tube was removed. No stitches or anything. Today was also my first saline fill into my tissue expanders. 100 cc's were placed in each side. (Bringing me up to 500 cc's in each side now.) The syringes look GIANT because they hold 50cc's at a time. I looked away each time, and it was over before I knew it. I get one stick in each side, and then the doctor fills me with 50 cc's then replaces the syringe to get the additional 50 cc's in.

• June 22, 2015 - Second saline fill into my tissue expanders. 100 cc's were placed in each side. (Up to 600 cc's in each side now.)

• June 29, 2015 - Third saline fill into my tissue expanders. 100 cc's were placed in each side. (Up to 700 cc's in each side now.)

• July 6, 2015 - Fourth saline fill into my tissue expanders. 100 cc's were placed in each side. (Up to 800 cc's in each side now.)

• July 13, 2015 - Fifth and final saline file into my tissue expanders. 100 cc's were placed in each side. (Up to 900 cc's in each side now. Finish line reached!)

• July 20, 2015 - Pre-operative appointment with my plastic surgeon to go over all the do's and don'ts for surgery to swap my tissue expanders for silicone implants. So happy to walk in this time and NOT be stuck with giant needles.

• July 22, 2015 - Lymphedema class at Highlands Oncology to learn about the risks and ways to manage having fewer lymph nodes.

• July 23, 2015 - Pre-operative appointment with my hospital to get ready for surgery the following week. Blood was drawn and my instructions were given to me. Also had to do another pre-surgery pregnancy test.

• July 30, 2015 - Surgery #3 - Out-patient surgery to replace tissue expanders with permanent implants. The procedure itself was only about an hour. I was at the surgery clinic for about 5 hours total. Everything went great!

• August 5, 2015 - First post-op follow up appointment with my plastic surgeon. Everything was on track! There are some uneven areas on my right side, but I'm hoping that things might settle in over the coming months and additional surgery won't be needed to address symmetry.

• August 19, 2015 - Second post-op appointment with my plastic surgeon. This was a quick one. He looked at my incisions, and said that everything looks great. The nurse gave me brown micropore tape and said that I can keep my incisions taped to keep my scars flat. He mentioned that he can do a revision surgery to address the dent in my right breast with fat grafting, and he said he'd extend the incision a bit under my arms to get rid of the fat under my arms.

• September 21, 2015 - Third post-op appointment with my plastic surgeon. This appointment was also quick. Just a quick visual review and another confirmation that everything is going great. The implants are settling into place and the unevenness has improved somewhat. Dr. Taylor mentioned that we can do a revision surgery with a bit of lipo to remove the "redundant" skin under my arms. (It's actually FAT that stick out and must go away.) He said he'd like to see me in 4 weeks, and at that time we'll discuss if I'd like to move forward with a revision surgery.

• September 30, 2015 - Amber turns 37! Yay! :) Princess themed cards and party gear. :)

• October 19, 2015 - Fourth post-op appointment with my plastic surgeon. My implants have dropped and have a much, much better shape and positioning on my chest. At my appointment we discussed a revision surgery, and I decided that I want to move forward with it. Even though I'm focused on my diet and am losing weight, I'm not confident that this area will ever look normal again. The skin under my arms didn't seem so pronounced before my mastectomy, and I want the best result possible. My surgeon also pointed out a "dog ear" at the beginning of my scar on my right side, that he would like to repair as well. We are looking at the surgery being scheduled in November.

• November 13, 2015 - Surgery #4. Revision surgery. Outpatient. SUPER easy. I had liposuction on both sides, had extra skin removed on both sides, and had the "dog ear" repaired on my right side - the inside of the original mastectomy incision. I had 5 incision sites total - 1 on each side where extra skin was removed; 2 tiny pencil-sized incision sites where the liposuction was done, underneath the breast fold on each side and then the scar repair site that was only 1-inch long. Even though that sounds pretty intense, and it looked pretty intense, this surgery was the easiest yet. The incisions on my sides are very large incisions - like 5 inches long on each side - but they didn't hurt. I felt pretty awesome afterward. I rested and took my pain meds, but I didn't need them for long at all. I rested all weekend, and was back to work on Tuesday, November 17.

• November 23, 2015 - First post-op appointment with my plastic surgeon. Things look GREAT! I'll still wear the brown tape over my incisions to help the scars heal evenly and flat.

• February 8, 2016 - Second post-op appointment with my plastic surgeon. Things look great, but symmetry is still not perfect. We discussed redundant skin on my right side, and agreed to take another look in a few more months. My "after" photos were taken today.

• April 11, 2016 - Annual exam with my OB/GYN

• May 9, 2016 - Third post-op appointment with my plastic surgeon.