I met the surgeon Friday. He ran way behind schedule, but he was collaborative and kind. My surgery is scheduled for this Friday, the 11th. I was told to find a front closure support bra that I will wear home from the surgery, which is an outpatient procedure. They will use wire localization to find the titanium piece left from the last biopsy, and then will remove tissue around that the size of a large marble. It may take 90 minutes for this, because they need to x-ray the tissue to see if they’ve gotten enough margin around the chip. If not, they’ll remove more before closing me up.
The follow up visit is set for March 18, and he told me his practice is NOT to give pathology results via phone. But he assured me that there was a 90% chance no cancer would be detected. (Though there had been an 80% chance the stereotactic biopsy wasn’t going to show a problem, but I wasn’t in that group.) He said after we get results, regardless of what they are, I should consult with an oncologist to discuss how to determine my risk and options to reduce it. He also recommended that I talk to a genetic counselor, at least to find out whether it might behoove me to get tested.
I might very well do so. My mother is a breast cancer survivor. Her mother, however, died of breast cancer when she was in her early 50s. And her mother, who lived to her 80s, had breast cancer and ovarian cancer. In fact, I think it was ovarian cancer she died of. I had dismissed my great-grandmother, because one doctor told me years ago that it’s inevitable to die of something when you get old enough, and it wasn’t indicative of a heritable condition. In light of my situation though, I’m now thinking perhaps it is. Three generations of breast cancer — regardless of the age it developed — surely has some significance, at least to me personally.
One of my sisters is worried that if I get the test done and turn out to have a mutation, that this will cause me problems getting insurance coverage later on, if I should change carriers. Fortunately, the Genetic Information Nondiscrimination Act of 2008 (GINA) was passed, which makes it illegal for health insurers and employers to discriminate on the basis of DNA information. You cannot be denied medical coverage based on DNA results. The insurance company may require additional intervention because of it (such as more frequent screenings), but it is not a pre-existing condition. Having a gene mutation does not guarantee an illness will result. So, no worries, sis!