A Phone Call No. 4

The iPhone starts buzzing on the bedside table this morning.

“Hi, it’s Dr. Hwang. I was driving in this morning and I started thinking, ‘It’s been a long time since I talked to Heather. You’ve been really quiet! I guess that means you’re feeling OK?”

(Have I mentioned that I LOVE this doctor?)

I say that, mostly, I’m OK. The underarm incision is still pretty sore. She tells me that this is normal.

“Well, the pathology is back, and we’re not going to see each other until Monday, and I didn’t want you to have to worry over the weekend.”

Love, love, LOVE!

“So there was ductal carcinoma in situ (DCIS). We found a lot of DCIS. We took out a pretty big portion, I don’t know if you can tell yet. The margins are clean on three sides, but there’s one margin that is not clear. [If the tissue that they take out does not have a cancer-free margin on all sides, that means that they haven’t got it all.] This means that we’ll have to go in for a re-exision [doctor talk for cutting more out]. Probably in a couple weeks. If we can’t get a clean margin in that surgery, then we may have to talk about mastectomy. But we’re not there yet. I’m not recommending mastectomy at this point.”

I tell her I was bracing for this sort of news, and ask her to go on.

“Well, we also found some invasive cancer, ductal carcinoma. The tumor was small, about 1 centimeter. But it’s an aggressive kind of cancer. Your lymph nodes are clear, which means it hasn’t spread outside the breast, so that’s good. The pathology shows that it’s reactive to estrogen and progesterone. [This is good.] The first Her-2 test is negative. [Having a Her-2 reactive tumor is not good.] But they’re doing a chromosome Her-2 test; those results won’t be back until after our appointment next Monday. But it’s an aggressive kind of ductal carcinoma, so chemo may be on the table. It depends on the results of the test, and the next surgery. You’ll have to talk to the oncologist about balancing the risks and benefits.”

“OK,” I say. “Let me see if I understand. I’ll need another surgery to try to get the rest of the DCIS. If you can’t, then mastectomy may be on the table. The invasive tumor is small, but aggressive, so chemo is a possibility. Hormone therapy and radiation for sure. Is that right? The decision on chemo will depend on more pathology results and what you get in surgery next time.”

“Exactly right,” she says.

She asks about my family, whether I’m settling in. She asks about my daughter’s new school. She tells me the school puts on GREAT events, amazing catering. We talk about how over-pressured kids are today. We chat some more about stuff I can’t remember.

It’s good news, kind of. Also bad news. Yet once again, Dr. Hwang makes me feel strong, and hopeful. I guess it’s normal to idolize the person who’s trying to cure you of a scary disease. But Dr. Hwang rocks.


About leftbreast

I have had breast cancer. I was diagnosed at 47, and am now 49. I have finished "active treatment," two surgeries, chemo, radiation, monoclonal antibodies. These days, I only take a drug to suppress my uptake of estrogen, since my tumor was highly reactive to that hormone. I have been married to my husband Pete for 21 years. I have a stepdaughter, Maureen, 30, and a daughter, Erin, 10. I've been a freelance magazine journalist for 20-plus years, covering everything from Chinese foreign policy to Catholic nuns to endangered species. I have had a great life. I have lived in Asia and all over the United States. I have spent nights with tree-sitters in Oregon and with astronomers at the Mauna Kea observatory in Hawaii. I've been to a cocktail party on the poopdeck of a British destroyer docked in Shanghai. I've taken the bus to Tibet, and tramped through the cloud forests of Panama with biologists. A magazine sent me on a raft trip down the Colorado through the Grand Canyon; another sent me to cooking school for a week. I have spent time with celebrities, presidents and heroin dealers. I love my work. I have a loving, supportive family and more friends than I probably deserve. I have had the space and time to camp, ski, cycle, garden, cook and spoil my pets (an Australian shepherd, a German shepherd and a tabby cat). If it all ended tomorrow, I would have to say that it has been a really, really good ride. When I was in thick of treatment, I was simply fighting for more time. Now, I'm trying to connect the experience of cancer with the rest of my life, with the time that's been won. I hope the cancer never comes back, but if it does, I'll be ready. That's what this blog is about.
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3 Responses to A Phone Call No. 4

  1. Laura Conaway says:


    We’re thinking and thinking and thinking you.

  2. Catherine says:

    I sent you an email last night that was returned–will resend tonight to your new email addy. So sorry you got this news. I hope you can get away with the least amount of tx and still kick the beast out the door. xo C

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