35. Reassurance needed

I have a further check up with Giles two weeks later and he advises a 6 week wait before deciding on a date for the nipple construction. This is to ensure that there is no risk of undoing any of the surgical work and so that the skin can loosen to create enough to fashion a new nipple. He explains that the procedure is very short (about 20 minutes) and I can either have a general anaesthetic or opt for a local which would obviously be less risky but slightly more freaky. Giles helpfully suggests I can turn the music up – I wonder if I can bring my iPad and watch an episode of Holby City in a weird art imitates life kind of way.

Before leaving I remind Giles that he agreed to recap on my cancer risk factor again for my benefit – mentally, I’m still not convinced that I am officially cancer-free and that I have minimized my future cancer risk as far as possible. If I developed it once, what’s to stop it happening again somewhere else in my body? Giles takes the time to go through all the components for me, despite patients in the waiting room. I am grateful and make a mental note to not get irritated the next time I am kept waiting for an appointment. He reassures me that despite having medium/high grade multi-focal DCIS, there was no micro-invasion, the lymph nodes were clear and they were confident that there were clear margins when the tissue was removed. He reinforces that the mastectomy reduces my risk factor to the point where the risk of breast cancer would be outweighed by the risk of womb cancer if I took Tamoxifen now.

There are still articles appearing regularly in the various medical journals I have surfed debating whether women are being over-treated, but I hang onto the words of a more recent study: it explains that in up to half of DCIS cases the cancerous cells stay where they are. But in the other half of cases the cells spread into other tissues of the breast, and can then spread to other parts of the body. The difficulty is in accurately predicting which half a woman falls into, meaning up to 2,400 women a year in the UK may receive unnecessary treatment. But, until an accurate prediction test can be developed, there appears to be little alternative for those such as me wanting to reduce their risk levels in a bid to reclaim some control over their destiny.