A Delayed Screening, a Breast Cancer Diagnosis, and Membership in a New Club

Beam me up
In mid-September, after a follow-up mammogram, consultations with oncologists, an MRI, and an ultrasound, I got “mapped”—my breast was tattooed with four tiny blue dots that marked the path that the beam of radiation would take. As tattoos go, they were a complete disappointment; I had imagined something a little more butch.

Five mornings a week, for almost seven weeks, I went to the office of John Rescigno, MD, a caring man with an equally caring staff, to get my radiation treatment. The routine rarely varied: Check in with Marie, who asked my birthday every last time to be sure I was the right Maura Fritz (what are the chances?); say hi to Jasmine, who handles all the insurance; change, then wait for one of the technicians—David, Jose, or Toni—to wave me in; hop up on the table, get precisely positioned, and lie still while the radiation beam tracked across me, painlessly and soundlessly. Generally, I was in and out in about 15 minutes.

Most mornings I went to work afterward. By the end of each week, my energy was sapped. I knew exactly when it was 10:15 every night—for some reason, my body seemed programmed to crash then. I had random bouts of nausea. And my breast bloomed with radiation burn, the redness spreading up under my arm, the skin sore and cracking by my last treatments. But in the scheme of things, all of that was minor. I had come around to Deborah Axelrod's thinking: I considered myself lucky.

Getting my last treatment on November 5 was surprisingly emotional. I made cookies for the staff—not something I do casually. After I got off the table (for what I hope will be the last time ever), I exchanged hugs with David and Toni. These were good people; I’d seen more of them in the past weeks than I had seen my family, friends, or colleagues.

A few days later, on the recommendation of Amy Tiersten, MD, my medical oncologist, I started on tamoxifen. The drug blocks the action of estrogen, the hormone that can promote the growth of cancer cells in the breast. The one-two punch of radiation and tamoxifen would squelch the DCIS, my team thought; the drug would also reduce the likelihood that cancer would either come back in my left breast or develop in my right one.

It has potential side effects, ranging from headaches to an increased risk of developing certain kinds of uterine cancer, and I seemed to work my way through some of the lesser ones (headaches, hot flashes) as my body adapted to the medication. But none was so awful that it outweighed the benefits.

Postscript
Almost 10 months after I finished radiation, my breast still does not look quite the same. It’s a little brown, a little pink, in places it wouldn’t be naturally.

In April I went for my follow-up mammogram. The news was good (my left breast is clean) and not quite so good (I now have calcifications in my right one). I had a pelvic ultrasound, too, which showed a thickening of my uterine lining that made my doctor unhappy; at its most extreme, this sort of thickening—an adverse effect of tamoxifen—can indicate hyperplasia, a precancerous condition. Erring on the side of caution, Dr. Tiersten has pulled me off of tamoxifen and put me on Evista, though it’s the runner-up of treatment choices when it comes to DCIS.

In the coming weeks I’ll do another round of tests to help sort out what’s happening in my body. Are the drugs holding the line against DCIS in my right breast? Will the change in medication stop the thickening of my uterine lining? What it all means long-term, in truth, I don’t know. What has finally sunk in (no one ever called me fast on the uptake) is this: Once you’re in the club, you’re in it. This is my life now. I’m grateful for it.

Maura Fritz is a senior editor at RealSimple.com