Six Month Active Surveillance Follow Up for Early Stage Breast Cancer
When I was first diagnosed with very early stage breast cancer I chose “active surveillance” instead of a lumpectomy as my treatment. I wanted to take a “wait and see” approach for the progression (if any) of the small group of malignant cells in my right breast … taking action as necessary, but not before.
The first surgeon I was referred to after the pathology reports from my two biopsies came back, said that surgery (with the possibility of radiation post surgery) was pretty much my only option, even offering a double mastectomy as an alternative to a lumpectomy. As I sat in his office listening to what he was telling me, my head was spinning … but I reluctantly agreed to a lumpectomy in six weeks time.
Over the next few days, during which I did a lot of research, I began to question if that was the right choice, and if it was even necessary. I remember at one point this surgeon briefly mentioning that this type of cancer has the possibility of never developing into anything life threatening. Yet in the same breath, he went on to say that since my mammograms and ultrasounds had now shown these cancer cells present, it meant that action needed to be taken. To me that made no sense whatsoever. Why would I jump into surgery, that has the chance of leaving my breast disfigured, knowing that there was the possibility that the cancer cells could remain dormant for the rest of my life?
I decided to put my agreed upon lumpectomy on hold and sought the opinion of another surgeon ... a surgeon that would honour my questioning and uncertainty about the necessity of going under the knife without delay. I was not feeling confident that it was the necessary treatment for me at that point. Luckily, that is exactly what I found.
“Helping patients to understand that low-risk DCIS does not require immediate action or rushed decision-making is important.”
Sarah T. Hawley, Ph.D.
My diagnosis was given to me on January 12, 2018. The six-month active surveillance approach that was agreed upon between myself and my second surgeon took me to July 16, 2018. On this date a follow up mammogram would offer a comparison of my previous ones, letting us know whether the malignancy had spread, grown smaller or remained unchanged.
The news I received affirmed to me that my decision had been the right one for me. My six-month follow up mammogram showed that the cancer cells had remained unchanged. My surgeon was happy to report that this is a very good sign, as the first six months is typically the most notable time that a newly diagnosed early stage malignancy will spread. I was ecstatic for several reasons. The obvious one being that there had been no change. I also felt proud, proud of myself for taking a stand and going against what much of the medical community is telling us … that early detection is saving women’s lives, which it absolutely is for some women, yet it is also leading many others to drastically over treat something that years ago would never have even been detected or caused any concerns in a woman’s life.
“While some breast cancers are very aggressive, most are slow growing, taking a decade or more to become detectable. Many of these slowest growing cancers would never become a problem for women and would not be found were it not for the mammograms we are entreated to get.”
Karuna Jagger - Executive Director, Breast Cancer Action