TheBanyanTree: Episode almost over

[Janice Money]

There are any number of rare diseases that students will hear about and then
forget about.  I suppose the ones they are more likely to remember are the
ones that are treatable but can be quickly fatal if not diagnosed.  You
might see them only once in your whole career but making the pick and
organising the fix is a thing to feel mightily chuffed about.  I've never
done it but my husband has.  He felt very pleased with himself to have
picked Addison's disease in a US serviceman who was in town for some reason
or other.  The US serviceman and his family were pleased too and sent a
thank you card.

 

Paget's disease of the breast is rare.  I think I remembered it because the
images of it in my old dermatology text were so ugly and because, the texts
said, it is almost always associated with ductal carcinoma in situ which, if
you're going to have a carcinoma, is a pretty good type of carcinoma to
have.  In any case, when I noticed the changes to my own breast, and even
though they didn't look anywhere near as ugly as those old text book images,
Paget's disease was the first thing I thought of and, having thought of
that, I was not particularly concerned.  

 

However, I did want to see if there were any more images of Paget's on the
internet so I could either decide that it was Paget's or rule that out.
What I found was both reassuring and not reassuring.  I found not so ugly
images that made me think, yes, I probably do have Paget's disease.  I also
found the accompanying text which said that ductal carcinoma in situ can
become invasive.  That's when I decided it was time for a mammogram and that
led to the whole treatment show starting down the road.

 

The local go-to fellow for breast surgery thought it wasn't Paget's disease.
Maybe it was eczema.  Since I couldn't see why I should have unilateral
eczema I asked him to take a biopsy when he did the lumpectomy and he
agreed.  The biopsy showed that I was right and he was wrong.  But there you
are.  It's rare.  He was probably thinking my bosom should look like those
ugly text book pictures and, being a busy man, doesn't have the time I have
to go googling.  

 

Just over a week ago I had a second surgery.  Again, all the margins were
clear and there was no evidence of invasion.  The unbearable itch of wound
healing can be tamed with oral Loratidine and Lanacaine cream.  In 4 - 6
weeks I start radiotherapy and after that my chances of recurrence are only
about 1% so, for all practical purposes, I have nothing to worry about.
Lucky me again.

 

Janice