#119: Cancer Language

We are learning a new language now
and it’s called breast cancer,
pouring over the pathology
report, trying to make sense
of her malignant neoplasm, 
surrounded by subcutaneous
fat with features
consistent with healing
a surgical incision.

The biopsy shows
features consistent with
the previous biopsy,
ductal carcinoma in situ,
lobular intraepithelial
neoplasia, and fibrocystic
changes. 4.0 centimeters
from medial to lateral,
2.5 centimeters from
anterior to posterior,
1.7 centimeters from
superior to inferior,
right laterality, 3:00.
But here’s something
we understand: no
invasive carcinoma in
this sample–but then
there’s this ductal
carcinoma in situ
making its second
appearance.  Grade 3,
9 millimeters of DCIS.
Necrosis present and focal.
More good news,
we think: lymphovascular
invasion, not identified;
nipple, not applicable;
skin, uninvolved;
skeletal muscle, not applicable;
surgical margins, (part B).

Finally, we like the sound
of the following, only some
of which is included in
the gross description:
Estrogen receptor, 100% strong;
Progesterone receptor, 100% strong;
Proliferation rate, intermediate.
Will to live, 100% strong;
Hope over despair, 100% strong;
Gratitude, 100% strong;
Health, normal, except for
the feeling that a part of her
is missing, and the
anticipation of follow-up
treatments for an illness
for which she feels not
a single symptom, the
unspoken, unwritten
cancer language,
against which, we find
love, 100% strong,
to be the most effective
medecine.