What happened, in summary

Kathleen first lived with years of imaging follow-up for a small shadow in her left breast, then developed bloody nipple discharge. Biopsies and imaging did not clearly show invasive cancer, but DCIS became concerning enough that mastectomy was recommended. She was diagnosed with DCIS in 2021, and after mastectomy pathology in 2022, she learned there was also invasive lobular breast cancer. The invasive component was very small, about 2 mm, but it was a shock because lobular cancer can grow in a diffuse pattern that is hard to detect on imaging. Kathleen’s main treatment was surgery. She did not need chemotherapy, and she said tamoxifen or aromatase inhibitors such as letrozole were not required, although aromatase inhibitors were discussed with a specialist. After the first mastectomy, unclear margins and calcifications meant another surgery was needed. She also chose removal of the other breast for peace of mind. A major part of her recovery involved fighting to be left flat rather than having unwanted extra skin or reconstruction; she later had a wild rose tattoo over her scars and became active in the flat community. As of April 2025, Kathleen was in survivorship, continuing surveillance with alternating ultrasound and MRI, using tumor-marker blood tests by preference, and helping others understand flat closure and advocacy after breast cancer.