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First mammogram leads to breast cancer diagnosis

justine wettschreck/Daily Globe Doreen DeWall of Okabena was diagnosed with breast cancer in December 2009.

OKABENA -- At a suggestion from her doctor, Doreen DeWall scheduled an appointment for her first mammogram when she was 41 years old, just so there would be baseline results in the years to come. Going along with that suggestion may have saved her life.

The doctor who performed the biopsy told the nurse, "In the past, we would never have found this."

On Dec. 10, 2009, Doreen was diagnosed with ductal carcinoma in situ (DCIS), the most common type of non-invasive breast cancer. When the doctor called to tell her the results of the biopsy, Doreen immediately handed the phone to her husband Matt.

"I went numb, and I knew I'd never be able to repeat any of the information back," she admitted.

The youngest of 11 children, there was no history of breast cancer in her family. At the time she was diagnosed, her own four children ranged in age from that of a first-year college student to a fourth-grader. Her first concern when the cancer diagnosis sunk in was for her children.

"I think that's what every mother thinks about," Doreen said. "I think their major concern was not the surgeries, but that I would change -- become a different person."

Matt was her rock and her caregiver, she said, but even after almost two years since her diagnosis, she still sees the effect it had on him.

"My husband had to endure more than anyone realizes," she explained. "His own fears, seeing me go through those trials and caring for me was tough."

When she was first diagnosed, she assumed she'd have a lumpectomy, but after an MRI her surgeon's recommendation was for a mastectomy. She opted for a bilateral mastectomy -- a surgery which removes both breasts completely -- then had a reconstructive procedure that utilized tissue, fat and skin from her abdomen.

Because her lymph nodes did not test positive and the pathology testing showed the cancer was non-invasive, she did not need to undergo chemotherapy or radiation treatment. About a year after her surgery, she developed a weakness in the supportive structure of her stomach wall -- a common problem for those who have TRAM flap reconstruction -- and had another surgery to repair that issue.

The decisions to have the bilateral mastectomy and reconstructive surgery were not easily made. Those decisions are very individual and personal to each woman, she said.

"I had to wait a month after diagnosis to have the surgery, which was very difficult," she explained.

Attending a plethora of doctor appointments at Sanford Health in Sioux Falls, S.D., and trying to get a handle on things was made easier by her Breast Oncology Care Coordinator, who sat in on doctor appointments and spoke with Doreen on other occasions.

"She was a godsend," Doreen said. "I cannot imagine how confused I would have been without her."

A breast cancer survivor herself, the coordinator answered questions, discussed procedures and helped to ease fears.

Afterward, getting back to "normal" took some time. Doreen and her family coped with her cancer by concentrating on their spirituality and faith in God.

"I focused on that when I didn't know what else to do," she said. "We feel that's what got us through it."

The experience changed her, she said, because she learned she wasn't the one in control of her life.

"You kind of let that go and take every appointment one step at a time, knowing that He is in control," she said.

Having learned how a coordinator -- someone to talk to who understood what she was going through -- could help her, Doreen's advice for anyone who has been diagnosed with breast cancer is to talk to women who have experienced the diagnosis.

"It doesn't take long for someone to reach out to you or someone else to put you in a survivor's path. They are valuable as they come to terms with what is happening," she said. "It can be difficult to talk about. I struggle."

But it's not that she doesn't want to talk or help.

"Learning that someone else will have to go through it brings it all to light again," she said. "You feel terrible, and wish they didn't have to do it."

That didn't stop Doreen from reaching out to another person she knows who was diagnosed. She hoped that what she shared would help that person cope, and let her know she wasn't alone.

"You really need another woman's perspective -- another female to talk to who has been down that road," she explained.

Doreen also admitted to feelings of guilt, because her experience "wasn't the worst experience." Her cancer was detected early, her prognosis was hopeful and she didn't have to go through chemo or radiation. She knows, she said, that she was fortunate.

"Surgically I went through a lot, but that doesn't mean I completely understand what all women diagnosed go through," she said.

Since her own diagnosis, Doreen has become part of a cancer study and also participates in the Biking for Breast Cancer event in Sioux Falls to raise awareness. Research is important, she believes.

"There are a lot of people working on treatment and cures, focused on finding the cause and stopping it," she explained. "The fact is, there are different cancers that grow at different rates. There are women that do everything right and get aggressive cancers, and women like me who get cancers that are thankfully found early due to mammograms.

"I feel that a cure could come in my lifetime. That's my hope," she said. "I'm hoping my daughter, my future daughters-in-law and my granddaughters never have to go through this."

In an email to relatives at the one-year anniversary of her diagnosis, Doreen made a list of what cancer had given her in that year.

"Cancer gave me a fresh start to try and become a better person," she wrote. "Cancer gave me an inner strength and faith in God's plan for me... Cancer gave me freedom, a chance to forget about material things and learn to care about what truly matters in this life... Cancer gave me cheerleaders in my community, friends, family and even strangers, encouraging me and letting me know I was loved... Cancer gave me a new-found beauty to be who I am always, scars and all... Cancer gave me a devoted husband who cared for me so lovingly, seeing my wounds, and in those moments I recognized those vows we spoke to each other on our wedding day -- in sickness and in health... Cancer stripped me of my fears, death and dying, and in return gave me an incredible peace... Cancer gave me a new vision of the future, full of things to see, accomplish and do."

She thanked those who had loved her, cried with her, fed her family when she couldn't or gave her strength when she needed it.

These days, Doreen said she is more diligent about eating cancer-fighting foods, but as time passes, she doesn't think about the disease coming back into her life as much.

"My biggest hope is that my grandchildren will wonder about cancer of the past," she said, "because a cure will have been found."