Breakfast Before Screening — Horn and Iris

Horn put the toast between them and sat down. The appointment letter lay beside the butter, safely out of reach of the knife. There was time to eat before leaving for screening.

Iris closed the laptop and moved a mug off the leaflet.

“There's a term in here I wanted to check,” Horn said. “Ductal carcinoma in situ. What does ‘in situ’ actually mean?”

“‘In place,’” Iris said. “I read that part twice. DCIS is a non-invasive breast cancer. The abnormal cells are inside the milk ducts. They haven't broken through the duct wall into the surrounding breast tissue.”

“So confined to the ducts. Not the same as an invasive cancer.”

“Right. But not something to dismiss, either. If it were found, a specialist would explain what it meant and discuss care. The phrase alone wouldn't tell us every detail.”

Horn spread butter into a corner of the toast. “And it can be there without a lump?”

“Yes. It often doesn't cause symptoms. A mammogram can show tiny calcium deposits—microcalcifications—that nobody could feel by hand. Some patterns can be a reason to look more closely.”

“Calcium deposits don't automatically mean cancer, though.”

“No. Screening looks for changes. It doesn't turn every change into a diagnosis. More imaging, and sometimes a biopsy, may be needed to work out what a finding is.”

Horn glanced at the letter, then finished the toast. “All right. Today is the screening appointment. Not a result we've already decided on.”

“Exactly,” Iris said. “Want the last slice?”

“Leave it for when I get back.”

Iris covered the plate while Horn rinsed the breakfast knife and picked up the letter.