Breast Cancer – Think you might have it? What happens now?

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Have you missed a mammogram or are ignoring a lump in your boob because you think you might have breast cancer?  Early diagnosis of breast cancer is very, very good!  I found that out in 2013 when I got to take a trip on the “breast cancer cruise.”  My diagnosis was accidental but the outcome was everything I prayed for.

If you are procrastinating, I hope this blow-by-blow story of my cancer trip makes you call or email your doctor right now.  Consider this your Breast Cancer Month obligation to everyone who loves and depends on you, including yourself.  And if you find out that you’ve joined this sisterhood, here are some steps to take immediately to help you stay strong in mind and body while you take care of this detour.

Breast cancer hits like a drive-by shooting

This Halloween, I’ll be cancer free for four years.   Of any eight women, one of us will get breast cancer.  Finding out you could have cancer when you don’t feel sick is scary, something you can’t imagine.   It’s a little like being the victim of a random drive-by shooting.  You hear the shots but surely you weren’t hit.

And if you are hit, the damage can vary from a bullet hole in the garage door to a senseless death. Mine was more like the garage door damage. Just a slight dent from a lumpectomy and some discoloration from radiation.  A Tamoxifen or Arimidex pill will now be part of my evening ritual for five to ten years.  I’ve had few side effects and little pain so I am definitely not complaining.

A diligent doctor raised the concern

I’m also very lucky considering I had unknowingly skipped a year on my annual mammogram. Doctor H. discovered that while she was giving me a pre-trip checkup a few days before I was leaving on a week-long canoe trip on the US-Canadian boundary waters (BWCA). You can find that trip link below.

I had originally scheduled this appointment to take care of an arthritic left pointer finger.  Didn’t want that to flare up after days of paddling and portaging. Dr. H. made me squeeze in my mammo before I left for vacation.

A day later, my husband and I left for Ely, Minnesota to spend Labor Day week 2013 without beds, showers, toilets, dry clothes, or wine. My biggest fear was learning the protocol for pooping in the woods.  Can you believe it?  I found  a YouTube tutorial on how to use a boundary waters latrine. Bring toilet paper and always wear your bear whistle – got it.  I didn’t even give a thought to the mammo.

No premonition or warning

We spent six glorious days on the water, in the wilderness, and without cell phones. When we paddled back up to the outfitter’s dock, a worker handed me the cold beer I’d be dreaming about for days.   I was out of the habit of checking my phone and didn’t think to even look at it.  We celebrated our canoe adventure survival with a crew dinner at the Grand Ely Lodge.

While at Grand Ely Lodge, my phone mated with a cell tower and started downloading all the messages I missed during the days on the water. Dr. H had a couple of messages.  Here in Minnesota, sitting at a long table with my canoe crew, freshly showered, fed and slightly buzzed, I refused to give up my last night here to any disturbing news from back home.  It’s easier to ignore the messy news and hope it goes away.  

Questionable mammograms common – don’t ignore

Also, many of us have been through a call-back from the doctor for a questionable mammogram.   If my doctor had gotten through to me on the first call, I would not have been too worried. About twenty years ago, the doctor found some calcifications on my results so for a couple of years, I saw an oncologist every six months. Calcifications can be cancer markers. Mine were scattered throughout both breasts but they never changed locations, size or appeared to be massing together for criminal purposes. I thought that maybe these very common, pepper-like grains were causing my clinic to do another check as I got older.

Five additional messages followed with increasing urgency from clinicians and nurses trying to schedule another look. I’m glad my clinic was so persistent so I didn’t even think about blowing off the ultrasound scan they wanted to do. With cancer, always follow through and check it out.  I now know how critically important that is.

Beyond a mammogram

The morning after the day I got back home, I was sitting in the frigid radiology waiting room, with about six other women who were trying to stay warm.  We were each wearing the skimpy gown that all women know “opens to the front.” Don’t suffer in silence.  Ask for a blanket.  They usually give you those warmed-up ones!

Around me, I could hear the other women talking about “their cancer” as if were an unruly pet, like a troublesome cat who regularly missed the litter box. Some were in the middle of treatment, others had been newly diagnosed and were waiting to see how they would tackle their malignancy. One lovely black woman in her late 60’s was down the road with her treatment. I do not remember what she said to the woman next to her but that woman radiated a calmness that confused me since she HAD CANCER!  

Make friends in the waiting rooms

I would have saved myself some anxiety if I’d talked to those ladies more.  There is a sisterhood of all women who have cancer or are facing a possible diagnosis.  I learned that later.  Had I reached out, they would have wrapped me in an embrace even warmer than that blanket. It is easier to face this process with friends, even if you just made those friends minutes ago.

I heard back from the clinic quickly. They needed another test, an ultrasound assisted biopsy. Also, I’d see an oncologist surgeon on the same day just in case. I realized I could be living out my last cancer-free days.  The uncertainty was disorienting, a little like a forced move to a new neighborhood.  Weird, huh?

Meeting the surgeon

The surgeon saw me around 10 o’clock in the morning. He put the first ultrasound images on the lightbox and explained that the jagged edges of a pea-sized mass had caught the radiologist’s attention when she reviewed my original mammogram.  Those jagged edges can be what you sometimes feel in a lump in your breast.  Feels a little like incompletely popped popcorn or something that just doesn’t feel right.  Any lumps like these should be checked out immediately

Breast cancer treatment options

 “So if it is cancer, what happens then?” I asked. “It’s small so prognosis could be really good. If it has not spread into the lymph nodes, then a lumpectomy and some chemo or radiation as insurance against a re-occurrence. You wouldn’t be slowed down much during treatment,” he said.

“And if there’s cancer in my lymph glands?” I asked. “Then probably a mastectomy. More extensive surgery so there would be some trauma to some of your muscles in your upper arm. You would probably have to modify your routine for a couple of months. Again, it is small and it if is cancer, we have it early. You’ll have a great prognosis,” he assured me.

The upside of a mastectomy

This is a much later note  – I found out after my diagnosis that another friend was dealing with breast cancer.  She had to have a mastectomy but got a tummy tuck when surgeons used her belly skin to rebuild her boob.  She could hardly wait to show me her new flat tummy.  That’s optimism!

Surrounding myself with nature helped

It was now about 10:45 in the morning. My biopsy was scheduled for around 1p so I had two hours to wait. My house was only 15 minutes from the clinic but I did not want to wait there.  In looking back, it’s not uncommon to get some strange inclinations as we contemplate a threat like cancer. 

My instinct was to drive into a gentrifying neighborhood that surrounds the clinic. West University is upscale but homey with some new homes and lots of old trees. The remaining houses from the 1930’s are either extensively remodeled or inhabited by old people who don’t want to leave their lifelong home.  Some seniors don’t have much left after their high property taxes to update but many just ceased to care all that much about appearances.  That aged wisdom seemed a good setting to await my biopsy.

Saying “I think I have cancer” out loud

There are a couple of shady pocket parks sprinkled throughout West U where landscape and construction workers take a break at noon. It was a little early for their lunch visits so I took over a bench, enjoyed the fall weather and called the office. I was working on a project with K. and wanted to check in.

I like working with K., her style and her directness, but we were just getting to know each other. Before we got down to business, she asked offhandedly how my doctor appointment went. “I think I’ve got cancer,” I said and I started to cry. I had not said it aloud to anyone until right then and it felt funny claiming “my cancer”. Kath did not know what to say.  And at that moment, I think I knew I had breast cancer and was just waiting for confirmation.

Ultrasound Assisted Biopsy 

At 1 o’clock, I was back on the ultrasound table. Dr. R explained that an ultrasound assisted biopsy grabs a piece of the tumor with a spring-loaded needle. She gave me a warning right before the needle took each bite. It is a loud, sharp report like a little gun and each bite jars you slightly. A smidge uncomfortable but not bad. A hard shell shielded part of the mass and the doctor had to have a second go at a couple of areas but it was all over quickly.

The surgeon tried to reach me in the early afternoon on Wednesday. I missed his first two calls. I called back as soon as I returned to the office and saw the 713-442 prefix which meant a clinic call.

Breast Cancer confirmed

Thankfully, the surgeon got right to it. “I’m sorry but the mass is malignant. Stage one but invasive so we should proceed with treatment quickly. There is some good news. It doesn’t look like there is anything to worry about with the lymph nodes.”

This is the real shock of the diagnosis. That you expect to be so devastated when cancer was finally confirmed.  Instead a little of the calmness I had felt surrounding that woman in the radiology waiting room started to seep in. Sure, I cried, first alone and then every time I had to tell someone close that I now had cancer.   It was hard to witness their disbelief and equally hard to see the fear that, if it was happening to me, it could happen to them. 

Get yourself checked now!

I’m glad my friends took that knowledge to heart.  For me, I had my diagnosis, which was a step towards treatment and my recovery. And my cancer was caught early through that accidental mammogram and my vigilant doctor. 

Thinking you might have breast cancer is scary, but having it and not getting diagnosed early enough is so much worse.  I hope this glimpse into the clinical procedures makes you less frightened so you’ll put on your big girl panties and find out quickly.  If it turns out you are going to spend some time on the Breast Cancer Cruise, my post on how my month-long  “spa vacation” at MD Anderson Cancer Center went!