Because I would love to read someone's blow-by-blow experience to normalize the fear of breast cancer treatment, and I process through writing, I present to you my life since February 14, 2022.
14 February Valentine’s Day, at the Princess Grace Hospital Breast Clinic getting a breast exam. What’s more romantic than boobs? Worst part, the mammogram, is over.
Spoke too soon. After the scheduled ultra sound, they did another, special ultra sound, then a biopsy, which hurt worse than the mammogram, but I survived. Looks like a small lump- may have to be -ectomied? How can they know this soon?
19 February I’m either a future cancer survivor or am worried to the point of petrified about nothing. Why would the clinic do this? Scare me that it’s cancer? They did this to me ten years ago, and so did the clinic in Portland,Oregon--they had me suffering scanxiety for a week before I got the news that all was well.
21 February Met with the oncologist-plastic surgeon, "Mr"--as surgeons are called here in the UK--Patani. I indeed will need a lumpectomy to remove a pea-sized Invasive Ductal Carcinoma from lefty. We wait the results of hormone and protein testing to determine if I will need chemotherapy before surgery. All this feels unreal and I’m emotionally exhausted.
House of Cards is my escape.
Will I be able to wear a tiny bikini after the surgery? Oh good, because I never could before.
Man, if being in your 50’s doesn’t make you stop giving AF about anything, having breast cancer will.
I have, like, best case breast cancer. Tiny. Early. Non-scary kind. Forgiving work situation. Insurance. Great care. My friend Gina says I always have good bad luck.
But I’m dreading surgery, I've never had general anesthesia before and I'm so weepy about it. And I have even more apprehension about the pre-surgery Covid PCR test! I have PCR PDST from the overly-aggressive German test center in Muscat.
March 1 Clinic called to tell me that before the surgery they will only need a rapid Covid test—if I’ve had Covid. No fair! Talk about performance penalization!
March 3 The pea-sized cancer is HERS negative, which means it’s not the kind that calls for pre-surgery chemo.
It IS the kind that is reactive to both estrogen and progesterone, as is all breast tissue. It's ERPR positive for those who speak breast cancer, not a language I ever wanted to learn.
[ After surgery and radiation, they want me to take a hormone suppressant, an "aromatase inhibitor" or AI. I've been doing Hormone Replacement Therapy (which ups my ERPR) for eight years and it has saved my teeth, skin, hair, bones, heart, and most importantly, my sanity. I've tried to go off, but I get really depressed within a matter of days. I will try to cut down. The benefit of the AI (the hormone suppressant) gives me an extra 2% chance of being alive in ten years, from 85% to 87%.
Would you rather live longer with dentures, visual migraines, broken bones, and feel like everything is bad? Will I regret that decision when I have to have a double mastectomy later if the cancer comes back in either boob? Or one cell escapes and metastasizes somewhere else? Vigilance will be key. I just don't think I can wean myself all the way off the HRT and then suppress what little estrogen I still produce. If my kids were small and I was 35 years old I might feel differently? Right now I think: Let me live beyond Peter retiring in four years to so I can go for a few hikes in Big Sur with my kids for a while. What a hellish decision. Quality of life vs burden of symptoms.
It sounds like an easy decision until you hear the AI horror stories--sort of like Mefloquin stories for Malaria. ]
This is a really good tool developed by the NHS to evaluate the statistical outcomes of early invasive breast cancer treatments.
March 1 Peter had a work trip to Brussels, so I got to go. Riding the Eurostar, pawing through goods at a flea market, and meeting up with a long-time friend was a great therapeutic distraction.
Now I’m back home from Brussels and crying. I don’t want surgery. So, I’m sitting on the little sofa by the big windows that open onto the back garden and the magnolia tree gloriously in bloom with two dogs on my lap.
March 7 Since the cancer is small and nearly invisible, the next step is to locate it via ultrasound and mark it so the surgeon can locate it with a beeper. Wish I would have known that being microchipped wouldn’t hurt at all.
March 8 Coffee, the first Wordle I had a nearly impossible time finishing (v i v i d) and Covid, blood, and heart tests today in prep for Friday.
Covid test was like the rapid test, not horrible at all. The blood stick was harder—I had to be poked twice. I couldn’t get an Uber so I rode the bus, which I don’t know why but I sort of enjoy. I can see better out of the bus, I kind of get car sick in the Ubers. It’s nice to be with people in the coziness of the bus, but I don’t have to talk to anyone.
In three days, I will be practicing some radical self care by having the poisonous pea removed. I really don’t like this cancer mindset, it takes over your identity. I’m trying to think of this process as taking tender care of myself.
March 9 Surgery Eve Eve. The last night before the last night. I will wake up and drink self-care coffee and check on my friends and Zelensky in Kyiv. Vacuum and mop. Maybe do a little work. Wash my hair. Admire the magnolia tree in our yard and "check into" Princess Grace Hospital around noon for my four o'clock surgery. I will spend the night.
March 11 It’s a chilly morning, I feel nauseated and Peter picks a bus route I don’t like. Whatever. I was the one who didn't want to go by car.
First stop is a clinic where I get a shot in the nipple with a radioactive isotope that will trail along to the sentinel lymph nodes that will be removed during surgery. They will be biopsied to see if the poisonous pea has polluted the area. The syringe is brought into the room in a lead box. The injection is a little poke and I wish I’d known not to be worried, it was quick, with a tiny needle, and totally tolerable.
Peter has to Covid test himself in the hospital to be allowed onto the surgery floor with me. I “check into” my room. Lots of visits from the doc, the anesthesiologist, the nursing care person, the people taking meal orders, the physio person. It’s all keeping me distracted, but my palms are sweating anyway. My surgery is scheduled for 4:00. I don’t like laying around in a bathrobe, it makes me feel like I’m supposed to be sick. I postpone changing into the hospital gown for as long as possible. Gown, robe, stupid cheesecloth underwear, compression socks, non-slip socks over those.
The nurse walked me, with sweaty palms, to the surgical room where I was invited to lie down on a narrow table. Patani, in surgeon mode, used a wand to locate the microchip, which chirped in a sure-minded way and made him the happiest I've ever seen him. After a short, but really good conversation about artistic talent vs learning, the handsome anesthesiologist asked me “What’s your drink?” giving the situation a party-chatter vibe. Awaiting my answer, he poked a needle into the back of my hand. “Old vine Zinfandel,” I told him. “Here’s two glasses!”he said pushing the medication into the needle. What’s more friendly than that? The ceiling rotated slightly.
One and half hour surgery to remove a 9 mm lump, knit the breast tissue back together, and remove two lymph nodes.
Post-surgery feels like one of those painful transcontinental flights. All I want to do is sleep and they have raised the window blinds and mistakenly think I want to eat an omelet.
I spent the evening propped up in bed, strapped into my black neoprene vest, pouring chamomile tea from a cute tea pot and texting my friends. Great mantra from Dani: Float on your blessings.
March 12 My boob looks okay, not too scary, and Patani was happy. If he’s happy, I’m happy. The scar is around the nipple, he didn’t have to slice into my boob at all, and didn’t have to inject any dye to find the lymph nodes, turning me into a partial Smurf. The locator marker was easy to find and right where the lumpy bruise was, he said that made his job ten times easier. So, yay?
Now a tortured week-long wait to see if the lymph nodes are clear. If they are, I swerve around chemotherapy. Patani keeps finding ways to threaten chemo, but if the lymph nodes are clear, chemo is indicated based on tumor size. Mine was smaller than 2 cm, so I’m hoping this is just his strategy of posing routes I don’t want to take to up-sell less odious options.
Another Patani masterpiece:
March 13 Day two post-op. Took the bra off for the first time to take a partially submerged bubble bath and it feels like my skin is all that’s holding my boob together. Like a little puppy it needs to be held all the time, in a wet-suit vest, for six weeks. Sometime after mid-April I should be able to be a braless hippy again.
March 14 Righty is looking bruised and smaller, but otherwise okay. I’m glad Patani didn’t have to cut into the sides at all. Unintended consequence: not sleeping on my side is killing my back. Found a little pillow of the kids' I still had and sewed a new organic cotton cover to aid side-sleeping. It's the little things that bring comfort.
My friends have been so wonderful! I didn't realize how much a card, flowers, a package of bath products, or even a message could mean when you are undergoing something so alien.
I am more bruised from the biopsy and chip placement than the surgery. One cm tumor meant they took out a 3 cm ball of tissue. Now it looks like I have one D boob and one C boob, or one C and one B? unless the newly smaller boob is swollen—doesn’t seem like it though.
Looking back at “before” photos, one boob was always bigger than the other one! Now they’ve traded, the smaller is now the bigger one. Or maybe now they are the same? If I never noticed, neither will anyone else.
March 17 I vacuumed using mostly my left side and gave myself permission to do a less-then-perfect job. A week ago I was so anxious about the surgery. It was really quite painless and I needn’t have been so worked up about that part of the process. Pain is now about a two, and I haven’t taken Advil (which I prefer over Tylenol) in a couple days. I’m back in my neoprene vest, but I bought a pretty bra that will do what it needs to do, and makes me feel less like a patient.
Waiting to hear about the lymph node results has been the hardest part of the recovery.
I’m going to say recovering from the surgery is a bit like jet lag, you think you’re fine and then it hits you again. I’m so lucky to have a comfortable sofa and a magnolia tree to admire.
March 23 Went to Patani's office for mostly good-ish news: lymph nodes were clear.
However. Lab tests showed the cancer area was bigger than he thought during the surgery. Although they got all the cancers out --surprise!-- there was a mixed bag of cancers in there, including a 4 mm lobular cancer they didn't know about. They also didn’t get quite enough clean tissue around some edges to 100% promise that no new cancers will grow in that soil. Only one in ten lumpectomies have to be re-marginalized, but I'm the one. So, I have to go back for a clean up in a couple weeks. Now that I had surgery I’m not as scared, and it will be with the same team. It doesn’t hurt and I recovery quickly. Onward!
The surprise easter egg of lobular cancer isn't detectable by mammogram or ultrasound, so now I have to have an MRI with contrast dye to see if there is more.
And if there is more, I will consider myself lucky that they found the lobular bit which forced an ultrasound. Early detection is what leads to good outcomes.
March 28 MRI day. The technician can’t find a vein on the inside of my arm, so he pokes the needle into the back of my hand which hurts but at least he does it the first time. With my extra small lady-like veins, it’s a good thing I’m not a drug addict. Afterwards, I sit in a little room and sweat with anxiety. Change out of my clothes into scrub pants and a hospital gown. A week and half later I still have a yellow-green bruise on the back of my hand.
I lay on my stomach with my boobs in a mold and tolerate, repeatedly and in a cycle, a jackhammer, the open-doors signal of the Parisian metro, and loud banging that says “Bab! Bab! Bab!” Or “Bear! Bear! Bear!" Half way through the ordeal they inject a radioactive dye into my hand that is cool and dissipates after a moment. Back to the duck and cover drill sounds, right on the edge of the tolerable volume threshold. I try to recount the last episode of House of Cards.
Regarding lobular cancer, more than half the time there are more that one area, almost half the time in both breasts. I don’t expect that the one they extracted was the only one. What to do with the more that might be found will be the decision. Early detection is key, but I’m worried.
April 1 Pretty good news on the MRI, left boob remains pristine! Yay! Right boob, the OG boob, has something that lit up. Next up is another ultrasound and biopsy to figure out what it is that's lighting up. But they have to go back in to redo the first surgery there anyway, and the lymph nodes are clear on the right side so if its a cancer, it hasn’t spread. So, overall good news. I can breathe.
It’s hard to undergo so many unpleasant treatments. My poor boob was swollen and now it was punch-biopsied three more times this morning, and marked with a tiny wire so they can locate the area again. Rotating Tylenol and Advil, one boob is twice the size of the other now. Really hurts. And Patani called to say if they don’t find cancer, I’ll have to have an MRI-guided biopsy to be sure. Why didn’t they just go to the MRI biopsy directly? I want to cry. Want this over.
April 4 Biopsied area is a 9mm-ish area of a rare, lobular cancer, only--10% of all breast cancers are this kind and they don’t screen for it. It’s the kind my sister had. You don’t see it on mammogram or ultrasound, which is how my sister’s got to stage four before they discovered it.
Note to self: if there is a one in ten chance, I'll be the one.
There’s no way this cancer would’ve been found if I hadn’t had the other easy-to-find IDC pea.
Have to have another marker placed. The anesthetic doesn't go that deep, but the microchip does, and the whole area is chewed up inside. This procedure hurt, and caused more painful bruising.
Surgery number two next Friday. Update soon.