Remembering Before I Forget: The Beginning

I have breast cancer.

I found this out when my husband Chris felt a lump in my breast (thank God, thank God, I have a husband who still touches my breasts – otherwise who knows when I would have found it? I admit, red-facedly, that I do not do regular “self breast exams” as all we women have been instructed to do. I simply relied on my yearly Ob/Gyn appointments and yearly mammograms).

Puzzled, Chris asked, “has this always been here?” No. It hadn’t. It felt like a small dried pea about a half an inch below the surface of my right breast. At the time, I wasn’t that worried; after all, I’d heard dozens of stories from sisters or girlfriends who had benign cysts or dense tissue or other non-cancerous things in their breasts. It’s probably nothing, I thought. I had gotten mammograms every year since age 35 or 40 (I’m 51 now), and in fact had had a clean mammogram just this past April.

The end of October brought an ocean of tests: a diagnostic mammogram, an ultrasound, a needle biopsy of my breast and lymph node, an MRI. After the ultrasound, the radiologist called the “mass” in my breast “concerning” and said my right lymph node was “plump” (this is not a pleasant term in the world of radiation oncology).  She said she was pretty sure I had cancer.

The needle biopsy was awful, painful, and I cried throughout – not just because of the pain but also because 1) I was pretty sure by then I had cancer; and 2) I made the mistake of listening on my iPod to a playlist my son, Jonah (in his freshman year at Brown) had made me for my birthday – full of songs rife with meaning, songs that made me miss him. I was an emotional train wreck – plus it really effing hurt when the needle was digging around trying to find the lymph nodes under my arm.

My first appointment with the breast cancer surgeon, Dr. Leah Kelley, was on October 23rd. This was when she told me and Chris she was “80% sure” (pending the pathology report) that I had breast cancer, and that it may or may not have spread to my lymph nodes. I cried, of course, but was beyond gratified to discover that Dr. Kelley was a hugger, a real mensch. She did not hesitate to put her arms around me as I wept, sputtering, “I just need you to promise me that I won’t leave my three boys without a mother.”

She promised. She said that breast cancer is very curable, especially in a young(ish), relatively healthy woman such as myself. She said we needed to wait for the results of the pathology report to get more information on exactly what we were dealing with, but in the meantime she wanted me to schedule an MRI to look at the tissue in both breasts – to be sure the tumor was only on one side.

October 31: Halloween (insert lame joke here) was the day we met with Dr. Kelley and got the definitive news: I did have breast cancer for sure. The preliminary biopsy results showed a “low-grade, mucinous” (which is good) cancer, one which was not aggressive (Dr. Kelley called it “lazy” or slow-growing – also good). The lymph node at this point was “suspicious” but inconclusive, according to the initial biopsy result.

Dr. Kelley’s best guess was that it was a stage 2A and that the mass in the right breast was about 4 cm long by about 1 cm wide. Because I’m not a person with big breasts or with a lot of extra weight on me, and because of the relatively large size of the tumor, it did not make sense in Dr. Kelley’s judgment to consider a lumpectomy – the cosmetic result would not end up being a desirable one.

She recommended mastectomy with a sentinel node biopsy – which means cutting out part of the lymph node and doing a biopsy during the surgery to see if that’s cancerous too. If the lymph node showed “involvement” at the time of surgery, Dr. Kelley would just keep on cutting out more and more lymph nodes until she was confident I had “clean margins.”

Next post: Processing the News You Hope You’ll Never Get, with apologies to Dr. Kübler-Ross