This is Breast Cancer Awareness Month, in case you havenít noticed that the entire country has turned pink for the occasion. But I am, unfortunately, a little more aware of breast cancer than I had been hoping.
Itís been fourteen years since I first had breast cancer, followed by two lumpectomies, radiation and chemotherapy. None of it was particularly pleasant, but I went through it all thinking that since the tumors were small, and nothing was found in the lymph nodes, I would be making sure to avoid a recurrence. I passed the five-year mark without one, and there was a temptation to think of myself cured. When I passed the ten-year mark, I had nearly forgotten about breast cancer except for self-exams and a yearly mammogram. But once youíve had it, and faced your own mortality, there is a little part of you that expects every mammogram to show another tumor.
So when I felt that something had changed in my right breast, the one where my cancer occurred the first time around, I checked the calendar, saw that I was due, and called Winona Health to arrange for my mammogram.
The receptionist at the Womenís Imaging Department was very thorough. ďHave you felt any changes in the breast?Ē she asked. I said yes, it seemed denser and heavier, though with so much scar tissue itís hard to tell. And it hurt. She scheduled me for the procedure within a couple of days, and mentioned that they might want to do an ultrasound as well.
The Winona Health volunteer when I got there showed me to the dressing room, and pointed out the coffee and cookies. I never turn down a cookie! When the mammogram technician came to get me she was cheerful and gentle and the procedure seemed to take no time at all. Back to the waiting room and shortly the ultrasound technician came to get me. She had a student from Winona State University working with her that day, did I mind? No.
The ultra sound experience was uneventful, and everyone was wonderful. Then Dr. Matt Hayes came in to look at the results and take a look at me as well. There was definitely a tumor of some sort. So he numbed up my breast and did a series of needle biopsies. The results would be ready the next day after three.
When I called the next day, I wasnít surprised ó disappointed and angry, yes ó when he said the pathology report had come back Positive ( a strange word for bad news) and it indicated that I do indeed have a cancer recurrence in the right breast. This time, there are two different kinds of breast cancer ó ductal, which I had last time, and lobular, a new little surprise. Dr. Hayes told my usual physician, Dr. Wilfahrt, whose nurse, Donna, set me up at Mayo Clinic for a series of appointments prior to surgery and treatment. She also set me up with all the records I would need. I called Gundersen Clinic for the records from fourteen years ago to be sent to Mayo, too.
Three days of consultations later, I am waiting for a surgery date, to be worked out with the general surgeon, and the plastic surgeon. But in the meantime, there are so many decisions to make that I find myself antsy and prone to headaches.
There is no chance of saving the right breast, but it wasnít exactly picture perfect, anyhow, and with no sensation, off it goes. But the left breast, what about that? Lobular carcinoma in situ, which I have in the right breast, is likely to appear in the other breast as well, although it is slow to spread to other sites in the body. So, do I want to wait around for it to appear in the left breast? That was actually an easier question to answer than I thought it would be.
No, I donít want to go through this again, so I have opted for a double mastectomy. Every doctor I have talked with has said, ďThatís probably a wise decision,Ē although even with a mastectomy, there could always be microscopic breast tissue present, and there are no 100% guarantees. But Iíll take 90% or even 80%.
Mastectomy. Double mastectomies. Now what? I called several friends who had been through it. They all opted for reconstruction, which I prefer to call rebuilding. Off to see the plastic surgeon. We also talked with Johnís brother Lee, who is a plastic surgeon in Rhode Island. At Mayo, we first had an education session with Darlene, originally from Kellogg, who was wonderful. By the time we finished with her, we were confident we knew what to expect of the various options.
On to meet the plastic surgeon. This has been the first time since my mammogram that Iíve had to take off my clothes. He is a pleasant man with a Ukrainian accent, slightly balding. I have to show him my stomach, which is where the skin and fat will come from to build me new breasts.
No, he tells me, I am too thin. Too thin? When in my entire lifetime have I been too thin? Why do I have that drawer of ďshapewearĒ? But he grabs my tummy flab and says, ďThis will not make two breasts!Ē It will, however, make one breast, which is good, because my radiated breast is not a good candidate for an implant. We talk for an hour. Finally, we decide to use up my tummy fat (Iím eating! Iím eating! I donít want to have to buy new bras!) for one breast, and to put an implant in the other.
I am anxious. Now that I know it is there, I want all this cancer out of me asap! But my odds are good for survival, so I am glad of that. Iím not quite ready to check out. In fact I am not ready at all!
Iíll keep you posted. My poor son-in-law of nine years says I was due for surgery anyway. As long as heís known me I have had some sort of surgery every two years! Here we go again.