Finding and diagnosing the SLAB

On Saturday, 17 December 2016, I found a lump in my right breast. It would have been easy to miss, as it resides in the lower part inside the soft, fatty, tissue. It doesn’t hurt at all or produce any sort of soreness. It was pure luck to find it.

I have never really bothered with breast self-examinations. Every once in a while throughout my adult life I’d think of it and have a bit of a feel around, but never regularly. This was not because I didn’t think it was important or useful. It just doesn’t enter my mind on a regular basis. I always thought it would be difficult to spot a lump, with breasts feeling lumpy anyway, but this one was unmistakable.

I went to the GP on the morning of the 19th. He confirmed the presence of the lump and referred me to the “Breast One Stop” clinic, which I attended on Friday, 30th December. The GP described what would happen there and kept underlining the fact that most lumps (9 of 10) are harmless. He said they needed to do that to rule out cancer. He never once looked me in the eye, which made me a little paranoid.

During the 13-day wait, I kept feeling the lump and I read too much online. I went from thinking that the lump was nothing, to that it was actually getting smaller, to even feeling guilty that I would be wasting everyone’s time at the clinic.  I wanted to believe it was a cyst but in my heart I didn’t. I read that a cyst moves easily under your finger – this did not. I read that a cyst is regular/smooth and round (maybe oval, I forget now). This was not. To make things worse, when I lifted my arm a dimple would appear on my breast and this is one of the signs of breast cancer.

On the day, I had to recognize that I am not a doctor, I have only ever felt one suspicious lump in my life and that there are other things that the lump could be. Why should I have cancer when 9 out of 10 lumps are benign? I thought about those odds when I arrived at the hospital and looked around the room. It seemed that lots of women had the same sort of Christmas I did and I couldn’t help thinking that a few of us were going to get the short straw on the day. I worried that would include me.

I was seen pretty quickly and things moved fast. First I met a nurse who explained how things would work on the day and did a physical examination and then sent me off for a mammogram and ultrasound. The mammogram was straightforward and it wasn’t nearly as uncomfortable as I expected it to be. Afterwards I had to wait to find out if they wanted more images, which they didn’t, and then they sent me in for an ultrasound.

I could see the screen during the ultrasound, which would normally interest me quite a lot, but it was the ultrasonographer’s face I stayed fixed on. There was something about her concentration, the number of pictures she took of the lump and the way she went over it again and again that was troubling.  I asked if it might be a cyst to which she gave me a quick and decisive “no.”  They took two core needle biopsies then asked if I had any questions. I asked if it was cancer and she told the wall somewhere over my head that it was indeterminate. Right after that she told the wall that the good news was it hadn’t spread and the lymph nodes looked clear. So, I formed the idea that there was a flip side to that good news which was cancer.

I realized that I might be leaping to conclusions and tried to stay positive and focus on the word “indeterminate.” It’s easy to read into someone’s words and create invalid assumptions – a bit like a game of telephone. I went back out to the waiting room where I was told to wait to be called in for my results. The room was full when I went back out there and it slowly emptied and I was the last person to be seen.  I noticed people who had been in the small waiting room with me for mammograms and ultrasounds get called in a leave quickly. I was worried about how much time it was taking, because to me it suggested the results needed a discussion between a few people or they were getting me a person. You know, the person who helps you deal with bad news. I couldn’t tell you about the former, but the latter was certainly true.

The nurse called me in and we walked down the hallway and as I stepped into the room, there was the extra person whose name was Jackie. The first nurse, the one I had met in the morning, gave me the results in a slow drip. I couldn’t tell you what she said exactly. My mind focussed on what she was building up to saying but not yet saying. She finally said it and then kept talking about it and I really don’t know what she said anymore. I was mostly having an internal struggle not to cry. So, I brought attention to the fact that I was being told that I had breast cancer with no biopsy results. ‘Isn’t there a possibility that it comes back benign?’ This is a question I found myself repeating a lot and all it did was produce a look of pity and the same response.

Jackie took me into some sort of room that tries to be calming and homey to speak further, which actually increased my level of anxiety. Instead of the setting giving me comfort it added to the gravity of the situation. She said a lot of words and things like multidisciplinary team, treatment plan, surgery, mastectomy, reconstruction, radiation, chemo, workplace rights and other things. They all floated in the air. At some point, I said that I couldn’t talk about it anymore and left with an appointment card.

Tomorrow at 4pm, I am meeting the head of the breast surgery team to get my treatment plan, which will be based on the biopsy results. Jackie sent me off with a booklet written by Breast Cancer Care, which took about 48 hours for me to open and stare at but not read.  I ended up reading it on the Breast Cancer Care website on my iPhone, as I found the bitesize pieces of information a small screen offers much easier to deal with.

Since then I have had an on-going internal struggle. There seem to be several versions of myself who take turns controlling my brain. I go from being totally ok, objective and rational to being an emotional wreck. When I am the former, these are the thoughts:

  • This sucks but at least it was caught early.
  • It’s just the one lump and they can see that it hasn’t spread anywhere else – a little surgery and I’ll be all good!
  • Radiation sucks but maybe I can get away without chemo.

There is another personality within me that purely emotional. I’ll leave those thoughts out. They only make me feel weak-minded and underline why you should not read about your possible health conditions online.

What’s weird is that I can be this objective positive person and go about my day, and then suddenly some sort of grief hits me. No warning, no slow shift in thinking or mood. I am fine, and then I am absolutely not fine with no warning.

The best thing that happened to me this weekend, apart from the company of a very good friend, has been the task of assembling flat pack shelves – 2 sets. Took my mind right off things.

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