“The biopsy’s here.”
I am in the reception area of the radiology department at the local hospital. It is December 23, and I am the biopsy.
This morning, I was here for a mammogram, which was a follow up to my original mammogram from a week ago, which showed a mass in my left breast. Mammogram #2 was followed by an ultrasound, which revealed a “thickening” in the tissue. When the radiologist mentioned the difficulty of scheduling a biopsy over the holidays, I said, “Can we do it now?”
“Now” wasn’t possible, but four hours later was, so here I sit, the biopsy-in-waiting, mulling over the depersonalizing quality of being referred to as a procedure rather than a person. I decide that given the way patients and procedures can get mixed up at a hospital, perhaps it’s just as well to be known as “the biopsy.”
The radiologist’s nurse, Cynthia, retrieves me from the waiting room. The procedure itself is thoroughly explained, first by Cynthia and again by the radiologist, Dr. Johnson, and I sign the permission form.
Dr. Johnson performs a second ultrasound to pinpoint the mass, which measures one centimeter. I watch on the black-and-white screen.
“There it is,” he says.
“What’s that next to it?” I ask.
“I was just wondering the same thing.”
It is a second mass, half a centimeter.
“We’ll get tissue from both of them,” he says.
My breast is numbed with lidocaine. He’s good with a needle, Dr. Johnson. I don’t even feel the lidocaine injection, although on the screen, I watch the tiny needle enter my body. The doctor makes a small incision, which I don’t feel, to allow the insertion of the biopsy needle, which is considerably larger than the lidocaine needle.
A needle biopsy sounds like a delicate procedure. It isn’t. The smaller mass is biopsied first. The needle is inserted into the mass, and Dr. Johnson counts to three, and there is a sound like that of an ear-piercing gun as the needle grabs a tissue sample.
Two samples are taken from the smaller mass. Three samples are taken from the larger mass. Twice during the procedure, which takes about an hour, I feel not just pressure but actual pain, and Dr. Johnson gives me two more injections of lidocaine. The larger mass is tough to penetrate.
“The tissue is like gristle,” Cynthia tells me.
I have gristly breasts. Just what every woman wants to hear. Mind you, they don’t look gristly. They look rather nice.
“It probably is cancer,” Dr. Johnson says. “I would be more surprised if it isn’t than if it is.”
I appreciate his directness, and I tell him so.
“Call me tomorrow afternoon,” he says. “If the pathology results are in, I’ll tell you.”
Cynthia puts a Band-Aid on the tiny incision and prepares an ice pack while I put my sweater back on in the adjoining bathroom. She instructs me to take Tylenol, use the ice pack, and change the Band-Aid in the morning after my shower (I am to discover the hard way that Band-Aid Tough Strips are not optimal for applying to the breast—or more accurately, for removing from the breast). Cynthia says I have a great attitude. I wonder if this is the first time I’ll be told that, or the only time.
Christmas Eve. I call Dr. Johnson, who tells me I have “interesting results.” The pathologist at the hospital is “unwilling to say it’s cancer” because the cells don’t have “typical pathology for cancer.” The slides are being sent to a larger hospital, 90 miles to the south, for additional staining. Leave it to me to have results that are “interesting.”
December 30. I see my primary care physician. She tells me the results aren’t in yet. I am to call her Friday, January 2.
Two major holidays, one weekend, and several weekdays since the biopsy, I find out I have breast cancer.
One mass is carcinoma in situ, or Stage 0, nothing to worry about so long as it’s excised. The second mass is “infiltrating ductile carcinoma with tubular features.” Tubular? Totally. My composite grade is 1. On a scale of 1-3, 1 is good. I’ll take it.
I am calmer than I would have thought I’d be, although since it’s a Friday, I agree with the doctor that a precautionary prescription for Klonopin is probably a good idea. What if I have a meltdown over the weekend? I’m not prone to meltdowns, but then, I’ve never been diagnosed with cancer before. What if I completely freak out?
I don’t. I have a good weekend. I email friends on Friday afternoon, and when I check my email on Saturday, there’s a flood of good wishes in my inbox. I told everyone in my group email that I’m not ready to talk about it voice-to-voice. A couple of people call, anyway. The boyfriend fields the calls.
I feel feisty and pro-active, but I am not panicking. An MRI has been scheduled for later this month. An appointment with a surgeon is two days after that. I’m checking out a second surgeon. It’s good to have options. Both surgeons are breasts specialists, female, and highly recommended.
Over the years, I’ve given a lot of thought to what I’d do if I ever were diagnosed with breast cancer. I have fibrous cysts in both breasts (remember, the girls look good, but they’re gristly), which makes the development of breast cancer more likely, and for that reason, I’ve had an annual mammogram since I was in my early 30s. For me, the answer has always been clear: a double mastectomy, not only to treat the cancer that exists, but also to prevent any recurrence.
One friend suggested that it’s too radical a choice, unless it’s absolutely necessary. “Too radical” and “absolutely necessary,” I believe, are in the eye of the person who has breast cancer. I have yet to consult either surgeon, but unless she can convince me that it’s unnecessary—and I will take a lot of convincing—that’s my treatment of choice.
Nearly a week after my diagnosis, I’m out of the shell-shocked phase and in the research phase. I believe in being prepared, although a friend who has just gone through two years of treatment for breast cancer has cautioned me that too much information can be frightening. So, I will try to be aware of my limits as I surf the Mayo Clinic and American Cancer Society websites, browse through books, and list questions for the doctors.
You know what scares me right now? It isn’t the thought of dying, because it appears this has been caught early, and I’m hopeful that the MRI will show that the cancer has not metastasized. It isn’t the thought of losing my breasts, since reconstructive surgery can usually be done at the same time as the mastectomy. It isn’t even the thought of losing my hair, should I have to undergo chemo.
It’s the idea that I might have to wear a bad wig.
I am determined to stay positive—and, if chemo is in the cards, to find a good wig.