My Diagnosis.
My Diagnosis.
I have triple positive, stage 1A breast cancer with a tumor grade 3.
My two tumors are under 2cm and have not spread to my lymph nodes. But they rank a 3 (out of 1-3) on the aggressiveness scale. Triple positive breast cancer means that my cancer cells have receptors for Estrogen, Progesterone, and have high levels of the HER2 protein. This cancer responds well to treatment but requires chemotherapy, surgery, infusions for 1 year and hormone blocking drugs for five or more years after.
I learned this information on Tuesday, April 23rd at an appointment with my breast surgeon while we discussed my treatment and next steps. But let’s back up a little bit, four weeks to be exact.
On March 26th I was putting lotion on my upper chest and as my hand slide down over the top of my left breast I felt a hardened area about the width of a few fingers.
It was just a bit different than normal, but not a focused marble-like lump as I had been taught to look for. I am not a careful self-checker when it comes to breast exams, and I have never been a worrier or someone who jumps to conclusions. But the Friday before I had seen a new acupuncturist and as we were reviewing my general health, we chatted about breast health and she mentioned that breast cancers were more commonly found in the “upper quadrant” which I had never heard before. That phrase popped up in my head right as I brushed over this hardened area in the upper part of my left breast and I picked up my phone to send a text to my OBGYN.
My doctor has been a friend of mine for years (even before I chose her as my OB) and I generally try to avoid abusing the privilege of having her cell phone number, but I fired off a text “Hey, feeling some breast tissue that feels lump-ish…do I just call for an appointment?” She wrote back right away and told me to say I felt a lump, and they’d get me scheduled. The office got me in the next day and when she felt the area she said “yep, let’s go ahead and get a mammogram and ultrasound scheduled”. I felt oddly good about the whole thing. I was being proactive, we were going to get more information, and SURELY there could be nothing seriously wrong with me as a 37-year-old healthy woman. I was exercising weekly, ate a healthy diet, and had absolutely zero symptoms of being “sick”.
That weekend we went on a family trip and my next appointment was scheduled for Wednesday, April 3rd.
I remember on that vacation feeling for the lump a few times and telling my husband it was a little strange but since I had only just noticed it, I was hopeful it would possibly change or go away with my cycle. By the time I got to my mammogram I was eager for more information. They got several images in my mammogram and then brought me back in for more (another round of awkward positions to stand in with your skin pinched between plates). The ultrasound tech went back and forth over the area capturing image after image and went to speak with the radiologist. I had another round of imaging done years before after some breast pain in another area so I knew what to expect, and I also knew that it shouldn’t take two hours. By then it was 5:30pm and the entire office was empty as the radiologist came in to discuss what they found. I remember a few key phrases from this conversation: “what I’m concerned about here are the broken borders” and “we’ll need to get a biopsy of this next week” and “if it is cancer, the treatment they have now is really effective”.
My brain short circuited at the casual dropping of the c-word.
He started to describe the biopsy process and at that moment tears started streaming down my cheeks. He kindly put his hand on mine and asked if there was someone who could pick me up. I assured him I was okay and that the biopsy procedure scared me a bit and then called my husband as I was walking out to update him.
My doctor helped get me in quickly with an excellent breast surgeon and we had a biopsy scheduled a week later April 11th. The process for me was not my favorite, and they took a biopsy both areas of concern on the left and another small cyst-like area in my right breast just to be safe. An ultrasound guided breast biopsy requires some local anesthetic, a small scalpel incision, and then a core-needle that the doctor guides through your tissue to the area. The needle “punches” out pieces of tissue (five from each area) to be sent to pathology and they place a small metal marker at the spot for future procedures. My husband held my hand and kept me calm while I fought off a queasy feeling (I’m really not great with needles or blood).
After my biopsy all there was to do was wait and we knew it could take up to a week.
I told close friends what was going on and a few people reassured me that they “knew someone who had to do a biopsy, and everything was fine”. Even google will tell you that only 20% of biopsy results some back malignant. But in my gut, it felt like something was wrong.
While waiting on the biopsy information I received a letter that informed me that the results of my mammogram were “highly suggestive of malignancy” and encouraged me to get a biopsy to follow up with those results (clearly an automated requirement from the office after my mammogram). If you google that phrase it will tell you that the findings have a “95% or higher chance of being cancer”. I opened that letter in our kitchen on a Friday night and showed it to my husband and we stared at each other with shock. It wasn’t the formal diagnosis, but it changed the feeling of a possibility into almost certainty. That was the night I let it sink in that I likely had breast cancer and cried into my pillow wondering “what kind? how bad is it? when did it start? what will happen to me? what will happen to my family if I’m not here?” I tried to get through the weekend and work week without thinking about the impending diagnosis and still my friends and family assured me it would probably be fine and prayed for positive results.
We had a birthday trip planned to Vegas with some good friends to see Garth Brooks and we were set to leave on Thursday, April 18th. On Wednesday the 17th (after checking my phone obsessively for days and calling more than once to ask about my results), I saw my doctor’s number light up my phone after work. I can tell you exactly what I was wearing and that I had broccoli in my hands that I was debating steaming or roasting for dinner, because that moment will live frozen in time forever as the marker between before and after my diagnosis.
I walked out in our back yard to take the call, and she confirmed what I felt in my gut that it was cancer.
I took a breath but didn’t cry (yet) and thanked her for the call, and she added “and you will need chemotherapy”. I gasped for air. I had kept myself from going down the research rabbit hole of “what ifs” and had no idea how common it is to require chemo for breast cancer (of all stages) so this was the part that shocked me the most. I pulled myself together through tears and asked if there was any other information that I needed about the type, the treatment, the stage, and she said “no, you’ll come into my office next week and you will find out everything you need to know. But for now, go and enjoy your trip as much as you can.” My husband pulled into the driveway just as I hung up and we locked eyes through his car window as I shook my head back and forth and cried. He knew the news before getting out of the car.
We cried and hugged and called my parents and sister and my best friends to tell them, but I wanted to go on this trip we had planned and wanted to wait to tell our girls until coming back and getting more information. So, I wiped away the tears, put away the broccoli, ordered takeout and sat with the news. Somehow, I truly was able to compartmentalize the diagnosis and truly enjoy the two days with our friends. We ate, we shopped, we saw THE MOST amazing Garth Brooks show, and I couldn’t be more thankful that we had that trip planned and went.
When we got home, we decided to share the news with our girls which was probably one of the hardest moments of this entire journey. I told them I had something I wanted to tell them, and my 8-year-old blurted out “You’re pregnant!” (which was the comic relief we all needed). When they heard the word cancer, they both burst into crying fits and hugged us so tight. It felt so scary to introduce this fear into their lives, but I assured them again and again that this cancer is treatable (even though I knew nothing specific about my diagnosis) and I was going to be okay, which I needed to hear as much as they did.
The next day the nurse called and asked if I’d like to move my port placement surgery up to that Wednesday, April 24th (my 38th birthday). It still amazes me that 4 weeks and 1 day after I first felt this lump, I would be diagnosed with cancer heading into a surgery in preparation for my first chemo treatment.
This was chapter 1 of my Breast Cancer journey, the chapter where my entire world was flipped upside down in a matter of weeks.
The chapter that shows you just how important it is to check your breasts for changes, to call your doctor, to make the appointment and to trust your gut. And never to believe that you’re “too young and healthy” to have breast cancer.
This is also the chapter where the love poured in.
My 38th birthday was spent recovering from surgery, but it was also spent receiving flowers, cards, balloons, gifts, texts, calls, prayers and well wishes from friends, family, strangers and breast cancer fighters and survivors. And that positivity and support lifted me and carried me right into my first treatment. I felt so encouraged and loved that I didn’t get stuck in fear or trapped in the “what ifs”. I believed when it came to treatment and conquering cancer that I could “do this” and I had so much support for the days ahead when it would sometimes feel like I couldn’t.
