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Journey (Blog)

The Diagnosis You Don’t Want to Hear: It’s Breast Cancer

I Missed One Mammogram

For several years, I had been very good at getting mammograms and ultrasounds on a regular basis. In the midst of health insurance confusion, I missed a mammogram — just one.

I was off insurance for six months before going in for a mammogram. I have fibrocystic breast disease that can make it difficult to exam and spot abnormalities. As usual the imaging service sent me a note suggesting that an ultrasound be done due to my dense breast tissue. An ultrasound is usually ordered but this needs a referral from the primary care physician or gynecologist. During the time off insurance, I hadn’t paid a visit to the GYN, who was the one that made sure I always had both a mammogram and ultrasound.

Then I felt a lump similar to one I had in the other breast several years ago, that had been removed and turned out to be benign. I mentioned the new lump to my primary care doctor. He examined the area and I mentioned that I had not had the usual ultrasound. He didn’t order an ultrasound, but later handed me a note scribbled on a piece of paper and told me to find an oncologist that was part of my insurance plan. I sent him an email with a list of names and numbers, heard nothing back, and got busy with daily life.

I was becoming increasingly concerned about that doctor. Let’s just say that he was approaching retirement age and seemed to be forgetting which tests he had ordered and what prescription drugs I was on. What made matters worse, he kept files the old-fashioned way - with notes scribbled on the inside of a folder that held pages of my medical reports. When he couldn’t find the last mammogram results among the jumble of papers, I knew he needed to be replaced. I decided to find a new doctor, periodically examining the breast and noticing no change.

Several months had passed and it was time to renew my health insurance plan. I made a mistake when enrolling on the health insurance marketplace and ended up without a plan again, this time at least for only three months. In the meantime, I finally found a new doctor who fortunately accepted my new plan, and instantly sent me in for an ultrasound and made a referral for me to see a surgical oncologist. Upon physical examination, the oncologist thought that the lump was probably benign. It felt like a marble and was mobile just like the other lump I had discovered in the right breast. I was cautiously optimistic.

Typically a biopsy would have been done, but just like the lump found in the right breast, it was prominent enough to remove. I had a cruise and a family reunion coming up and asked if the surgery could wait. Since it would take time to get approval for the surgery anyway, the doctor said it was fine and surgery was scheduled to happen the next month, the week following the reunion.

Meanwhile life went on — in a downward spiral. Back in April I had lost one of my outlets that provided a major source of my income, in May found out that a friend was a lot sicker than she first revealed. In July I had surgery to remove the lump. Two days after my surgery I found out my friend had died from ovarian cancer. Five days later, the surgeon called. Hearing his voice on the phone, I knew it couldn’t be good news. The pathology report showed that the tumor had malignant cells. I was told to set up an appointment and the surgeon suggested that I bring someone with me.

Deer in the Headlights

The next day my sister and I were in the doctor’s office. At some point the doctor stopped talking and glanced at the notepad and pen in my hand. I’m the type who might jot down notes during a simple phone conversation with a friend. And here I was with notepad and pen, and hadn’t jotted down a single word. He was speaking and I was just staring at him, nodding my head. That, he said, is why he wanted me to bring someone with me. My sister was beside me, diligently writing down everything he said.

“So this is a malignant tumor?” He knew what I was really asking. He nodded. “It’s cancer.”

That day was the first time I uttered the words breast cancer. As if malignant cells or malignant tumor made it any less dire or frightening. The doctor explained that I would need further surgery to remove tissue that had surrounded the tumor and lymph nodes to make sure the cancer had not spread. In addition, my ultrasound had found something on the right breast as well. I was sent in for a biopsy. Luckily nothing was found.

The second surgery was done the following month. All of the tumor was taken out, the cancer had not spread to the lymph nodes, but he said I would still need chemotherapy and radiation treatment. I was confused. If all of the cancer was gone, why would I need chemo? The surgeon explained that they wanted to make sure that no microscopic cancer cells had escaped and were circulating somewhere in my body.

Another Cautionary Tale

I was beating myself up for not going in for a mammogram and ultrasound sooner, insurance or not. But I’m not alone when it comes to waiting. After telling certain family and friends about my diagnosis, I’d hear “I’ve been meaning to get a mammogram” or “I’d better go in for a mammogram,” but the next time I spoke with them, they still hadn’t set up appointments.

We put things off to our own detriment. My late friend, who had a distrust for doctors, prescription drugs and the medical industry as a whole, held off seeing a doctor even when the stomach issues she was having worsened and she began losing weight. It was only after she collapsed and was forced to go into the emergency room that the malady was checked out. She nearly died that day. Still, it was too late and I miss her dearly. I don’t want to have to lose another loved one before their time.

You know how they say, if you see something, say something? When it comes to your health, when you feel something, do something.  Read More 
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