THE PATHOLOGY REPORT

My appointment was so informal that it didn't even require me putting on one of those ever so lovely gowns. I hopped up on the table, exposed myself and my suture strip was quickly removed. As I readied myself to head out for last minute Christmas shopping my doctor asked me to sit down so that she could talk with me about the results of my pathology report. I actually asked her to repeat what she had just asked me to do, thinking it made no sense at all to sit down for what would only take mere seconds. I think that was the first moment I realized that my "simple, no big-deal, I've had 'em before lump" may actually be more than that.

She began by telling me how surprised she was with the pathology report. In fact, so surprised that she said she repeated my name and identification number to the lab several times, thinking their must be some confusion with the patient and the report but the lab assured her that mine was the only breast tissue taken that day. Still, in disbelief and doubt herself, she told me how she then re-reviewed my two previous mammograms and all of the pathology reports from my previous lumpectomies, as well as the reduction I had.

As a side not, but yet perhaps important, I underwent a breast reduction in September of 2006. That in itself is a story and not one that I am writing about here! - ;0) It is significant though because of the pre- and post-surgery tests conducted with the reduction (mammogram and biopsy of the removed tissue). She studied all of the available information on that as well and nowhere in my rather extensive breast tissue medical history was there any indication of cancerous cells.

Still, up to that very moment she had not told me the actual finding. She merely kept telling me how surprised and how unsure she personally was. It hit me then, that it wasn't WHAT she was telling me, it was what she was avoiding telling me. Amongst what seemed like rantings to me at that point I realized that she was about to follow all of that up with some very bad, disbelieving, shocking news.

She told me that the pathology report came back showing cancerous cells present. I don't think she ever said the actual phrase, "you have breast cancer". It was almost as if she was emphasizing that the LAB said it, not her. She followed that news up by again by telling me just how surprised she was. She may have been more surprised than me at that very moment because I think I was just numb. Her bedise manner was wonderful. She was very sweet and concerned and she even seemed as if she felt sorry for me the entire time she was telling to me. Now that I reflect back on those very long few minutes I think that is how she treated me from the minute she removed my suture strip. As if her entire being softened in an effort to take the edge off of the blow she was about to deliver.

Perhaps because she was trying to be positive, because Christmas was only a few days away, or maybe simply because she didn't want to be the one to tell me I had cancer, she told me how she struggled with whether or not to tell me that day. She said that it "didn't fit" and that she had spoken with a colleague who said maybe the biopsy result was an error, that mistakes had been known to happen before, particularly with that company. She said her deciding factor was that she would be on leave starting the day after Christmas and that in mid January she was transferring to another hospital and didn't want me to be told by a doctor who had never seen me and me wonder why she hadn't. She tried to reassure me and console me by telling me not to let the news ruin my holidays or the Christmas trip I had planned.

I thanked her as I left her office and other than that, I can't tell you what I thought or felt. I think maybe it was nothing at all.

As is my usual course of action when it comes to all things, I got busy. I had Christmas shopping to do (or pretend to be doing - I don't think I bought a thing that day). I spent the next few hours by myself - trying to comprehend what I had just been told. I honestly wasn't sure if I had been told I had breast cancer or that I had cancer but maybe, even probably it was a mistake and I didn't actually have cancer. For as positive as I wanted to think, I knew what she told me was, UNLESS I later heard otherwise, I was just diagnosed with breast cancer.

LUMPECTOMY & BIOPSY

A lumpectomy was scheduled for November, which I had to cancel and reschedule. Honestly, after cancelling the first surgery I considered not even rescheduling it, simply because I didn't "feel like" going through any more medical appointments and treatments, and after all. the holiday season was quickly approaching and my social calendar would surely have little room for recouperating. Call it what you will, intuition, gut instincts, my guardian angel, but something inside of me KNEW that if this was the one time I didn't get it removed it would turn out to be something much more.

I underwent a simple lumpectomy in mid December. I came out of surgery feeling very good, and very drugged, but alert enough to ask my doctor how everything went. She said I did fine, the surgery went well and that the lump was able to be removed very easily. As standard protocol the tissue would be sent to pathology and biopsied but it appeared to be exactly what she initially thought and that I could relax with nothing to worry about.

And so I did. I went home, a bit sore, healed well and returned on the 21st of December to have my sutures removed. VERY unexpectedly I also received the news of the pathology report.

DISCOVERY

Here's the story of my breast cancer.

I found a lump in my left breast in October during a self breast exam. It was small, pea-like, very defined and felt very close to the surface of my skin. Throughout the past years I have had a few "lumps" which, once removed, were discovered to be fibroid adenomas - benign tumors (sort of a solid fatty growth), NOT related to cancer or the potential of later development of. Although in a sense this particular one did feel different to me, I honestly was not overly concerned but regardless, a lump is not something that should be overlooked and so I scheduled and appointment with my primary care Dr.

I was seen within a couple of weeks at which time she scheduled me for a mammogram and referred me to general surgery. The detection of the lump made her visibly nervous but I attributed this to her being a relatively young doctor. She was so involved with my care that she actually scheduled the MRI for me as well as call the surgical clinic to get me in as a priority. I think it alarmed me more that she went out of her way and called me on my cell to let me know of the appointments far more than the detection of the lump.

My appointment with the general surgeon was prior to that for the mammogram. After reviewing my medical history (and believe me, my ta-ta's have history!) and examining the lump she assured me with all confidence that it was a mere subcutaneous (or surface) "skin lesion" and that I had nothing to be concerned about. In fact, she was so confident that she told me I need not have it removed but have the mammogram anyway.

Shortly thereafter I had my mammogram. Although by touch the lump was unmistakably there, even visually to a point, the mammogram showed no sign of it whatsoever. Based on the findings, or lack thereof, the radiologist then did an ultrasound of the area which showed a 1 centimeter solid mass that she too, like the general surgeon, was convinced was a skin lesion and need not be removed. Much more than concerned, I was confused as to how the lump could be felt as well as be seen on the ultrasound but not visible on the mammogram. Believing that mammograms are the most accurate detection for breast cancer I was not too alarmed, having every reason to believe that the specialists were correct in their diagnosis. (I have since found out that although mammograms are the best detection for early breast cancer, it still only detects 80% of cancerous masses. That doesn't mean don't get them - it means monthly self-exams and annual clinical exams are all components of early detection.)

I followed up with the general surgeon once she received the radiologist's report. Once again, even more convinced after having seen the mammogram, my doctor assured me that it was completely safe to leave the lump in my breast but I just didn't feel completely comfortable with that.