1: A Lump

In late March of 2015, I had a regular check-up with my primary care physician. Over the previous few months, I had noticed some changes in my left breast, and I mentioned this at my appointment. The physician said that based on my age (36 years old) and lack of relevant family history and other risk factors, breast exams are not a standard part of the check-up, but since I had noticed changes he would perform a clinical (i.e., tactile) breast exam. There was a medical student who had been observing during my appointment, and after the physician performed the breast exam, the medical student repeated it. I was assured that nothing seemed out of the ordinary and that fibrotic changes are normal when women are in their 30s. I left the doctor's office and went on with my life.

Over the next several months, I continued to notice changes and some pain, but Dr. Google said that breast pain is almost never associated with cancer, and Dr. Real-Person had said I was just experiencing normal, age-appropriate changes in the fibrotic tissues of the breast. My significant other (SO) noticed changes, too, but again, I just didn't think there was anything to be concerned about. In early November, my SO voiced a real concern, and I agreed to see someone about it. 

The next morning, I went to work. Part of my job includes work in a mammography department of a large hospital, so I went up there and pulled one of the technologists aside. I explained the situation and asked for advice. Worst case scenario, in my mind, was that there was a cyst. Worst, WORST scenario was that the cyst had to be drained rather than going away on its own. The mammography department does walk-in screening exams, so she recommended that since I was there, we just do a mammogram. 

About 15 minutes later, I was on the receiving end of the mammography machine. Something was visible on the mammogram, but the technologist said it looked like a cyst. I still wasn't concerned. The radiologist, a colleague of mine, recommended I have a follow-up ultrasound. At this point, I called my SO (we work together, too)  just to give him an update. He headed over to keep me company. I still wasn't concerned.

About 15 minutes after having my first mammogram, the radiologist was doing the ultrasound. When I saw the ultrasound image, I could tell it wasn't a cyst. Okay, I thought. It's not a cyst, but is probably just a benign lesion. The radiologist recommended that they biopsy the lesion and said they could fit me in an hour later. My SO and I went and had a bite to eat and then returned to the mammography department for the biopsy.

Sitting in that room waiting to have the biopsy done was the first time it really sank in that I might be sick. The radiologist did the biopsy, taking samples from the lesion and two axillary lymph nodes that the ultrasound had revealed as being enlarged. Towards the end of the procedure, I asked the radiologist what his feeling was about this. He said, "You want my honest opinion?" "Yes," I said. 

"I'm 99% sure it's cancer. That will most likely mean chemotherapy, followed by surgery, and then radiation therapy."

There it was. In the course of a few hours, I went from walking into the mammography department thinking the "worst case scenario" was that I had a cyst that had to be drained, to being told by a respected colleague that I most likely had breast cancer, and not the kind that was easily treated, but the kind that meant multiple treatments. 

My first thought was my kids. My second thought was that I didn't know whether it was cancer, and that I would have to wait for the biopsy results before really knowing anything definitive. So I told no one while we waited for the biopsy results to come back the next afternoon.