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July - in the shower, I feel a pea-shaped lump above my nipple - I don't remember feeling that before. GP says not to worry, probably a cyst. Come back if it's still there after my holiday.

Back from holiday, lump still there and sat in the waiting room at the breast clinic. Consultant says probably a cyst but best to check. Two mammograms and a scan later - the consultant is surprised at the results showing multi focal calcification. Suggests a biopsy – I’m the last patient left in the waiting room at the hospital. Results to follow next week.

Nervous wait over the weekend but not really considering it would be the unthinkable. 

News

The consulting room is small and full - two doctors and two nurses looking sympathetic. That's not encouraging. "We've found an unexpected diagnosis of DCIS - that is the earliest form of breast cancer. I'm afraid we're now at the start of a process...". I feel distinctly wobbly and the butterflies in my stomach that have been intermittently flying over the last week now start flapping in earnest and don't stop in the near future. The second biopsy is a mammogram-guided biopsy to ensure the tissue samples include the calcification spots highlighted previously. This involves an uncomfortable 30 minutes with my breast clamped in the X-ray plates and a number of tissue samples being taken. Unwisely, I look down and there is a lot of blood on the glass. The radiographer hastily wipes it up.

I wait for the results of my second biopsy a week later - there are even more people in the room than last time...not good. The consultant confirms that the DCIS is in at least two quadrants of my breast and a mastectomy is the recommended next step. My husband reaches for my hand. I feel slightly detached like it's happening to someone else. The consultant looks concernedly at me. He says "The prognosis is very good - I'm glad we're talking to you now and not in 18 months’ time though, as we would be having a very different conversation". This is the theme that stays with me throughout my experience - the sense of a near miss, what could have been.

Back in the consulting room my immediate reaction is, "I haven't got time for this. I'm busy - my son, my husband and family, work, friends, house, plans, exercise. My priorities are 1. I need to live, 2. Recover quickly and 3. Worry about how I look afterwards". 

The Plan

The next meeting with the consultant is less intimidating, with no other medical staff. He takes time to explain the procedure and reinforces that the cosmetic outcome should be good with an immediate reconstruction. I am encouraged by some of the photos he shows me, although less by others. My priorities come to the fore again as we discuss treatment options - we agree that a simple implant would give me the quickest recovery time and would meet my top two priorities but would also give a good cosmetic result, if less natural. The opportunity to ask the many questions I have is helpful but I am focused predominantly on the sentinel node biopsy the consultant refers to. I will have a five-day wait after the mastectomy to find out if the cancer is invasive and has spread out of the ducts. This would be a whole new ball game with chemo and/or radiotherapy and other stuff that I really don't want to consider. 

We agree a date for my operation in the following fortnight and even manage a joke or two about whether the years of expensive organic food were wasted. I'm amazed that the procedure is so quick and only requires an overnight stay. The consultant suggests a fortnight off work would be advisable - that sounds positive if slightly bizarre for what I had assumed would be a major procedure. I'm encouraged.

My husband asks whether there are support groups we should consider to help us cope. The consultant is in tune with my thought processes when he replies that there are some excellent networks but aimed at sufferers undergoing more extensive and life changing treatment. As my treatment is mostly preventive I may not wish to be part of that world. I selfishly agree and hope that he is right. 

Telling

I have a date. At this point I have to tell my parents and son. I dread telling my mum, my sister having died five years previously; I don't want her to have to deal with this. I massage the consultant's words, "I have cancer, but the operation should clear it. We've caught it early". My parents sound shocked, my son looks nonplussed, "Cancer is deadly isn't it?". "It can be, but in this case it's not", I say firmly. He seems reassured and proceeds to show me his latest karate move.

I tell my client at work, now that I can be more precise about the time I will need off.  Telling other people suddenly makes it all feel very real and the butterflies in my stomach are flapping wildly again and my hands are shaking each time I have to tell another person. 

My breast care nurse, Jan, calls. She manages to balance being matter of fact and practical with warmth and understanding - that must only come after many years’ experience of dealing with patients. She asks what I have told my son - I describe the words I used and she reassures me that these were spot on. I feel relieved; my mum had queried whether I should have mentioned the C word and Jan's reassurance is important.

Operation 1

My mum arrives the day before my operation, emergency food supplies in hand. She is thankfully keeping it together too - this is better for me. I want to keep it together, retain some semblance of control when my body is letting me down.  I'm finding dark humour is helpful. My husband and I have already drily discussed the silver lining of my stress-induced weight loss and opportunity to choose the size of my new breasts. I make a mental note to hide all foot pumps. I also wonder if I should continue watching Breaking Bad on TV or if Walt's cancer will be cured?

The day of my operation. I'm asked to arrive early to visit the nuclear medicine department to enable the sentinel lymph node to be targeted during the operation. There is some confusion over my appointment and I use this as an excuse to focus on poor hospital admin as a distraction. I then wait on my bed in my hospital room for the consultant. He looks perky and relaxed - I feel sweaty. He draws on me with a pen whilst regaling me with stories of surgery carried out on the wrong side. Mental note to repeat 'right hand side' as often as I can as I go under the anaesthetic. The operation is not until 4pm. My husband and I spend the afternoon watching Scrubs on Sky TV - I wonder if this is sensible before an operation but find I am strangely calm and it is a good distraction. 

Finally the time comes and I am wheeled down to the operating theatre - I kiss my husband goodbye. The nurse sweetly offers to stay with me and we discuss schools in the area whilst the anaesthetist prepares. I manage to remind them it's on the right hand side once before I know nothing more until I wake up in the recovery room.