my Breast Cancer blog

My breasts have been a problem for a long time. For years, they were too big. I was a 34 DDD and hid them with tight fitting bras and under big shirts. So I had them reduced and lost 4 pounds of tissue. I am now a 34 C, which is much more manageable. But the surgery left me with scars, loss of sensitivity, and an inability to breastfeed my babies. This has not been a big deal to me, just life circumstances and I’ve adjusted to them. And now I’m on to another life circumstance with these problem breasts. I have breast cancer.

On November 16, 2004, I felt a lump in my left breast while taking a shower. I have always been aware of what my breasts feel like. I have a lot of dense tissue, so dense that the surgeon who performed my breast reduction had trouble separating the tissue to take some out and leave some in. My breasts always seem lumpy to me and I never knew if I’d be able to tell the difference between normal and abnormal tissue. Four years ago I had a mammogram because of something I felt. It all turned out fine. It was just the dense tissue. All of my annual GYN visits have revealed nothing abnormal. But I’ve always been aware and curious which is why I found something in the shower. I knew it was not normal. It was hard and felt like a small green pea. It moved around and for the first few days, I had a hard time locating it. Once I became obsessed with it, I could find it immediately.

I went to my OB/GYN on November 18. My doctor felt the lump but was confident it was nothing to worry about. It moved around easily, there was no discharge from my nipple, I did not feel any pain: all signs that it was benign. But it’s routine to get a mammogram for any mass so I got one the next day.

I was the youngest person waiting to get my mammogram, another sign that this lump was nothing serious because it is not common for young women to have breast cancer. Mammograms are not even recommended for women under the age of 40. I am 34.

The mammogram films looked OK, and the technician told me the doctor would talk to me but that she was not worried about anything. This was true but she did an ultrasound anyway to look further at the lump. She determined it was not a cyst, which is fairly common, and nothing serious. It could be a fibroma (a common growth that can be removed or left in place without harm) or it could be cancer. She said she wanted me to have the lump removed. She wanted it out and in a jar, she said. I asked her if it could be cancer and she said it could be.

On November 23, I had a biopsy. A large needle was placed in my breast and a piece of the lump was pulled out. The surgeon had a hard time getting a piece, however, because it moved around so much. He said this was a good sign, the movement. He sent the tissue to pathology and told me to call his office the next afternoon for the results.

The next day, November 24 and the day before Thanksgiving, my phone rang at 10:00 AM and the doctor who did the biopsy said the pathology report was back already. He said that unfortunately, cancer cells were found. He said I would need a lumpectomy (surgery to remove the lump), radiation, and possibly chemotherapy. He told me to buy a book called Dr. Susan Love’s Breast Book. I got the book that day.

Somehow, I made it though the Thanksgiving weekend, with my thoughts jumping from the hope that this would turn out OK to the fear that I would not see my boys grow up. My mind wandered and worried about surgery and what treatments I would have. I wondered if I could have more kids and whether or not I would lose my hair. I cried and lost sleep and was hopeful too. I learned a lot from reading my new book. I learned that many women do go on to have kids after cancer but I also learned that chemotherapy in young women could cause early menopause. I learned that I have an 85% survival rate and also that I will get tiny little tattoos surrounding my breast to aid in the proper delivery of radiation. These permanent tattoos will also alert any future doctors that my breast has had radiation because I can never have it again in that same area. The book helped me feel positive about this journey but it also helped me face reality.

On November 29, I met with a surgeon at Shands who prepared me for my first step: surgery. He said he would remove the lump and would determine whether or not my lymph nodes were cancerous. He would check all the margins around my breast to see if any surrounding tissue was affected and would identify all the defining factors of my cancer. If he found extensive cancer, he would have to remove my breast. I had to sign a form stating that my surgery was to be a lumpectomy but could turn into a mastectomy. My surgery was scheduled for Friday of this same week.

On Thursday, December 2, I had a radioactive dye injected into my breast. The dye slowly collected in my main lymph node, the sentinel node. During surgery, this lymph node would be blue so the doctor could easily find it and biopsy it. The biopsy would give him clues about my other lymph nodes. For the rest of this day, I was very anxious about surgery. I didn’t know what kind of prognosis I would wake up to hear and whether or not I would still have my breast.

I do have my breast. And I have a fairly good prognosis. My lump was removed and measured 1.1 cm, which is small. My lymph nodes were negative for cancer, although four were removed for biopsy purposes. My margins were clear, and there was no apparent spread of cancer. My cancer is considered stage 1. And that is good. I have two incisions, one in my armpit where lymph nodes were taken and one underneath it, on the side of my breast. They are both about 3.5 inches long. Besides a bad skin reaction to the tape I was bandaged with, everything went well. There are minor inconveniences right now. As my incisions heal and my skin tightens, it’s harder to lift my arm. So I have exercises I must do each day. Because of the missing lymph nodes, I may have trouble with swelling in my arm so I have to watch for that. I have not been able to shave my armpit since my surgery on December 3.

And now I await the next step in this battle. I will begin receiving chemotherapy in mid-January. This will last for three months. I will go for treatment four times, once every three weeks and will have a combination of drugs sent through my body via IV. The purpose of chemo is to kill rapidly growing cells, and cancer cells are rapidly growing. Unfortunately, all rapidly growing cells are killed, like hair cells and bone marrow cells. The chemo should kill any cancer cells that floated away from my breast, if any did. I don’t know how I will react to this process, as each person responds differently. At the very least, I hear I will be tired at times during each three-week time frame. I may also be tired from the radiation. This will begin three weeks after chemo ends.

I will receive radiation every day for 6 weeks. The purpose of radiation is to zap the actual area where the cancer was found to prevent it from recurring. Many women take a drug after chemo and radiation to prevent recurrences. The drug (usually tamoxifen) is taken for five years. My body will not respond to this type of drug due to negative estrogen receptors (if they are positive, the drug can be taken) so chemo and radiation will be my only two real treatments.

For now, I am trying to keep life simple. Joey and Danny help me do that. Joey knows I am frequently going to the doctor for a “boo-boo” I had in my “booby” and he has been very attentive. One day after a doctor appointment, he said, “Mommy, you need to go home and rest. I’ll bring you a banana.” He is almost four years old. Danny, at 19 months, does not seem to know anything is going on and it’s my hope that he never has any recollection of this path our lives are taking. I will never forget it, though, and that’s OK. I will take this experience and make it matter. A friend sent me a breast cancer bracelet inscribed with trust your journey. I do. I trust that I will be fine in the end. And I trust that I was given this fight so I can help others. That is why I have written this. I hope everyone who reads about my journey is affected in some way. Perhaps it will increase the amount of women who do self-exams. Maybe it will arm others with information to help loved ones who are affected by this common disease (about 1 in 8 women will get breast cancer at some time in their lives). Maybe it will spread hope. At the very least, writing helps me. And for now, that is enough.

Jacki Donaldson