Dense Breasts, Self Exams and Persistence

I had mammograms and ultrasounds every year since the age of 35. I would find cysts, they were filled with fluid, they would aspirate them. I can not tell you how many times I heard “you have very dense breasts, dense breasts do not cause cancer, but they can hide cysts, so make sure you do self exams”. Three years before I was diagnosed, I had moved to California. When my mammogram was completed, I would tell them that I always had ultrasounds too. I was told they would contact me if they felt that they were needed. I was never contacted.

In July of 2005 I started to have severe cramping during my period. I mean almost take me to the hospital pain, which I never had before (except when my appendix burst). It would happen every other month for about 6 months. They thought that I was just passing a cyst. After the holidays that year I had gotten sick and I just could not shake the cold. In late January, I got shingles. When I was doing my self breast exam in late February I felt a hard lump. It felt a bit smaller than a peach pit. I decided to wait one cycle – to see if it was a fluid cyst. Next month it was still there. It was harder than any I had had before. I also felt another smaller cyst. I think deep down I knew at that point that it was not going to be good news. I am not sure why I waited another few weeks but I finally went to the doctor April 21, 2006. I now had a third lump near my nipple. The doctor did not like the feel of the lumps – one had a slight “hook” to it. She immediately sent me for another mammogram.

The mammogram really did not show much. They said it “looked like a snow storm” and they could not see a thing. They did an ultrasound, I kept saying “you found all 3 lumps – right”. They found a mass so I was scheduled for a core biopsy on April 26th. During the core biopsy I kept talking about 3 lumps. The doctor said “what are you talking about – the ultrasound found only 2”. I kept insisting that there were 3. They took 19 cores of the 3 lumps. My breasts were so dense that the doctor had a hard time getting the needle through my breast tissue and into the cysts and the one under the nipple was no fun at all. The doctor and nurse kept giving each other looks “over me” the whole time. They were being so conscientious trying to make sure to get good samples of each mass. When I left the office they said if it is good news the tech will call you if it is bad news the doctor will call. On Friday April 28Th at 9:30 am the doctor called. I was at work and she asked if I could talk? I said “I assume that it is not good news if you are calling me?” ” You have breast cancer.” I did not cry – I took down all of the information that she was telling me. My next call was to the breast surgeon. She was going to see my that day. I went to pick up my films and was at her office by 11:00am. She examined me and spoke about a lumpectomy as the tumors we about 3 to 4 cms, she also mentioned a mastectomy was an option. She thought because of my age I would do chemo and possibly radiation. She scheduled me for an MRI at 1:30pm. It was not until I got into the MRI machine that I broke down. All of the information that I just received the past few hours was starting to sink in.  I just kept thinking of my kids and I would cry.

I went home to have a family meeting with my husband and 2 kids. It was one of the saddest things that I have ever had to do. I told them I would be sick for awhile but I would be OK. When I told my then 5 year old son I was going to lose my hair he began to cry.  On Monday I went back to the surgeon, she had not had the pathology report from the biopsy when she first met with me. She was confused. The mammogram and ultrasound had only 2 tumors, but the biopsy indicated 3. I was whisked down the hall for another ultrasound. I said “I kept telling everyone there were 3”. That third lump – the one near my nipple changed everything. Now we were talking about 6.8 cms, a lumpectomy was no longer an option. We were now talking mastectomy. She told me that I had just saved my own life by insisting they biopsy the third lump.  They scheduled the mastectomy for May 11Th, I could decide if I wanted a bilateral by then.  I was scheduled to see the plastic surgeon on May 8Th, but I could not get an appointment with the oncologist until the end of May. My wonderful surgeon made a call and I was moved up to May 8Th. I had a bone scan and CAT scans prior to my meeting in which the oncologist spent 3 hours with me. He felt that I was a good candidate for neo-adjuvant chemo. I was ER/PR positive and he felt that I would respond to the chemo and the tumors would shrink and enable the surgeon to get clean margins. The MRI did not show anything in my nodes but he wanted to be sure. On May 10Th I had a PET scan.  My nodes were clean. My surgery was cancelled and I would start chemo in a few days….