Let’s cut to the chase

January 29, 2020. My cancer is back. There’s just no way to put it more delicately. It’s not a delicate subject. So here’s a timeline of how we got from my last post on December 19 to now.

• January 17, 10:45a I arrive for a routine mammogram, followed by an ultrasound of the left pectoral area where the worst of the cancer had resided. The mammogram was unremarkable. The ultrasound…not so much. On top of the pectoral muscle we can see a little nodule (7mm in diameter). It is suspicious. The radiologist tells me I should have it biopsied. I tell her I have a 2:30p appointment with Nurse Practitioner Shelley who works with Dr. Ewing.
  • 2:30p Shelley is running 90 minutes behind.
  • 3:45p Shelley arrives. She greets me and Steve warmly and asks how it is going? I say great, except for this little something that showed up on my ultrasound. She looks surprised and tells me she hasn’t had a chance to read the radiology report yet. So she turns the monitor towards me, and we read it together.

  • There is a 7 x 7 x 4 mm oval, parallel-oriented solid mass with indistinct margins, in the right breast, upper outer quadrant, 11:00, anterior third, 7 cm from nipple. This is on the upper chest wall and lies along the anterior surface, or just under the surface, of the pectoralis major muscle. This was not definitively present previously and appears to be different than the previously identified recurrences, and as such is suspicious for another site of recurrence.

  • Shelley leaves to look at the images herself and is hoping Dr. Ewing will have the opportunity to view them with her. When she returns she instantly begins reassuring me it could be scar tissue or debris from scar tissue breaking up. In my heart I know she is throwing me a bone. Ultimately, she recommends a needle biopsy. I readily agree. It is scheduled for Tuesday at 11a.
• January 21, 1:45a I arrive for the ultrasound guided needle biopsy. A nurse takes me back to the changing area. By 11:10a the radiologist has already numbed the area, has a fine needle inserted into the mass, and we are waiting for the pathologist to arrive to take the tissue sample. I am told she might take as many as three samples if she doesn’t get enough tissue from the first two excavations (my word, not a medical term…I don’t think). The pathologist arrives. I watch the monitor as she digs into the little marble-like mass aggressively grabbing tissue. Not to worry. I can’t feel a thing. She retreats and leaves the room with the sample. The radiologist checks to see if the pathologist is happy with the amount of tissue she has retrieved, and she is…except she wants to get more should additional testing be needed. Ding ding ding. Red flag. Red flag. I am now convinced it is malignant. My conviction mounts when she takes a third sample. Now we wait. The radiologist tells me I should have the results by Friday, and I should make an appointment with Dr. Rugo for follow-up. I get it scheduled for late afternoon on January 30.
• January 24 We are on pins and needles all morning waiting for Shelley’s phone call. Around noon I message her. Not long after she calls letting me know she wishes she had better news, but it is cancer. The pathology report stated that the mass does contain “abundant tumor cells.” As much as I am prepared for this result, I still had a smidgen of hope I would be wrong. There are times in your life when you really, really want to be proven wrong. I really, really wanted that. Shelley wants to schedule an MRI and a PET scan. The MRI is quickly scheduled for late morning on January 30 and by afternoon I have a February 5 appointment for the PET. (Due to a cancellation, the February 5 appointment was later rescheduled for January 29.)

So that’s it. That’s where we are today. I’m on my pre-PET scan Limited Carbohydrates diet and no exercise regimen. Steve and I will spend the night in San Francisco tomorrow. After that…schedule surgery soon after the test reports come back and the rest is TBD.

It’s mind boggling that this is my reality just a little more than 6 months after my last treatment. I find myself wondering if I’m a cancer incubator.

The good news is…yes, there is good news…this mass is tiny, it’s in a location that is easy to get to, and it is surmountable. So, as I recently told a good friend and fellow breast cancer warrior, “Steve and I are in a bit of a funk, but 100% optimistic. Just one day at a time. Staying in the moment as much as possible and trying not to get ahead of ourselves. Counting our many blessings, and feeling confident this will be nothing more than a big bump in the road we will navigate over with each other’s love and support and that of our family and friends.”

Above all, be the heroine of your life, not the victim. —Nora Ephron