“Call me,” Stan’s text read. Never a good sign. And so it wasn’t.
Turns out the third time isn’t a charm in my case. And the trend continues that every piece of good news comes with a kick in the teeth. This kick was a surprise though. On this very wide excision operation, where Stan got every bit of tissue in a very wide arc around the original little 6mm tumor, we have finally gotten clear margins! That means there’s no pesky DCIS (the pre-cancer) in the edges of the sample; in fact, there was hardly any DCIS at all. If only the sentence had stopped there.
What the histology found is that in a totally unrelated piece of tissue, 5 cms away from the little 6mm tumor, was a tiny 2.5 mm tumor. Not DCIS. More cancer.
This is very bad. The original 6mm tumor was first spotted before it was a tumor by Carmen on the ultrasound in December and biopsied. Then I found it in July and had it looked at in August. I’ve had numerous ultrasounds, a breast MRI, and a PET scan. Each of these was meant to find every last speck of cancer. But they missed this little lump, too tiny for Stan to even notice as he removed it.
Now it might be that Stan inadvertently stumbled on the last piece of cancer my breast has made, that the rest of the breast is clear, my margins are clear, and I could sail forward into radiotherapy.
Or it might be that 5cms in another direction there’s another tiny lump that lingers. Or two.
“It’s totally possible we got it all and now all that remains ins healthy tissue,” Stan says. “How much risk can you handle?”
So I sat with that question.
If I decide I can’t handle the risk, here’s what happens next. A fourth surgery, longer and more invasive and painful than the others. This time to remove the reconstructed breast, take out the implant, remove all the tissue of any sort that’s left there, remove as much skin as possible, and let it heal flat. And not just flat, Stan warns me, but a bowl—a “hollow deformity” as Stan calls it. Two nights in the hospital. The drain for a week. And a hollow deformity on one side and a breast on the other. A valley and a mountain.
Then radiotherapy a month later.
If I can handle the risk, I keep my beautiful two breasts and head into radiotherapy now.
I went out and explained the situation to the tiny but perfectly formed workshop I’m teaching this week (seven women in my living room for an advanced workshop—what could be a better place for this personal tragedy to unfold?). There were conversations about why and to whom breasts were important. There was excellent listening. Marian said, “You’ll know what the right decision is. You’ll wait and you’ll know.”
At the moment I was so bewildered, so caught between a rock and a hard place, that I could not imagine knowing.
Later, while they worked in groups, Aidan came down to comfort me. He is not afraid, he tells me, because this is finally bad news with out long term medical implications. “I’m totally there for you, Mom, because I know this is horrible for you. It would be horrible for me in your position. But usually when a kid sees his mom crying over a medical result, it means she’s going to die. And I’m just so happy you’re not going to die. That’s the only thing that matters.”
And with his lovely 15 year old manboy arms around me, I knew for certain what I would do. I would have a mountain and a valley, another surgery, another drain. Because the thing that matters is being on top of the planet rather than under it so that these kids can have a mom for as long as I can possibly manage.
So now I am trying to figure out when the next surgery is.
And I am trying to figure out how to make sense of losing a body part. I have a big set of equals in my head here, two breasted= normal; one breasted= mutilated. One breasted=never sexy again. These are big big equals, and they need to change. I intend to be one breasted for as long as possible, and so I need to find a way to find my way to psychological health as I find my way to physical health. I suspect you, Gentle Reader, are in for some entries on breasts and what they mean as I grieve mine and try to figure out what comes next for me. Pray for me.
[Picture is from dawn this morning. They still come, no matter what the news…]