Episode 10 - A Day in the Life with Metastatic Breast Cancer

Ah, here we are now in the first days of February. I promised I’d be back to let you know what was going on with respect to the surgery/no surgery situation I was waiting on last time I was here.  Well! The only thing I can report, after sitting on the razor’s edge of anxiety, and apprehension since early December is…not a lot. And so it goes.

As a recap, in early December, scans suggested some changes, but that I might be a good candidate to have the original breast lesion removed. My oncologist let me know she had already spoken with her surgeon partner, and they wanted to pursue a lumpectomy, as a way to forestall any future spread, and negate need for additional (read painful) chemo treatment. All I needed to do was have a breast MRI, to let the surgeon know more precisely what she might be dealing with.

So, after a breast MRI December 20, a meeting with the surgeon was scheduled, along with another mammogram, and ultrasound. Because of the holidays, I had to wait until late January for this. And what a long, strange day that was!

The first order of the day was the mammogram. Before I launch into that, let me relate a conversation I had about these exams with my rather well-endowed mother. She was in her early 50s, I was in my late teens, and I was driving her to her annual exam. As I’d never had one, I asked what it entailed. She shrugged, and said, “It’s not so bad. You go in, take off your blouse and bra, and pick up your breast and put it on a little shelf in front of an x-ray thingy, they squash you a bit, take some pictures, and that’s it.” I looked away from the road, caught her glancing at my barely B cup chest, and then she finished with, “Well. It may be a bit different for you.” Yeah. Truer words were never spoken.

A mammogram for small busted women with highly dense breast tissue IS different. I have not ever had one where I was not left bruised, and tender. And there has never been a time I did not have to go back for a second look, as the tissue density makes reading them a challenge. Lastly, there has never been a time when, at some point during the procedure(s), the technician did not ask, “Did you know you have extremely dense breast tissue?” I know! This last exam hit all the high spots, and a few more, as I have markers in my breast left over from 2021, when the cancer was detected. In her attempts to get the image the surgeon requested, my poor tech was reduced to a puddle of sweaty frustration. I could tell she felt bad, as she knew, despite my stoicism (gotta be a good girl, don’t make a fuss, don’t be a baby), that she’d had to hurt me to get the shot. She told me she might need me to come back after the ultrasound, for another go. I smiled wanly, knowing full well I’d be seeing her again very soon. She gave me a small plastic basket for my sweater, and camisole, and left me all alone in a thin, sad little robe in a tiny, ridiculously cold waiting room. My ultrasound would come soon. Well, soon-ish. 

So, there I was, freezing to death, and trying not to borrow trouble, as my ex-mother in law would have put it. And failing. While sitting there, I took in my surroundings. Faux Danish modern furniture, bland, anonymous wall paper, and a vaguely inspirational landscape hung crookedly over un-centered chairs. I sighed. “Let it go, Parker,” I said to myself, “you’re only here for a few minutes.”I closed my eyes, and tried to meditate. Opened my eyes. Tried to read my Kindle, but could not concentrate. And getting increasingly twitchy about that crooked, uncentered painting in front of me! Finally, after about 30 minutes, I got up, rehung the damned thing, and centered the chairs beneath it. Almost immediately after, the ultrasound doctor came in to get me. She didn’t even say hello, just blinked, and remarked, “Oh, you straightened the picture! That’s been bugging me for days!” “Mmm,” I replied. “And centered the stupid chairs.” She gave me a rueful smile, and led me into the exam room.

During the exam, I learned a few things — first, unlike the old days, ultrasound gel is now heated! Who knew? As I was already frozen, this was a delightful surprise, and I said so. The doctor laughed, and agreed it was high time. The second thing I found out was that, due to unclear mammo images, I would need to go back and have them done again. Well, duh. It was the 3rd thing, though, that caused me a bit of panic — the ultrasound doc thought she’d found another lesion in that breast, and let me know I should prepare myself for a mastectomy. Fucking hell! After many more passes with the ultrasound wand, she corrected herself - NOT another lesion — scarring from the original one, and the marker from 2021 still showing up. Ok, then. THAT little roller coaster ride was fun! Now, back to the mammo tech for round 2 with her.

Another surprise! The mammo tech (the one I’d exhausted with round one) brought in her supervisor, who employed a newer, more effective method for getting the tricky image needed, and I was in and out of there with much less fuss, frustration, and discomfort. Whew. Now, I was only waiting to speak with the surgeon.

So, an hour and a half later, I met with Dr. Lazarus, my surgeon. She walked into her sub arctic waiting room to find me huddled under my sweater, and barked, “Why didn’t they bring you a heated blanket, it’s freezing in here!” I just gave her a comic glare and told her I was owed one joke about her name as penance, and she laughed. 

As she was getting ready to give me yet ANOTHER ultrasound, I smiled evilly and said, “I think, given your family name, it was mighty considerate of you to agree to treat me while I am still alive.” She groaned, and said, “Ok, that’s your joke. Feel better now?” I laughed. And waited for her to finish with HER ultrasound exam. And to find out about that proposed lumpectomy, and what that all might mean.

So. After looking at the results of the bone scan, CT scan, breast MRI, two mammograms, and two ultrasounds, Dr. Lazarus determined there were no negative changes, and in fact, all evidence suggested my treatment was still working, and the original lesion smaller than was originally believed. No surgery of any kind was warranted, and I am to return in six months for another ultrasound, “Just to make sure.” 

Well! To borrow a phrase made popular by E. Jean Carroll in her Elle magazine advice column, I am now “whip-sawed by confusion.” Yes, I DID just quote E. Jean Carroll. Did you really think I’d be able to resist, should the situation present itself? $83.3 million dollars! You go, E. Jean! But, I digress. Yes, I am confused. Of course, it is all good news — no need for invasive, painful, most likely disfiguring surgery, and my treatment still working as designed. Then why do I feel so blue? I don’t know. Maybe I’m just tired. Perhaps my adrenals are exhausted from two months of anxious waiting, and the thrill of uncertainty. As I have let you all know time and again, uncertainty is one of the hallmarks of this condition, and this last profusion of tests has exemplified that. And so it goes.

After all of the exams, all of the waiting, and all of the worry, I am left with rather a wet fire cracker! No surgery of any kind, in my immediate future, much less a mastectomy. Only more exams, and those not for another six months. I went home, alerted my friends and family,  downed a great jolly shit load of water, and settled in for a night of decidedly mixed emotions. 

Really, in the light of day, all good news to report. I am still here, in one piece, and likely to remain so for a while longer. And so I thank you for again for allowing me to give you a peek into what it is like dealing with this stupid disease on an every day basis. I hope it was helpful, informative, and engaging, and I will be back soon. Happy Ground Hog’s Day?