So I Have Breast Cancer -- Now What?

They say writing is cathartic and it's always been so for me so I finally started my first online blog. Why it took being diagnosed with breast cancer for that to happen, I really can't say. But my further intention with this is two-fold. First, I want this as a way to keep friends and family informed with all the details. I found out that first week how many calls, texts, emails and such I had to send out to inform people and how overwhelming a task that was and then there's the bit about even remembering whom you told what. Second, I would like to provide a forum for others battling the disease. There are few people in the world that share a more common bond with you than fellow warriors in this fight. And those strangers are those whom you know completely understand what you are going through. Let's help each other.

I was officially diagnosed with stage 1 breast cancer on October 25th, 2017 after a core biopsy procedure that took place the Monday before. 

To backtrack a bit, I have a PCP (primary care doctor) who is, without doubt, the most instinctive doctor I've ever met. A cancer survivor herself, she either was erring on the side of caution to an extreme or crazy (which is a thought that occurred to me at least once). But on my very first visit in late August, she told me flat out that she was worried. All she had to go on was one symptom (we will get into that later) and a family history on the paternal side (also to be addressed later). Mind you, I had heard all my life it is the maternal side history that caused the great concern. And there was no cancer there. Yet, without so much as a blood test, she figured out I had cancer and every visit before all the testing and diagnosis came in, she treated me like a cancer patient. 

I didn't feel like a cancer patient. I wasn't tired and I felt no discomfort or pain. Furthermore, neither I nor the doctor could feel a lump. I felt ... completely normal. In fact, I recall as she was adding a blood pressure control and statin med to my life, she had ordered a follow up metabolic panel blood test. The only slightly abnormal reading was my calcium level. It was .01 higher than upper end of normal scale. When I asked what that meant, she said something to the effect of "cancer loves bone." Without even having had the mammogram as of yet, I thought to myself, "what an odd comment!"

My denial was soon to come to an end and my respect for Dr. Sears soon to grow. I realize now I just might have her to thank for my life. How she knew what she knew when she knew, I don't know (wow, that sounds a bit like a Tim Henderson song). 

The only symptom I had when I marched into her office was a clear or straw-colored fluid that occasionally leaked out of my right nipple. It would come and go and rarely discharge more than a few drops at any given time. It had been going on for more than a year at that point but after doing internet research and self-diagnosing with the knowledge that bloody discharge was more indicative of cancer (note to self & to everyone else : do NOT self-diagnose), I decided that the chances were slim this was anything to worry about. I would go through long periods of remission and think it was gone only to have it come back. As it turns out, I was partly right in that this particular symptom (and my only one) was not cancer. 

When I walked in to see the doctor, I had almost forgotten about the severity of my family history when it comes to breast cancer. My paternal grandmother had a diagnosis followed by a unilateral masectomy in her late 60s. She beat it and lived into her 80s before dying of other natural causes. My paternal aunt (her only daughter) was diagnosed at 57 with Stage 0/1 breast cancer and opted to have a double masectomy (as she put it "to be done with it forever"). She was just a little bit saner than Angelina Jolie ... only one breast was a prophylactic surgery. She is cancer free 20 years later and now in her late 70s. I am the only surviving daughter of this generation of the Pelton family. And now we are three for three. The notable part of that is we get it in my family, but it doesn't kill us. I have wondered about the genetic part of this equation. Research says only about 15 percent of breast cancers are a result of a faulty BRCA1/BRCA2/PALB2 gene. As of yet, I have not been tested for this. My doctors are lobbying for this genome typing but apparently it's very expensive and insurance companies don't like to pay (imagine that!). Of course, if I am able to get tested, and I am positive for this gene mutation, I will have my daughter tested as well. 

Naturally, the doctor's concern about the possibility of cancer put me into a higher alert status. She ordered a referral to a breast specialist and of course, a routine mammogram with a sonogram to look at my right breast more carefully. I didn't make an appointment with the breast doctor figuring why did I need her before I had any diagnosis? At that time, I decided I needed to take some action and prepare "just in case." Being that I have no other source of income or support other than my working, I called AFLAC. I immediately took out a cancer policy being very careful not to tip my hat about any suspicion. I found out that with my previous clean health record I would be accepted, but there was a 30-day waiting period once the policy started. The agent told me not to do my yearly mammogram or any other testing until after this 30-day period. So I waited about 5 weeks before going in for the mammogram/sonogram in September. 

It had been a long time since I had a routine mammogram and the last one had been completely normal 6 years ago in Colorado (note to self & to others: do regular mammograms at least every 2 years if older than 50!) I remember the technician saying I had the densest breast tissue he had ever seen in someone my age. Of course, I had been hearing about my dense fibrocystic breasts all my life and had an early mammogram in my late 20s because of that condition. While dense breast tissue holds up well to gravity and the aging process, the downside is that you are more likely to get cancer. Not a win here. 

They did the mammogram on both sides and turned the pics over to be evaluated. They then took me to another room where I lay on my back while they covered my right breast with the gel and performed a sonogram looking over and over every spot including my armpit (lymph nodes) and capturing certain views to also be read by a skilled professional. Of course, they found the mass just under the nipple in the ducts that was causing the leakage (I expected that) but they also found a small abnormality higher up on the outside upper quadrant measuring 0.6 x 0.8 x 1.4 cm. Neither of the two spots were bigger than a peanut. These were also visible on the mammogram. Before I left, they discussed this with me and scheduled me for a core biopsy so they could figure out what these abnormalities were in the lab. My left breast showed nothing and was given an "all clear".

I scheduled my biopsy for the third week in October (about a month later) and decided to take a well-earned vacation  the first week or so of October before returning to El Paso for a week to work. Then my company sent me to Houston for the weekend before the biopsy. I stayed Sunday night in the Hotel with a nasty cough/cold, a bad case of heartburn/sour stomach, and a heavy heart. Needless to say, I didn't sleep much at all. The anxiety was eating away at me. This, in spite of the fact that the breast clinic had told me that odds were good I didn't have cancer. According to their stats, only 2 out of 10 of patients ordered for biopsy came back positive for cancer. I didn't have any other symptoms. Nationally, the odds are 70% of biopsies come back negative for cancer. Sometimes the odds being in your favor are just not enough.

The biopsy procedure itself was not nearly as bad as I anticipated. My daughter was with me for most of it and drove me to and from. After taking me back in a front-opening hospital robe, the doctor had me lie on my left side with my right arm up over my head. They used local anesthetic to numb both spots where they were going to biopsy (yes, that hurt some) and then did the procedure, taking about 5 samples each from the two areas. They also left behind several metal markers a bit like staples in the biopsied areas that show up on X-ray but do not set off metal detectors. (Attention TSA agents: sorry that my breast is causing your alarms to go off but I can't exactly remove them!). These Scout markers are also helpful in guiding the surgeon should a breast surgery (BCS) be necessary as they will come out with the diseased tissue. It was all over in less than 30 minutes. After applying bandages and an ice pack to wear in my bra, I was sent home. After eating lunch and resting a bit, I drove to my condo in Conroe the same day to recuperate. I was planning on being at a Conroe event that's attended by many of my friends to get the news on the biopsy results which normally took about 3 days. The soreness went away after a couple days but the itching from the bandages and the healing about drove me crazy.

The results actually came in a day earlier than expected. It came in the form of a call from my PCP, Dr. Eagle Eye, who informed me that while the breast leakage area was indeed a ductal papilloma (non-cancerous condition somewhat like a wart in the milk duct), the other area was IBC (Invasive Breast Cancer). IBC accounts for about 80% of breast cancer cases. I went to my friend's land for the event and got on with the business of informing everyone and passing out pink ribbons; asking everyone to wear them throughout this upcoming battle until the day I am declared cancer-free and in remission. It wasn't gonna be a good week for me or my family: just a day after that I lost my 89-year-old stepmother and had to go back early to San Antonio for the service. 

And so ... the fight begins.