Breast cancer has never been so ‘in your face’. I know we notice things more when they become relevant to us, and I know I’m watching more daytime TV since I’ve been off sick, but I have honestly never seen so many breast cancer awareness campaigns before, and that’s a good thing. October is breast cancer awareness month all over the world, just in case it had escaped you.
In the UK, there’s the controversial Coppafeel! campaign commissioned by Cosmopolitan magazine involving Spice Girl Mel B and her husband Stephen Belafonte, with this image of him fondling her naked breasts. Whether you like it or not, the campaign achieves what it sets out to do. I personally can see why it offends some people, but I am of the opinion that, where breast cancer is concerned, any publicity is good publicity and we need to be in your face about the fact that you actually have to CHECK YOUR BREASTS – it’s not enough just to raise money for charity or wear a pink ribbon, as great as those things are. (Sorry for the shouty capitals, but this is a message that can’t be stressed enough.)
What do you think of the Coppafeel! campaign? Is it too much? Over-sexualised? The defense of Cosmo’s editor was that it would resonate more with women in their 20s – the magazine’s target audience – and I think she’s right. Older women are given regular mammograms and MRI screening but women in their 20s and 30s don’t get that, so it’s important that we learn about self-checking. Though, as one of my readers pointed out, sometimes there will be no symptoms of breast cancer and a tumour will only be detected by screening. Since youngsters don’t get screened automatically, if you have a family history of breast cancer, you could go to your GP and ask for advice.
Lots of shops and brands are selling pink-themed products and donating some of the proceeds to breast cancer charities. Cancer Research UK goes a step further and donates 100% of the proceeds from the products in this link, so do check it out if you’re in the UK, or Google your local equivalent. I am ordering the pink heart-themed reusable coffee mug – what better way to be kind to the environment whilst drinking tea and supporting cancer research?!
Also in the UK, the soap opera Coronation Street is running a storyline about Maria Connor, a girl around my age who discovered a lump in her breast. She puts off going to the GP for a while because she is scared of what she might find. She eventually confides in a friend and has an ultrasound, followed by a core biopsy, where something I can only describe as a giant needle-gun is inserted into the breast under local anaesthetic to take a tissue sample for testing (this is what I had in Ireland). I have missed a couple of episodes, but I believe Maria’s lump was found to be benign, i.e. not cancerous. Nevertheless, I think it’s great that Coronation Street ran the story line. They highlighted the importance of getting yourself checked out, while also showing that in most cases, breast lumps turn out to be non-cancerous.
I’ve heard about so many surveys this month where women said they found a lump and didn’t go to the doctor because they were scared. I also know people who have ignored symptoms for other types of cancer and have ended up with incurable diseases by the time they got it checked out. This is simply not acceptable in this day and age, when there is so much information out there about all types of cancer. It never even occurred to me to ignore my lump. What good can ignoring it possibly do? As with the case of my gene test, I knew that knowledge was power and the only way to get that knowledge was to go to the doctor.
Maria’s story made me think back to when I first found my lump. It was February this year and I was on holiday in Brazil. I had just arrived at the surfing resort of Itacaré and was on my own in the hotel room. Don’t ask me why I was fondling my own breasts – I wasn’t actively checking for lumps, but I guess sometimes I have a little feel – don’t we all?! My first thought was to go to the doctor. I genuinely didn’t think “this is cancer”. I knew that it was more likely that the lump was some sort of cyst, and I honestly don’t remember being worried – even with my family history. I knew that the lump couldn’t have been there long. I almost went to the public hospital at the beach resort, but when I ended up going there anyway with food poisoning and saw the flies swarming around everywhere, I decided it would be better to wait a few days until I got back to Buenos Aires, where I was living at the time. Plus which, I knew they would have to do tests and I would only be in Brazil for a week anyway.
I wasn’t familiar with the way the health system worked in Argentina – I didn’t have a personal GP like in England. There, you have to go to specialists for each particular medical problem, which in this case, I was told, was a gynaecologist. I set about finding a gynaecologist from my company’s health insurance directory, but after calling 10 of them and being told none of them could give me an appointment until March (it was the beginning of February), tears sprung to my eyes at work. I was going away on holiday again a few days later (there are lots of public holidays in February in Argentina!) and I needed an appointment as soon as possible.
Fortunately, a good friend, who was familiar with the health system in Argentina, told me that I could go to the emergency room of one of the private hospitals, so that I did. I didn’t even know how to say ‘lump’ in Spanish (it’s not often used in business talk!), so I’m thankful I had a friend. The doctor was a grey-haired old Argentine man, but I wasn’t bothered. He told me to strip off my top half and had a feel around my boobs on the bed in his consulting room. He then sent me for an ultrasound, where another grey-haired male doctor spread some liquid on my chest and moved an ultrasound sensor around both breasts. I could see the lump on the computer screen and he zoomed in and printed off the pictures. The lump was 12 millimetres at the time and was at the very top-right of my left breast. You couldn’t see it to look at me, but you could easily feel it as it was just below the skin.
Next, they sent me for a mammogram. The doctor told me this might hurt a bit, but it really didn’t. Mammograms involve standing up and whapping your boobs out one by one onto a sort of glass platform. Then the nurse moves another platform down so that your breast is wedged firmly into a vice-like clamp, and they take a few X-ray photos. It feels a bit uncomfortable but certainly not painful and it’s over in minutes.
I was extremely lucky to go to a private ER because I had the result within hours. I went back to work for a few hours and then returned to the hospital and saw the first doctor again. He told me that the lump was probably a fibroadenoma, because it had smooth sides and did not move around. His words, translated into English here, were along the lines of: “It is almost certainly nothing to worry about. You don’t need to have any more tests, but you could go and get it checked again when you move countries, just to be sure.” In 99% of lumps with characteristics like mine, it is not cancer, he said. Tears sprung to my eyes again. They were tears of relief, even though there was an element of frustration that I didn’t have the 100% all-clear – I just had a “probably”. Nevertheless, I returned to work again, relieved that I could now go wine-tasting in Mendoza with peace of mind. (And I intended to have a jolly big glass of wine!)
A month later, I had quit my job and moved to Dublin. I was unemployed for a few weeks before starting my new job, so I had no medical insurance. On the encouragement of family and friends, I begrudgingly paid the 60 euros it costs to see a doctor in Ireland and told the lovely female Irish doctor about the tests I’d had done in Argentina. She said she was surprised they’d given me a mammogram because they don’t normally show good results for women under 35 because of the consistency of the breast tissue (or something like that). Once again I got my boobs out and allowed her to have a feel around. She told me it felt like a fibroadenoma and that I had almost nothing to worry about, but that it was best if I went for further tests just to be sure.
I had a 6-week wait for my appointment at the hospital in Dublin, by which point I had started my new job at Facebook. My appointment was just a consultation and therefore involved getting my breasts out once again (I was used to it by this point!) for another female Irish doctor, who told me exactly the same – it’s very likely to be a fibroadenoma. Both Irish doctors also looked at the printed mammogram and ultrasound results I brought with me from Buenos Aires. She then referred me for tests, for which I would have to wait another 4 weeks. I wish that the first Irish doctor had referred me for tests urgently. She said there was no urgency, particularly because of the tests the Argentine doctors had already done, but in hindsight, all three of the doctors should have taken note when I told them my maternal grandmother had breast cancer at a young age.
This all takes us to Thursday 14th June, 2012 – exactly four months after my initial ER visit in Argentina, and a little more than that since I found the lump. The appointment was at St. Vincent’s hospital in Dublin, and I was first taken for an ultrasound. The lump had doubled in size, to about 24mm. I was then called in for a mammogram, which I thought was strange, given the previous advice that they don’t give mammograms to women under 35. It hurt a tiny bit more this time when they squeezed my boobs into the vice – the Irish doctors were a little more forceful than the Argentine ones! I was then taken to the waiting room in my hospital robe and told I would be given a second ultrasound. I know it’s a little naive, but it really didn’t occur to me that there was anything wrong, because I’d had so many doctors’ reassurances up to that point. I just figured it was all routine, and nobody told me otherwise.
In the room for the second ultrasound, the air conditioning was on arctic mode and I had to lie with my top off on a bed for ten minutes waiting for the nurses to come back. One nurse and one doctor came, and they started ultrasounding me again. Both were female and were absolutely lovely – in fact, all the doctors and nurses I had dealt with up to that point in both Argentina and Ireland were lovely. They then told me they needed to do a core biopsy, and this would involve sticking a very large needle into my side under local anaesthetic. I would hear a loud gun noise and may have some discomfort, but I shouldn’t be able to feel it, they said. Believe it or not, I had never had a local anaesthetic, apart from once at the dentist, and all of a sudden I felt weak and shaky and then got pins and needles in my legs. This made me feel scared, and tears came to my eyes for the third time and my voice went all shaky. The biopsy took about ten minutes. I could see the needle jabbing around inside me on the computer screen and it felt very odd. The nurse was holding me in position while the doctor prodded me with the giant needle and it was very uncomfortable but not exactly painful. Nevertheless, I was very shaken, and quite sore for a few days afterwards.
After the test, they stuck a big bandage on my breast and the nurse took me behind a screen in the waiting room and gave me a cup of tea and some biscuits as I felt so shaky and emotional. It’s hard to describe why I felt so emotional. At no point that day did I think “I must have breast cancer.” But I had never had anything done in hospital before and the whole experience really scared me. I kept saying to the nurse “I’m so sorry, I’m being so pathetic, I’m honestly fine, I don’t mean to cry but I can’t help it”. She kept assuring me that I was being really brave and it was natural to cry. Of course, she knew that I probably had cancer, so she thought I had much more reason to cry than I knew at the time. But I wasn’t crying because I thought I had cancer. I simply had no idea.
I went straight home that day and didn’t go back to work. You could see the bandage out of the top of my lowish-cut dress and I needed to cover it up, plus I just felt too shaken, shaky and sore to go back. I texted my Mum to tell her about the test. Unfortunately, unbeknownst to me, one of her friends had died of cancer that day, so my news came as a double blow. I was told to go back to the hospital for the result one week later.
On Friday 22nd June, I skipped off to the hospital for my appointment at 10:15 a.m. and told my team I’d be back at work in a couple of hours, knowing there is always a long wait at hospital. But once I got there, I was seen pretty much straight away. A female nurse collected me from the waiting room at Dublin’s St. Vincent’s and took me to a private room, where a male doctor greeted me. The three of us sat down.
“Did you bring anyone with you today?” the nurse asked. And that was the moment I knew.
Of course, I had absolutely no idea that I needed to take someone with me that day, because I had no idea I had cancer. In a way, my naivety was a blessing because it meant I didn’t spend a whole week worrying about the test result. If I had even so much as Googled ‘core biopsy,’ I’m sure I would have realised, but I just passed it all off as routine. Sometimes ignorance is bliss.
So that’s my story of how it all happened, right up to diagnosis. I hope that by sharing this story, I will help you understand exactly what happens when you find a lump and what the different steps are like. Of course, every case is different, but it’s not a process to be scared of. There are occasions when a doctor misdiagnoses, so if you are in any doubt whatsoever, get it checked and then get it checked again. There is never any harm in getting checked out. As I said in my Candy Pink Announcement, the worst thing you can ever do is ignore it.