THE C BOMB
If you find yourself reading this – its probably because the reality or threat of breast cancer has entered your life (or that of someone you know and love) and we’re guessing not in a ‘quietly slipping in the back door’ kind of way, but more of a ‘jaw dropping, earth shattering, face slapping, pardon me?, WTF?’ kind of arrangement.
As a young woman aged between 20 and 40, your life is pretty lovely (at least some of the time!) filled with grand plans, exciting adventures and many possibilities. Thankfully, you can bet your lovely life, that embarking on a personal battle with breast cancer won’t crop up on your to-do list. That is unless you’re one of the growing number of a select few for whom this nightmare becomes a reality.
That is why we’re here. The women behind Shocking Pink are battling this too, so we welcome you to this exclusive club. The price of membership is unbelievably high, but you, fabulous young woman, are not alone one little bit.
CHECKING IT OUT
From your first “WTF is that?” moment, through to some or all of the following procedures, this can be a very stressful time. The key is to try not to let it occupy your mind 100% of the time. Also know that in young women, there are many explanations for breast lumps and change in appearance, including, but not limited to, fibroadenomas (benign growths), cysts and infections. That is not to say that you shouldn’t get anything suspicious checked out – because you should! Breast cancer rates are very low in women under 40, but it does happen, so any lump or change in the appearance of your breast (redness, dimpling skin, nipple changes) should always be checked by a doctor.
SUSPICIOUS GOINGS ON
WTF is that?! Most of us are on reasonably good terms with our boobs. They might not be as big/small/perky/full as we would like, and we might look at them through squinted eyes on occasion, but we know what they pretty much look like, feel like and how they behave. Its no wonder then, that a sinking feeling stirs in your stomach when you feel something that wasn’t there before, or they just look a little different to how they usually do or you just have the feeling something isn’t alright in the boob department… what then?
Firstly, no matter how small or trivial it may seem, DO NOT give it the brush off! While many lumps and changes in appearance have innocent causes (like gravity for example!), some definitely do not, so the best thing to do (no matter how scared you are) is to get yourself down to the doctors office and find out what the devil is going on. At worst you’ll feel like a neurotic self-groper (I assure you your doctor probably won’t think that) but you also might just make the visit that saves your life.
Ultrasounds and mammograms
For any significant change in appearance or sizeable breast lump your doctor will probably send you for an ultrasound or mammogram to see exactly what’s lurking underneath the surface. Neither of these are the most pleasant things to experience, but they are a necessary evil in the process of suspicious character elimination. As a young woman, you are more likely to be sent for an ultrasound than a mammogram, as young breasts are naturally quite dense, which makes them more difficult to image using a mammogram. Also if you have an infection or obvious swelling a mammogram would be unsuitable squashing a swollen boob would hurt….a lot!
The ultrasound consists of an examination of the breast by a radiographer who will pop some gel on the revealed offending boob and use a wand with high frequency sound waves to see what’s going on under the skin (or science to that effect).
A mammogram on the other hand is slightly more challenging in that they sandwich your boob between two pieces of clear Perspex and then slowly squeeze it flat (its actually pretty impressive just how flat a breast can get – if you can bear to look). Just when you’re quite uncomfortable and don’t think they couldn’t squash you any more, they wind it up just a bit further. Don’t you dare let this put you off getting a mammogram though – it’s not painful, just a tad uncomfortable. The hardest part is staying still standing upright while this all sandwiching lark happens. Usually, images from a couple of different angles will be taken, but the whole procedure doesn’t take long at all. The end result is that it gives the radiographers an x-ray picture of your flattened boob so they can check it all out and see if you have a suspicious character lurking there or not.
Non-suspiscious characters this way please, you are now free to go. All suspicious characters please follow me to the land of the biopsy, we’re not done with you yet.
Two kinds of biopsies are most commonly performed on suspicious goings on in the breast – the more pleasant sounding ‘fine needle aspiration’ and the somewhat less pleasant sounding ‘core biopsy’. If your boob looks to be harbouring a suspicious character, a core biopsy is more than likely what will come next. This takes a sample of the offending cells to send to a pathology lab, and is usually performed under ultrasound (so they can see what they’re doing) with local anaesthetic because they’re about to take slivers of your prime boob via a punch needle . There’s no place for it alongside kittens in mittens and brown paper packages tied up with string (anyway so its hard to rhyme with biopsy!) but it’s a necessary evil to definitely see what’s going on.
Now the hardest part of the deal so far… the wait for your results.
Keep busy, keep your spirits up and keep on keeping on – you can’t change what’s going to happen next for good or bad.
An ideal scenario would go something like this… “Okay Miss/Mrs XXX your results are in and your breast has a benign cyst/tumour/fibroid/mastiis”. You’d have any treatment necessary and be free to go back to your lovely life. Not unscathed by the experience, but not devastated by it either – a close shave you might say.
For the select few, the possibility of looking like you’ve had a close, full-body, shave is just where life is about to take you. You probably won’t remember hearing the rest of the conversation but you’ll sure as hell remember hearing the words…
“You have cancer”.
When the C bomb drops there’s a moment of eerie silence. As you take in the surroundings, you stare blankly at your doctor/specialist’s sympathetic face while trying not to see the disbelief and pain register in your support person’s face (if you are indeed lucky enough to have one there). You will never more be the embodiment of ‘being beside yourself’ than as you sit in suspended animation trying to make sense of it all.
Here’s where your personal journey really begins – some shout, some cry, some scream, some continue on as normal. However you respond, you need to hang on tight because you’re about to enter the biggest, scariest and most nauseating roller coaster ride of your life. Oh, and grab yourself a dictionary cause you’ve got a whole new language to learn on the way!
Any questions so far?
You betcha! Firstly, how about… am I going to die? … is it in the other boob? … indeed where the hell else is it?… how did this happen? … and what are we going to do about it? Oh, yes…and WHY THE HELL DID THIS HAPPEN TO ME?
The next round of tests is designed to shed some light on most of these, but that final question is one that just keeps on coming up until you either find out that it’s in your genes, or if not, resign yourself to the fact that as crap as it is, it just is. Sh*t happens, and as unfair as it is, it has happened to you. Now you need to pick yourself up, dust yourself off, and get ready for the next stage of the ride. Feel free to have as many tantrums and meltdowns as you need to along the way – no one will blame you, and in fact you will find that you will get away with acting like a 2 year old far more now than you would have before all this happened.
An Magnetic Resonance Image (MRI) is usually performed to find out the extent of the tumour’s penetration in your boob, to check whether there is any evidence of spread to the opposite boob, and to get a look at the surrounding lymph nodes. After changing into yet another glorious gown, the MRI itself takes about 20 minutes. You have to lie on your stomach and position the girls into a square container that is built into the bed (we use the term bed loosely, it’s really more like a tray). You’ll then go into the giant cylindrical machine feet first while they take a bunch of images, during which time you have to lie very still. They also give you earplugs because it is really loud when taking the images. The last image they take uses a contrasting agent that they pump into your IV (the first of many needles, we’re sorry) – this is to visualise the blood vessels. It can make you feel a little dizzy afterwards but other than that it’s not so bad.
If there is any indication that your lymph nodes are involved, the chance of cancer cells spreading via your lymphatic system is a concern. In order to see if there is anything else involved (like your lymph nodes, lungs, liver… or indeed anything else beginning with ‘L’) you may have a Computerised Tomography (CT) Scan. Like the MRI, it involves a contrast dye being injected into your vein to provide a clear view of your insides. With the added bonus that this injection at worst makes you feel like you’ve peed yourself, or at best gives you warm fuzzies in your nether regions to some extent. You’re then scanned by something resembling a large white lifesaver (that’s a polo mint if you’re English) and they end up with a clear picture of your insides for analysis, and to add to the rogues gallery of pictures you’re already amounting. Not exactly the kind of thing you had in mind for the family photo album.
Another Test of Patience
Once the scanning is over, now is when you’ll again find yourself in that hellish holding pattern while you wait for your results. Nothing can make this any easier but every second that passes is a second closer to knowing your enemy. The sum of all of this scanning, poking and prodding is that once the results are all in, the treatment planning for Operation Kill Cancer can begin.