Until my mastectomy, the only doctors I’d interacted with were my surgeon and radiologists, but after the surgery, I met the rest of my team: my physical therapist, my meditation specialist, my plastic surgeon, and of course, my oncologist. For a period of a month or two after my surgery, I met with one or another of these doctors on a daily basis, and, ironically, it was one of the most positive time periods in my life. 

My first appointment was with my physical therapist, Bev. She was a petite woman with a salt-and-pepper pixie haircut, a great sense of style and a brisk, chipper attitude. It would be her job to help me regain the range of motion I’d lost in my arm as a result of the sentinel node biopsy. The first time I saw Bev, I had only about 5% of my normal flexibility in my left arm. I saw her twice a week for about six weeks, and my appointments with her quickly became a favorite part of my new routine. After I undressed and put on a hospital gown, Bev would give me a brief massage focusing on my left arm and the area of my chest where my breast used to be. It might sound weird, massaging a mastectomied boob, and it was, but it was also very soothing, not to mention beneficial. After the massage, Bev would spot me while I did simple stretching exercises to loosen up the muscles across my chest and underarm. Often the stretches were moderately painful, and sometimes I’d get frustrated with my slow progress. I saw myself as someone who’d gone from whole and perfect to deformed and disabled. But only some days—for the most part, seeing Bev was encouraging and relaxing. 

I also saw a meditation specialist once a week, Carolyn. Carolyn was also a breast cancer survivor, and it turned out that she and I had the same oncologist. She specialized in biofeedback and Buddhist meditation techniques for dealing with anxiety and trauma. Her office was pleasantly dim and warm, and for the first 10 minutes of our hourlong appointments, we’d talk about how things were going, how I was feeling physically and mentally. Then she’d stick some electrodes to my neck and lead me through some relaxation techniques. My meetings with Carolyn were some of the most meaningful experiences of my life in general, and she had a profoundly positive effect on the way I view the world. 

Carolyn told me about an experience she had shortly after she received her diagnosis of stage 3 breast cancer, and I hope she won’t mind me retelling it here. She had a dream one night. In her dream, she was in her house, walking into her bathroom, and as she pulled the shower curtain aside, she was horrified to find the bathtub was crawling with snakes and lizards and other dark, slimy things. She ran back out of the bathroom and gave herself a talking-to: in her dream, she told herself to turn toward her fears and not away from them, which was a Buddhist concept she was learning about in her waking life at the time. She walked back into the bathroom, pulled aside the shower curtain once again, and the reptiles had been replaced with gorgeous cuddly puppies. The next day, she related the story of her dream to a Buddhist friend of hers and asked her what she made of the dream. Her friend thought it was quite obvious: the reptiles in the bathtub represented her cancer—a dark, slimy, scary thing in her bathtub—but when she looked squarely at her fear, the cancer stopped being something scary and horrible, but a chance for new life and unconditional love—represented by the puppies. She taught me to look at my own cancer not as a setback or a death sentence, but an opportunity to live my life the way I always wanted: with more health, with more love, with more living. This was just one lesson Carolyn shared with me, and I will be forever grateful to her for showing me a more positive way to approach my fears. 

During the same time I was meeting with Bev and Carolyn, I also had my first meetings with the two men who would do the most toward “fixing” me: my plastic surgeon and my oncologist. 

In my life before my diagnosis, I always toyed with the idea of getting breast implants, because my natural breasts were so disappointingly small, though I never would have gone through with it. In spite of the whole cancer thing, I was pretty excited to meet my plastic surgeon and talk about the amazing rack he’d give me. Instead, in my first appointment, he mainly showed me pictures of his previous reconstruction patients, so I would get an idea of what I could expect with my own reconstruction. I hate to sound so anti-feminist here, and I don’t wish to be hurtful to my fellow mastectomy ladies, but a mastectomy is just…not awesome-looking, and in the plastic surgeon’s office, the reality of reconstruction came crashing into my brain. My new rack would maybe be bigger than before, and it would be a vast improvement over the mastectomy, but I’d still have significant scarring, and my new fake tits would pale in comparison to my tiny natural breasts.

Breast reconstruction is a process that can take six months or more, and can be very painful at times. The first step would be to implant an “expander” under the skin where my breast used to be. This would help stretch out the skin and muscles of my chest to accommodate an implant later. Every two or three weeks, I’d go to the plastic surgeon’s office for a “fill,” in which he’d inject saline into the expander to enlarge it. It sounds painful, but since the mastectomy left me with little feeling in my breast, it was actually comically un-painful, though the initial surgery left me feeling like someone had taken a sledgehammer to my ribs. Once the expander was filled to the size I wanted, I’d have another surgery to put an implant in the healthy side. This would bring my breasts to a roughly equal size, and the surgery would be as straightforward as if I’d come in like a healthy woman wanting breast implants. Finally, 3-4 months after my expander was filled to its final size, I’d have one last surgery to remove the expander and put in a permanent implant, matched to the implant on the healthy side. Voila. New tits. 

The last, but most important member of my team was my oncologist. My oncologist came highly recommended, and, as I would learn later, is one of the foremost oncologists in the country. He’s such a big cancer kahuna that he doesn’t take on many patients at all, but a friend’s husband, who is a radiation oncologist, pulled some strings for me and got me an appointment. My oncologist was a warm, bespectacled, professor-like man prone to tweedy jackets, and I liked him instantly. He had some good news and some bad news to deliver. 

The good news was that those six other possible tumors turned out not to be tumors at all, and I only had two cancerous lymph nodes. I was, as he said, “a clear-cut stage 1,” the lowest stage of cancer development. Also, my tumor had clear margins, which means it was more or less neatly encapsulated in its little sac of malevolence and hadn’t encroached on surrounding tissues like my pectoral muscles or my lungs. Yippee! As such, he didn’t feel that I’d need radiation treatment. 

However, I would definitely need hormone treatment, which was an entirely new concept to me. My tumor was strongly hormone-receptor positive, meaning that the tumor fed off the hormones in my body: estrogen, progesterone, and so forth. In diagnoses like mine, research had shown that shutting off the body’s hormones for five years was a very effective treatment. (In the olden days, they’d shut off the hormones for up to ten years, or entirely remove the ovaries, which produce hormones in the female body.)

Upon first hearing about this treatment, I thought: fantastic! Sounds easy! But I quickly realized that shutting off my hormones for five years meant I could not have children for five years. I’d always hoped to become a mother before I turned 30. I come from a very large family and I adore children. I was crestfallen, and it took me a few weeks to make peace with the new plan for starting a family—33 isn’t too old to have kids, after all. One of the biggest struggles about having cancer is learning to accept the fact that the plan you had for your life just got tossed out the window along with your boob. Hormone treatment would mean I’d start “medical menopause,” with all the fun that implies: hot flashes, frizzy hair, aching joints, mood swings. My mom helpfully pointed out that I’d get to go through menopause two times in my life. But still, I thought, it could be worse. I could go through menopause no times in my life. Because I could be dead instead. 

The big question I discussed with my oncologist was, of course, whether I’d have to do chemo. He had sent my tumor off to a fancy-pants lab for an actuarial analysis of its genetic makeup, in order to determine with scientific accuracy the possibility of its response to treatment and the likelihood it would return later in life. The results would take 2 weeks, and then I’d face the first and hopefully only life-or-death decision of my entire life. 

Today is the six-month anniversary (canniversary? cancersary? cancerversary?) of my diagnosis. I guess I should celebrate. 

Also, check out my series on Bygone Bureau!

After my mastectomy, I took two weeks off from work, mainly because I was not about to deal with THE DRAIN (in my mind, when I think about the drain, it’s always in bold, dreadful capital letters) in the bathroom at work: gross for me, gross for my coworkers, unhygienic for all. You guys can thank me later. 

The first few days after my surgery were the darkest days of my life, and they passed in a murky haze of heavy painkillers and ginger ale. My left arm was in a fair amount of pain, I couldn’t bathe because of all the bandages, and, worst of all, the unavoidable fact that I had just had my breast removed hit me like a steamroller. I realized too late that I had not prepared myself mentally for losing my breast—I’d been so focused on removing the tumors, I had forgotten to think about how it might feel to go from being young, whole, and perfect to having only one breast.

It took me more than a week to finally work up the courage to look at myself. Intellectually, I knew what to expect—one side of my chest would be flat, like a boy’s—but emotionally, it took me a while to accept it. During my post-op checkup with my doctor 8 days after my surgery, I still insisted I didn’t want to look at myself. My surgeon was very understanding on this point, but once I got home, my husband took me into the bathroom, stood me in front of the mirror and gently but firmly said, “you should just look at it, and then it’ll be over with, and you can stop being afraid of it and move on with your life. Ok?” I nodded, unzipped my hoodie and bared my chest. Once I saw myself, I had to hold on to the bathroom counter for support. I felt hideous. Deformed. Mutilated. 

But he’d been right: once I got over my fear of seeing myself, I was able to start moving on with my life. 

This is not to say that once I looked at myself, I suddenly got over my despair. I became obsessed with other women’s boobs in those two weeks. During my recovery period, I watched a lot of True Blood, which is just lousy with breasts. I stared at Anna Paquin’s heaving décolletage, envying her wholeness, worrying about whether she had cancer in there, too, and regretting that I’d taken my own breasts for granted, tiny and imperfect as they were. 

Thankfully, in those first few days, I was constantly surrounded by my family, who did their best to buoy my spirits with Twilight mini-marathons and grilled cheese sandwiches. But I remember one evening when it was just my mom and me. I walked from the sofa to the kitchen, maybe to get a glass of water, but once I made it there, I leaned my head on my arms and just…wept. I dwelt on the unfairness of it all: before my diagnosis, my body had been my temple. I went to pilates three times a week, yoga once a week, and I was training for a half-marathon. I was neurotic about what I put into my body. I drank kale smoothies, for god’s sake—surely that had to earn me some karma points, right? I was in the best physical shape of my life, and still, somehow, impossibly, I got cancer. I thought about my friends who smoked and drank and messed around with drugs, who ate crappy food and never worked out—why did they get to be healthy and happy while I was living out my worst nightmare?

My mom stood next to me while I cried. She rubbed my back and cried with me. At that moment I realized how horrible this ordeal had to be for my family, too. My parents must have been out of their minds with fear, but everyone had valiantly put on a brave face for me until that moment. We cried together for a while, and not for the last time.

Adding to my depression was the inability to bathe for several days after my surgery. Not only was I saddled with yards of bandages as well as THE DRAIN, I also had severely limited mobility in my left arm. As I’ve mentioned before, my surgery included a lymph node dissection, in which my surgeon removed cancerous lymph nodes from my armpit. The mastectomy required quite a large incision—my guess is that the scar is about 4-6 inches across. My surgeon decided to spare me an additional scar in my armpit for the lymph node dissection, so instead of making a second incision to remove my lymph nodes, she’d reached up through the main incision to take them out, and this is maybe the second most disgusting sentence I have ever typed. This was a kind and thoughtful thing for her to do, but it also meant that the muscles in my armpit and my chest would be extremely messed up for a while. Suddenly, everyday endeavors like shampooing my hair or reaching for a glass on a tall shelf had become impossible at worst, excruciatingly painful at best. 

Fortunately again for me, my older sister is a nurse with the fortitude of a saint.  The Monday after my surgery, she came to my house, changed into a bathing suit, and hopped into the shower with me to help me bathe for the first time in 5 days. She kept my attention away from my chest and the drain by telling me funny stories about her two boys while she quickly scrubbed my hair and my body. It felt so damn good to have clean hair after days without showering, but more than that, I felt humbled and grateful to have so much love and support from my family. I still have no idea what I’ve done to deserve such kindness, and I doubt I will ever be able to sufficiently thank them for all they’ve done for me. 

During my post-op checkup 8 days after my surgery, my doctor was able to remove my drain, and that greatly improved my mental state. For a few days, at least. During my second and final week off from work, my husband came home from work with what he thought was a cold—runny nose, sore throat, nothing out of the ordinary. I was sympathetic, but I didn’t think much of it until the next day, when I woke up with a fever, the worst sore throat I can ever imagine, and a tremendous headache. Because a fever can be an indicator of an infection after surgery, I went in to see my doctor. She used an ultrasound machine to inspect my scar, and blessedly it turned out to be fine. What was not fine: my husband had unknowingly given me the flu. A week after I’d had surgery. I was beyond miserable. I thought I was dying.

But maybe those kale smoothies did buy me some karma after all, because my surgeon hooked me up with a prescription for Tamiflu. Have you heard of this? Tamiflu is an elusive, magical drug that vanquishes the flu, but evidently a person has to have extenuating circumstances, such as AIDS or, as I found out, recent cancer surgery, in order to procure even a handful of these prized pills. It took a few days for the Tamiflu to work, but when Monday rolled around and I was due back in the office, I was feeling strong and ready for life to resume its natural rhythm—only with a new daily routine of visits with a cadre of doctors. 

Warning: if you’re queasy about medical stuff, stop reading now. Don’t feel bad—I used to be, too. 

My surgery started at around 3pm, and lasted until almost 6pm. My mom, my husband, my mother-in-law and my sister-in-law waited at the hospital the entire time I was in the operating room, and my mom and my husband were there when I finally started to wake up around 10pm. I didn’t fully wake up until 2am. In between 10pm and 2am, I’m told I was a giant pain in the ass for my nurses: I kept trying to pull out my breathing tubes, I hit my nurse call button every 20 minutes or so to complain that my “blood pressure was low” (how would I have known?), and I repeatedly refused painkillers that weren’t offered, because I couldn’t possibly be feeling pain yet, because I was still technically sedated. 

When I did finally wake up around 2am, my husband was curled up under an uncomfortably thin blanket on a cot near my bed, trying to sleep. My mom had gone home for the night and would return in the morning. I was propped up with pillows and there was a faint burning sensation in my chest where my breast used to be. 

I can’t easily describe how I felt—maybe it was an aftereffect of all the drugs in my system—but I think I felt fine, for the most part. Peaceful, almost. For the first time in weeks I’d had a good, long sleep, and for the first time in weeks I woke up feeling confident that my body was cancer-free. I looked over at my husband, who had been positive and supportive every step of the way, and I felt grateful for his strength. I wiggled my toes under the hospital blanket. I’d survived. 

Before he went to sleep, my husband had thoughtfully placed my iPhone on the table by my bed, and of course I couldn’t resist the urge to post a Facebook update about my surgery. I’m nothing if not loyal to my generation. 

Throughout the night, my nurses came to check on me every hour or so, and soon it was morning. My surgeon came in around dawn to check on the incision and give me instructions for when I went home later that day. She asked if I wanted to look at the incision myself, and my heart flipped over: I’d so far managed to avoid thinking about my once-perfect, now-deformed chest, but now there was no escape. I knew I couldn’t put it off forever, but nonetheless, I declined. Around 7 or 8am, my mom returned, and around the same time, my surgeon’s nurse came in to teach us all how to care for the drain. 

The drain. I guess I’ve neglected to mention this part so far, but here goes. (I’ll warn you again, this is gross, so please stop reading now if you get queasy about this kind of thing. Skip to the next post, it won’t hurt my feelings.)

I’ve talked about lymph nodes before, and how they relate to breast cancer—they’re the first place that breast cancer spreads to, and breast cancer surgeries usually include a lymph node dissection (also referred to as a sentinel node biopsy). Under normal circumstances, lymph nodes create lymphatic fluid, which circulates through your body performing some essential purpose, though I honestly can’t say what that purpose is. 

A mastectomy and lymph node biopsy disrupts the natural circulation of the lymphatic fluid through your chest, and if the fluid has nowhere to go, it pools in the void where your breast tissue used to be. This is not good. And so: the drain. 

Don’t say I didn’t warn you: here it gets really gross. 

The drain consists of a clear flexible plastic tube that goes under your skin and snakes around the surgical site. By my estimation, it’s less than a quarter of an inch wide, and the portion inside your body is maybe 12-18 inches long. Any excess lymphatic fluid goes into the tube, and the tube exits your body through a tiny opening in your side. A foot or two later, the tube terminates in a bulb resembling a grenade which collects the lymphatic fluid. Over the course of a couple of weeks, your body adapts and stops generating so much fluid, but in the interim, the drain has to be measured (to check the progress of your body’s adaptation) and emptied in the sink (!!!). This process is referred to as “milking the drain,” and I cannot think of anything in my life that was less pleasant than this. 

(In my previous post I mentioned that the mastectomy camisole featured special drain pockets—since you have to tote the drain around with you for a couple of weeks, the pockets come in handy.)

Once the nurse taught us how to care for the drain, an orderly delivered my breakfast and my first dose of Vicodin. After I’d finished my breakfast, I started getting antsy for home. With my mom’s help, I brushed my hair and put on my new jammies, and soon I was comfortably situated on my sofa in my living room. 

And that’s when things got really tough. 

Warning: If you’re queasy about medical stuff, stop reading now. Don’t feel bad—I used to be, too. 

I had my mastectomy on March 3, 2011. After weeks of uncertainty, unpleasant diagnostic tests, and sleepless nights, the time had come to get the cancer the heck out of my body. A few days prior, I’d decided, with the help of my mom, my husband, and my amazing surgeon, to undergo a unilateral mastectomy on the left side. I actually tried to persuade my surgeon to give me a bilateral mastectomy, in the misguided hope that removing both of my breasts would protect me from a recurrence of cancer in the future. My surgeon gently explained that a bilateral mastectomy was not necessarily an insurance policy, and suggested that we first deal with the known problem—the cancer in my left breast—before sallying forth against the unknown. Later, I would be extremely grateful for this advice. 

The day before my surgery, I left work early and went to Nordstrom to treat myself to some cute new pajamas. I figured if I was going to lose my boob, I might as well have some sweet jammies to wear while I wallowed on my couch. I also had to pick up a special “mastectomy camisole,” which had the distinction of being my first piece of clothing with “features:” a zipper down the front and down the side, snaps at the shoulder (all so it’d be easy to put on and take off), removable pockets for the drain (more on this later), and aloe-infused fabric for sensitive skin. The camisole was $60, but luckily it was covered by my insurance. I got two. 

The morning of my surgery, I woke up, took a shower with special antibacterial soap that decreased the risk of infection at the surgical site, and packed my new jammies and camisoles in my gym bag. My mom drove my husband and me to the hospital. I think I might have cried the entire way there. I wasn’t nervous about the mastectomy itself—in fact, looking back I’m not sure I really even considered what it would mean to have my breast removed—but I was extremely nervous about the anesthesia. I was terrified that once they put me to sleep, I wouldn’t wake up again. My mom and my husband had to literally pull me into the surgical waiting area. 

I should explain a little about what a mastectomy entails, from a medical standpoint. Underneath the skin, a breast consists mainly of fat and milk ducts, along with some other organic material, I imagine. During a mastectomy, the surgeon removes all of the tissue between the chest muscles and the skin. Many times, the surgeon will also have to remove the nipple, though not always. The end result is a flat chest on one or both sides, like a boy’s. Many women who undergo a mastectomy opt to have the breast reconstructed at a later date, as I did. 

During the operation, the surgeon may also perform a lymph node dissection. In an earlier post I mentioned that breast cancer spreads first to the lymph nodes in your armpit. An hour or two before the operation starts, a radiologist injects radioactive chemicals into your breast, and while you wait for surgery, those chemicals attach themselves to cancer cells in your body and follow the same pathways the cancer cells do. During the surgery, the surgeon uses an instrument not unlike a geiger counter to look for those radioactive chemicals in your armpit. Almost always, the cancer has reached at least a few lymph nodes, which have to be removed—one or two affected nodes is nothing to get overly worried about, but if the cancer is already living in many, or all, of your lymph nodes, it can change the course of your treatment, and it may mean the cancer has begun to spread to other organs. 

The surgery prep lasted several hours, and it stretched even longer because my surgeon’s patient before me encountered complications. While I waited, I was given scrubs and a bathrobe to change into, and a nurse came by to draw a few vials of blood to ensure that I was in good health before the operation. Just before the surgery started, my surgeon and her nurse came by with a Sharpie to draw a big black X over the breast they intended to operate on. It sounds primitive, but accidents happen. The anesthesiologist came by to start my IV, I said goodbye to my mom and my husband, and I walked into the operating room. 

Some general anesthetics erase your short-term memory. I remember climbing up onto the operating table and making small talk with my doctor as they all bustled about making last-minute preparations. Then everything faded to black. 

Before I talk about the mastectomy, and what that entailed, and how it felt, I want to explain why I am writing all this. 

I had my mastectomy almost 3 weeks to the day after I was diagnosed with cancer, and I won’t lie: those three weeks were by far the darkest, most terrifying weeks of my entire life so far. I lost sleep. I lost weight. I cried every single day. Being diagnosed with cancer, at any age, is a scary thing. For me, it was literally my worst nightmare come true. 

But here’s the other thing: 

My worst nightmare came true. And life kept going. 

It might sound terribly trite or painfully naive, but I think the most surprising thing for me was discovering that the sun still rose the day after I was diagnosed with cancer. I still had to eat and sleep and breathe, I still had to walk my dog and pay my bills. I still had to go to work and do the dishes. 

Certainly, some things changed. In fact, a great many things have changed, and I want to be frank and honest about those things. But even in the face of something so cataclysmic as cancer, many things in my life went on just as though nothing had happened. 

Over time, a new feeling began to take shape in my mind. I actually felt…happier. Let me be perfectly clear: when some stranger on the phone told me it was possible I might die, and soon, the 5-year-old living in my brain whined, “but no…I love my life! It’s not fair!” And I realized it was true: I do love my life. 

I get annoyed and stressed and bored like all people do. But in between those times, I have traveled to beautiful places—Africa, Australia, Europe. I’ve held my newborn nephews in my arms and smoothed their downy hair. I’ve sped down a deserted highway with the windows rolled down. I’ve laid in the grass and let the breeze wash over me. I’ve worked, I’ve created things with my mind and my hands, I’ve jumped off a cliff into the ocean, I’ve danced with a handsome stranger, I have loved. 

It sounds morbid at worst, sentimental at best, but facing my mortality at such a young age gradually came to feel like a blessing. Suddenly work e-mails and walks with my dog felt like a privilege—stolen pleasures on borrowed time. Deciding what to cook for dinner stopped being a chore when I realized maybe I have a finite number of dinners left in my life. 

For three weeks I walked around in crystallized time, terrified that perhaps I didn’t have as much time left as I thought, but also feeling inspired, and focused, and so, so grateful for every moment of my mundane existence. In those three weeks I spent a lot of time thinking back over the things I’d done in my life. The mental slide show of my time on this Earth was a marvelous thing to behold. 

I’m going to climb down off my soapbox now, but what I hope to convey is this: cancer is a terrible thing. It’s terrifying and painful. But cancer doesn’t have to be JUST terrible. Focusing on my gratitude has given me strength to look hard in the face of my worst nightmare, and my hope is that I can convey, through this blog, the beautiful, funny, and positive things that have happened in my life as a result of having cancer.

“Life is short.” We hear that old axiom everywhere, and we use it to justify all kinds of behavior and misbehavior. But let me tell you, life IS short, and here’s more: it’s even shorter than you think. 

My left breast. RIP boob. It was good while it lasted, I guess. 

And so began a period of my life in which I covered up that side with blankets…

and frilly clothes…

and lots of baggy shirts. 

My nose ring. 

(Lots of medical imaging techniques use strong magnetic forces to examine your tissues. Most of the time, you’re instructed to remove your jewelry and any clothing with metal components like zippers or rivets. Early on, I had to take my nose ring out for my MRI. I kept it out because I knew I’d have to take it out again soon, and somewhere along the way, I lost it. RIP nose ring. My mom hated you.)

So those six little spots on my MRI. 

Breast MRI’s are most effective when they are taken during a precise time in a woman’s cycle. Otherwise, they’re notorious for false positives. If you are like me and barely passed sophomore science in high school, a false positive seems to show scary things that aren’t really there. In my case, we couldn’t afford to wait for the perfect MRI timing, and I knew going in that the results might not be 100% accurate. 

My doctors took those six spots very seriously, but they also wondered whether they might be false positives. 

There was one spot in particular that worried my surgeon. Think of your breast like a clock, with 12 at the top and 6 at the bottom. Then divide it into quadrants—from 12 o’clock to 3 o’clock, 3 o’clock to 6 o’clock and so forth. My initial tumor was in the 5 o’clock position, way down at the outer edge of my breast and seemingly very close to the skin. This in itself is worrisome enough, but there was another spot on my MRI around the 9 o’clock position, and it was lit up like a Christmas tree in the images. The quadrants are important because two tumors in two different quadrants pushes you into a different stage of cancer development and most commonly means you will need a mastectomy. 

So—another biopsy. Back to the breast center, back to the young radiologist and the heavily-accented, motherly nurse, more needles, another ice pack in my bra, and several more mammograms. 

Unfortunately, this time, the radiologist missed the tumor. It happens. 

A few days before I was scheduled for surgery, I got a call from the magnetic imaging lab, confirming my appointment for an MRI-guided biopsy of those six spots, including the one we missed in my second biopsy.  

I panicked a little, and let me explain why. First, as I explained before, a biopsy entails poking the tumor site with a hollow needle and taking a sample. An MRI entails laying absolutely still in an uncomfortable position, in a tiny, loud tube, for half an hour or more. Put these two together, and remember that I had 6 other possible tumors, and you understand why I was not looking forward to this. I pictured my breast like a pincushion, with needles sticking out in all directions. No thanks. 

I called my lovely surgeon to ask her why I had to do this. A few days earlier I had decided to undergo a unilateral mastectomy, in which all of the breast tissue on one side is completely removed, instead of a lumpectomy, in which only the tumor itself is removed. By my way of thinking, the mastectomy rendered the MRI-guided biopsy unnecessary—they were going to take it all out anyway, those 6 little spots included, and they could biopsy to their hearts’ content once it was removed from my body. 

After some discussion with my surgeon’s nurse, and with my surgeon herself a few hours later, they decided it would be ok to cancel the third biopsy and move forward with my surgery as planned. I was relieved, and grateful that my surgeon was so open to hearing me out and discussing my options.

Everything was set for my surgery. 

Why I got cancer in the first place.

I was diagnosed with colloid carcinoma, sometimes referred to as mucinous carcinoma. Colloid carcinoma is like a little bag of mucus with cancer cells floating in it. Yum, right? I know.

Colloid carcinoma is a very rare type of invasive breast cancer, affecting less than 3% of all breast cancer patients. It usually appears in women who are older than 50. My mom, who is a nurse, dug up a bunch of studies on colloid carcinoma, and didn’t find any with patients younger than 48. I wondered, with morbid triumph, whether I was the youngest colloid carcinoma patient in history. I still don’t know.

The good news is that colloid carcinoma is a very slow-growing type of cancer, and it has only a 15% chance of spreading or coming back once it’s been treated. (As far as cancer goes, a 15% chance of recurrence is almost miraculously low.)

My cancer was also strongly hormone-receptor positive, meaning that the tumor was very receptive to (one could say fueled by) hormones like estrogen. This is a very good thing, because treatment for these types of tumors tends to be more effective than treatments for hormone-receptor negative tumors.

Breast cancer in women younger than 50 tends to be of genetic origin, and it tends to spread to the bones, brain, liver, and lungs. (All very important parts of your body!) Over the course of three weeks after my diagnosis, I underwent testing to determine what had caused the tumor (inasmuch as we can, anyway—more on that later) and whether it had already started spreading.

One of my first appointments after my diagnosis was with a geneticist. He wanted to test my blood for the BRCA1 and BRCA2 gene markers. These are hereditary genes, passed down through families, that signal the potential for breast cancer. If a woman tests positive for the BRCA markers, it means that her breast cancer is more likely to spread to her other organs or come back after treatment. I was told this test is still fairly cutting-edge, and many insurance companies will not cover it because it comes with a hefty price tag in the thousands of dollars. Luckily, my insurance did cover it. The lab took two vials of my blood and sent them off to California to be analyzed. The results would take two weeks.

In the meantime, to determine whether the cancer had already started colonizing other areas of my body, I had an MRI, a bone scan, and a PET-CT scan. The MRI consisted of laying boobs-down in a tiny tube for 30 minutes while it made very loud noises. You have to lay completely still, in a very awkward position, the entire time. (Think about how you look when you’re doing jumping jacks, when your arms are up in the air. That’s how you have to lay when you’re doing a breast MRI.) My arms and hands fell asleep after 5 minutes. The next 25 minutes were almost pure torture.

The bone scan was much easier—the machine made quiet, gentle swishing noises as I slowly passed through another tiny tube. The machinery is not sensitive to metal, so another person can sit in the room with you while you’re getting your bones scanned. Compared to the MRI, the bone scan was downright relaxing. I almost fell asleep.

Then came the PET-CT scan, which was as tough as the MRI but in another torturous way—because cancer cells love sugar, I couldn’t eat any carbs for two whole days beforehand. When someone tells you to stay away from starchy vegetables, let me tell you, the only thing you can think of is a nice, greasy bag of potato chips. For two. Whole. Days. I must have dropped 5 pounds just in potato-chip-related losses.

When you come in for the PET-CT scan, they give you a nasty “smoothie” full of radioactive chemicals. Calling it a smoothie does not make it go down any easier. And you have to drink two of them. At some point during your smoothie breakfast, they bring in a lead box, with a syringe inside (which is itself encased in a lead tube). This syringe contains more radioactive chemicals. At this point, your husband or your mom has to leave the room, because you literally become radioactive yourself. Sounds fun, right? I know. They inject you with the lead syringe and check on your smoothie-drinking progress, and before you know it, you’re in—you guessed it—another tiny tube. The PET-CT scan checks your soft tissues for cancer cells. It takes about a half an hour, but you’re allowed to take breaks and move around a little.

Then in the space of three days, I got the results from all of the tests:

Genetic test: negative. My cancer was not caused by faulty genetics. (Thanks, Mom and Dad!)

MRI: showed 6 other possible tumors in the side with the confirmed tumor, as well as one other questionable spot in the other breast and a spot on my liver. My doctors were already moving pretty quickly on my case because of my age, but after this test result came back, people got very worried. Cancer of the liver is very serious business. But, miraculously…

PET-CT scan: came back completely clear, meaning they didn’t see any troublesome areas in my soft tissues. This is why they did the MRI and the PET-CT scan—it provided a way of double-checking test results against each other. MRI’s are notorious for false positives, and the PET-CT scan showed that the spot on my liver was probably just “artifact,” meaning I had moved during the scan or the machine had picked up a spot of radioactive static. Needless to say, these test results were a huge relief.

Bone scan: also completely clean. My cancer had not spread to any other part of my body, as far as the doctors could tell.

But as for those 6 other little spots in my breast with the confirmed tumor…well, those would have huge implications on what was to come.

My name is Juliet. I am 27 years old. I have breast cancer.

One of the first things people ask me after I’ve told them I have cancer is: how did you find it?

For me, it was straightforward and ironically unremarkable: I felt a lump.

It was a tiny thing—about the size of a pea. Funny how something so small can have such huge implications.

I worried over it for a month or two, hoping it would just go away on its own. It didn’t. The impetus for finally picking up the phone and calling my doctor (I’ll be honest: otherwise, I might not have) was discovering a second lump in my armpit. I knew enough about breast cancer to know that it spreads first to the lymph nodes in your underarms, and I panicked.

In a hushed, almost embarrassed voice, I explained to the receptionist:

I have a lump in my breast.

She told me to come in that day.

My primary care doctor (oh America, and your capitalist-based medical system!) took a look, touched that tiny bump, and declared it a pimple. Or maybe a cyst.

Huge. Sigh. Of. Relief.

But just to be safe, she added, she was sending me to the breast center, so they could confirm it.

No problem! I felt a sort of feminist pride to be making my first trip to the breast center.

Only I waited another month to call them to make an appointment.

When I finally went in, a soft-spoken young ultrasound tech and a heavily-accented, motherly nurse ushered me onto a bed, squirted some gel onto my breast, and rolled a over it a couple dozen times. As I squinted at the screen, trying to make sense of the black and white fuzz, I silently joked with myself that this was not how I pictured my first ultrasound; I’d rather hoped that it would be for a happy thing growing inside me, namely, a baby, instead of an evil pimple-cyst. The motherly nurse held my hand.

After ten minutes or so, the ultrasound tech looked up and declared it a cyst. Or maybe a pimple.

Huge. Sigh. Of. Relief.

But just to be safe, he added, he wanted to biopsy the lump with a hollow-core needle.

I suddenly felt very cold.

After I dressed, they led me in to a scheduler, a brisk Indian woman with pictures of two teenaged daughters on her desk. She booked an appointment for me the next week and ushered me out the door.

The next week, my husband met me at work, and we walked the 6 blocks to the breast center together. I went in to the same exam room alone, and was comforted by the same motherly nurse. While the same ultrasound tech prepped his equipment, I silently cried, not knowing why—perhaps because I had no idea what to expect, or perhaps I hadn’t taken any of it seriously until that moment. I can honestly say, though, that it still hadn’t truly occurred to me that I could have cancer.

The biopsy was unpleasant—as any new, slightly painful medical experience is bound to be—but the tech and his nurse were fast and efficient, and soon I was on my way home, ice pack stuffed in my bra and a humorously numb feeling in my breast. After a few hours, the Novocain wore off, and I promptly forgot the whole thing ever happened. 

The next day, around noon, I got a call from a radiologist at the breast center. He had a deep, cartoonish voice and a Midwestern accent. He talked for a few minutes, using lots of incomprehensible science-y words, until I interrupted him:

“I’m sorry, but wait one second: you’re saying it’s benign.” More of a statement than a question.

A pause.

“No. I’m sorry. It’s malignant.” Another pause. “It’s cancer. We’ve already made an appointment for you to see a surgeon right away.” 

I felt like my legs were going to give out underneath me. I was standing in an empty hallway in my office, but the foundations of my world had just collapsed. That horrible word echoed in my head.

Cancer.

Cancer.

Cancer.

Cancer.

I barely heard another word the radiologist said, and after another minute or so I thanked him politely and hung up. Immediately I started bawling and shaking uncontrollably. I walked to a friend’s office in a daze but needing to share the news, to test the reality of the moment, to bump against it a little to see if it had any give. She wasn’t at her desk, but her office mate was. I closed the door behind me and whispered those impossible words:

It’s cancer.

By the look on her face, I knew it was real: horrified, then shocked, then sympathetic. She rushed to give me a hug and rub my arm while I rolled the words around in my mouth a little:

It’s cancer.

It was supposed to be a pimple, or a cyst, a little lump of nothing. Yet impossibly, it had turned out to be not-nothing, a huge and terrible something that in a phone call, had changed my life.

I didn’t know yet how much it would change my life.