"It's Back"

So.... its been a while guys. I had truly hoped that my cancer journey had come to an end but I found a new lump... well more like a spot if I'm honest so I got in touch with the breast nurses and they invited me in for an examination. 

Walking in to the breast unit felt so strange, I was immediately catapulted back in to a place of anxiety. My heart felt like it was pounding outside of my body. However weirdly, I wasn't worried. I genuinely thought, if anything, that I was wasting their time. 

Eventually I was called in to the consultants room. It wasn't Mr Martin, my previous consultant, it was his registrar. We spoke briefly and I explained about this 'spot' before I hopped on the bed to be examined. She spent a prolonged time feeling the area and then decided to send me for an immediate ultrasound. 

I left my mum in the waiting room while I went to have the scan. It soon became apparent that they were concerned and before I knew it I was having a biopsy taken and a marker put in to my left breast.

I tried to stay positive in my head. As I was sent back to the waiting room, I recalled that previous biopsy trips had resulted in a 3 week wait to get results. Knowing I had a holiday to look forward to in less than two weeks meant I could hopefully forget about all this until I returned. 

No... that's not how it went. 

Again I was called back to the registrar and she very bluntly said "Yeah, it's back". No hesitation, no pussy footing around, no three week wait for results... just "Yeah, it's back"

I was so confused and taken aback that I waked out of the office, collected my mum and went straight back to the car. I just was not expecting that news, especially not delivered in that way.

I head home in disbelief. Sh*t, how am I going to tell the children? We're supposed to be going to see Kings of Leon tonight in Manchester. It's the last thing I want to do right now.

I call the breast nurses when I get home to check that I had heard correctly. They apologised for the abruptness of it all and that I hadn't been spoken too by one of the breast care nurses to process. They said although they don't have the biopsy results, they know that it is definitely cancer so they tell you at this stage so you can prepare for it when you come back for the results.

I sit at home waiting for my kids to get home (they are 17 and 13). We have an honesty policy in our house... no secrets. So I get them together when they land back home. I explain that my breast cancer has returned and we go through their questions. They are so understanding but fearful. We hug for what feels like forever, before deciding we should still go to the concert... make memories... and we did...

So we begin again. I'm back in three weeks, after our Summer trip to Crete,  to get the biopsy results. 

Microductectomy Results Day - I Have Cancer

I've remained positive but inside I've been dreading today. We drive to the hospital and my tummy flutters. I try and breath deeply to calm my nerves. By the time I sit down in the waiting room my heart is pounding so fast that I feel like it is about to burst out of my rib cage. The wait feels like an age. Until eventually....

"Leanne Nash"

I just about get my date of birth out and enter the consultation room. This time there is an extra person in the room - another nurse. My brain goes in to overdrive. I sit down and I am asked how I am, hows the pain? I don't feel like I'm really there, I just feel odd. I'm asked to go behind the curtain and put the gown on. The consultant removes the steri-strips and checks the wound. Everything looks good so I get dressed and sit down again.

Mrs S, my consultant, explains that they did find a papilloma which was likely what was causing the bleeding. However, while she was removing the duct she had been able to feel that the surrounding ducts weren't right. They didn't feel as they should. She explained that she had tried to remove the areas that felt odd but they went deeper and deeper she had to stop. All of the areas she had removed had been sent away for screening and the results showed that there was a cancer present. A very early form of cancer known as DCIS - ductal carcinoma in situ. She was very apologetic - I think most likely because they were convinced I was healthy and it was me that had  to push for the microductectomy in the first place. Immediately the additional nurse was introduced, she was a Macmillan nurse specialising in breast cancer.

Time stood still for a minute. I don't think I spoke. The nurse left to get me some water.

It was explained that the next step would be for me to have a mammogram and another ultrasound to see if the DCIS was visible then we would need to go back and see her again later today. She thought that the best way to proceed would be to perform a central excision. A large incision would be made across my left breast. They would aim to remove all of the DCIS but they would need to remove my nipple.

I left the consultants room and began to cry. I honestly think the thought of losing my nipple had hit me harder than hearing the word cancer. That may seem ridiculous but right then in that moment that was what mattered to me. My femininity. It doesn't matter whats going on in the inside as long as you look and feel the same on the outside.

I were ushered in to a side room and handed some tissues. The Macmillan nurse came in with lots of booklets for us to read. I told her, "I honestly just want them to take both boobs". I didn't want to risk my life. We talked for a while and she explained that having a bilateral mastectomy was a huge decision. I'd have to have a reconstruction with silicone implants. The silicone implants wouldn't feel like part of my body, Id have no feeling and they'd feel very cold.

I asked more questions about the results. The consultant had removed a 10cm x 1cm area and a 2cm x 1cm area. All of which came back as high grade DCIS. Luckily DCIS is completely contained within the ducts of the breast and has not yet got the ability to spread outside. As far as we know, my cancer is contained.

DCIS is graded in three ways based on how the cells look under a microscope. A system is used to classify the cancer cells according to how different they are to normal breast cells:

Macmillan Cancer Support: DCIS Grading

The nurse asks about whether we will tell the children. I explain that because of Dad and the association that his death has with the word cancer, we would not tell them. She agrees its probably best. We're eventually left alone to wait for my name to be called for the mammogram. We hug each other tightly.

The mammogram was horrible. I was still healing from the operation and having my boobs squished in a vice was the last thing I needed. As I stood there top off, boob flattened, I realised that I just had to get on with it. I would fight this - no matter what.

A couple of hours later we were back in with the specialist. She explained that nothing at all was visible on the scan, there was no visible calcification. Mrs S explained that because of this she would need to go in blind but the only option would be for me to have the central excision. Ideally she would have liked to have had an MRI scan done but because of my recent surgery the scan would only show inflamed areas where the previous operation had been performed. You have to wait 6 weeks post surgery to get a clear view and she explained we didn't have time to wait. I'm told it is likely that I will need radiotherapy once I'm recovered, just to ensure that all of the bad cells are eradicated.

I asked how long I was likely to have had this growing inside me and she explained because it had reached high grade it certainly would have been a number of years. I explained my concern about having pain under my arm but she thinks it's likely just down to the surgery I've had.

I was given a folder confirming my diagnosis "left breast cancer". My operation will be performed on 8th January 2018.

As we leave the hospital I see the messages and missed calls from my mum. How the hell am I supposed to tell her I have cancer so soon after losing Dad?

FNA Results & Core Biopsy

After 9 agonising days, we fearfully head back to the hospital to hear the results. This time the waiting room is busy. It is filled with women and their 'support partners' - sisters, husbands, daughters. Again no one interacts. Everyone's heart pounding, hoping. We wait for 40 minutes. During that time my anxiety is through the roof, my tummy flutters and my heart is racing so fast I think it could explode.

"Leanne"

A nurse calls us. "Can I just check your date of birth?" I reel it off, my voice slightly broken by the fear. We are led in to the consultation room and sit down.

Mrs S, the specialist, shakes our hands. The results have come back. The FNA results were inconclusive but the swab from the bloody discharge has come back as 'suspicious'. I'll need to have a core biopsy. This is where a larger, hollow needle is used to take tissue - rather than just cells as in the FNA.

I'm advised that this can take place later on today if I have time to wait, the specialist again says she is convinced I just have a papilloma but because of the discharge she wants to investigate further. I head over to the coffee shop for an hour while we wait for my appointment.

I feel calm again. I'm not in the clear but at least I don't have to go away and wait for days again. I Google 'core biopsy' on my phone. I'll be given a local anesthetic this time so at least I won't feel anything.

An hour later I head back. I'm given a gown (it will not defeat me this time!) and I head to the changing room. Again there is another woman there waiting. I desperately want to speak to her, share my story, ask hers... but I cant. It's like my voice has gone.

Eventually Im called in to the ultrasound room - the same one as before. The curtain is pulled across and the nurse sent to the fridge to get the lidocaine. The radiologists asks me to remove my gown and lie on my right side with my left arm above my head. It's uncomfortable and I dread that I have to stay there... still... for a long period.

The local anaesthetic is injected in various places to numb the area. She apologies because the area is so close to my nipple and that is the most sensitive part. She keeps going around my breast but at one point she has to call for a superior to come in, one of the needles had gone in to the duct where the blood was and so a new aneasthetic needle was required.

The radiologist was really good at informing me what was happening at each stage however at the time there were so many needles that I thought that the biopsy had begun. Unfortunately that was only the anaesthetic! Eventually, I was numb and the actual biopsy could begin. A small cut was made in my skin and a big needle inserted. When the sample is being taken it's almost like a gun. There's a horrible loud noise and then the sample of tissue is grabbed. This was done 3 or 4 times over the course of hour appointment, with the senior radiologist was assisting and advising on how to best get to the areas that needed sampling. It wasn't pleasant but you just have to deal with it don't you.

After the biopsy the radiologist said "oh I forgot to tell you about this bit, I'm just going to put a titanium marker in place. Ok?" I was so traumatised from the biopsy itself that I didn't really have the chance to question it. I hated that it was just sprung upon me without any real detail and I had no time to think about it before it was done. It made me panic because in my head I felt as though they could see something bad and had to mark it up. I've since found out its so they know where they took the biopsy from so they can go back and remove anything nasty and locate it quickly

Afterwards a small dressing was applied where the incision had been made and I was sent home. The bumpy car journey was as awful as the last time and once the local anaesthetic had worn off it was really achey. Over the next few hours awful bruising began to appear. But for now life goes on, we just need to wait. Again.

First Time at the Breast Clinic

A few days later I received a call from the breast clinic and the date was booked. 17th October 7.00pm.

When the confirmation letter arrived it said that I could be at the hospital for a number of hours. They try to work on a 'one stop shop' basis where you see a consultant and have all necessary diagnostic tests in one go - a mammogram, an ultrasound and any biopsies.

I was so nervous heading in to the hospital. It was relatively quiet, probably due to the evening appointment time, but at 35 I was the youngest patient in there.

Eventually I was called into meet the specialist, I was relieved that it was a woman. Id been thinking about whether it would be quite a lot, I guess deep down I was thinking that a woman would understand the importance of femininity, what it meant to be a woman and just, well, know... you know? There was a nurse there too.

I sat down with my husband and explained my symptoms to her... the lump...the blood. I was then asked to remove all of my top half clothing and pop a gown on behind the curtain. The specialist examined the right 'good' breast first before moving on to the left. There was some dried blood on my nipple - evidence of something untoward. She tweeked my nipple to see if more came out - it did. The nurse passed over what looked like a clear glass slide - you know the type you would put stuff on at school before investigating under the microscope. It was put on top of my nipple and the dark brown blood smeared across it to be sent for testing. She feels the lump that I had felt and marks me with an 'X' with her black marker pen.

I keep the gown on, my clothes in a hospital plastic bag and I'm told to go and wait in a separate 'female only' waiting room. Apparently I am only having an ultrasound, a mammogram is not necessary. I sit down and stare at the TV in the waiting area. There is another woman there - we do not speak. It's almost as if we are gripped by fear and our voices gone. We smile but there are no words.

She's called first. I'm alone.

I get up to get a cup of water but the ties on my gown have somehow been caught on the arm of my chair. In some kind of slapstick comedy moment, my gown unties as I stand and I expose my whole top half. Thank god there is no one else here! I laugh to myself and that puts me at ease.

20 minutes later the door of the ultrasound room opens and I know I'm next. My heart rate starts to build again as I wait for my name to be called.

"Leanne"

I carefully stand, ensuring there is no gown/chair entrapment and walk through.

The room is dark, its divided by another curtain that blocks the door. I'm asked to remove the gown and lay down on the bed. The gel is squirted on to my breast, the screen turned out of eye shot and the scan begins. It's tense and I try to scan the radiologists face, eye movements, anything for clues. She tells me she can see something but it's likely just to be a harmless cyst. She want's to do an FNA (fine needle aspiration). This is where the radiologist uses a fine needle and syringe to take a sample of cells to be analysed under a microscope. I knew what this was and what to expect as my Dad had been through this during his diagnosis.

I'm wiped with a sterile wipe and using the scanner, the sonographer guides the needles in to the suspicious areas. As she inserts the needle in to my duct, the blood is released out in to her needle. She decides to drain as much of it as she can. I have no clues as to whether anything is spotted but it is over.

It hurts a little and my breast is really tender. I am told to get dressed again and go back to the original waiting area to see the specialist again.

We are asked back in. The specialist tells me she is convinced that my symptoms are being caused by an intraductal papilloma. They will send everything off and I'll be sent a further appointment to come back in for my results.

The car ride home was horrible. You don't realise how uneven and bumpy the roads are and how bad your suspension is until you are in pain.

Now I just need to wait. And hope.