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?

Microductectomy Day

I arrive at the hospital for 12.30pm. Today is microductectomy day. I'm just a day case but I've brought my overnight bag just in case.

The day case waiting room is interesting. Most patients appear to be hear for cataract operations. I watch them get called one by one to see the eye specialist and giggle as each of them appears with a giant black arrow drawn on their face, each pointing to their 'bad' eye. It takes a lot not to laugh out loud and I smirk to myself as I see the mass of 'drawn on' pensioners in front of me.

Eventually I am called in to see the anaesthetist. He seems quite young but he puts me at ease. I'm asked to confirm my name, date of birth and the type of operation I am having done today. He asks about my medical history and I tell him about the DVT I had when I was pregnant with my daughter 7 years ago. He explains I'll need to wear my DVT socks for a few extra days after the operation to be safe. Finally he asks if how I usually feel when I come round from anaesthetic (I've had quite a few operations in the past thanks to wrist injuries and a difficult nose, so I'm a pro). I tell him I just usually feel hungry. We laugh and I return to the waiting room.

20 minutes later the consultant arrives and takes me through the operation again. I'm first on her surgery list so she'll see me soon. I get changed into my gown, DVT socks and the fake NHS totes toastie style socks that I was given. I don my dressing gown and before I know it, the nurse is walking me down to theatre.

In the theatre I am met my the anaesthetist from earlier and he introduces me to the rest of the team. We chat as they prepare me, inserting my canular, putting chest monitor probes on me and the blood pressure monitor. A few minutes later I'm wearing an oxygen mask (vanilla flavoured oxygen apparently!) and I'm put to sleep.

--

I wake up in recovery with one other lady next to me. The nurse checks my blood pressure and brings me a glass of water. She offers me a cup of tea and a piece of toast. I accept the toast - I'm hungry as expected! The toast is THE most amazing toast - salted butter glistens and melts on the surface. It's amazing. I have another glass of water and I need the loo. The nurse helps me up, she tells me I can go myself but under no circumstances can I lock the door.

Within an hour and a half my husabnd arrives and we head home with a bag of painkillers. The drive home is the worst one yet, every single stone in the road makes the car jump and sends pain through my body. It's definitely time for bed.

Not Prepared to Wait

So I couldn't just leave it. If I learned anything from Dad's cancer journey it's to always trust your instincts and to never take no for an answer when it comes to your health.

On Friday I made the decision to call the breast nurses at the hospital. I told them I was really unhappy about being left for 6 weeks. I explained that whilst I completely understood that my biopsies had come back benign, I still had this horrible 'suspicious' bloody substance coming out of me and I really wasn't prepared to wait until the week before Christmas for another scan.

The nurse was lovely and booked me in to see the consultant again today.

We arrived at the hospital but I didn't feel as nervous today. I was on a mission. Today I would fight.

"Leanne Nash"

Date of birth confirmed, we headed in to see the consultant.

"So we aren't supposed to see you for 6 weeks? What are you doing here?" she said in a rather annoyed tone.

I reiterated my concerns to her about not being left for 6 weeks and she asked me to go behind the curtain so she could examine me again. The nurse always comes with me behind the curtain. I told her "I just know my own body and something isn't right." She looked back at me in sympathy and smiled.

The consultant came through and asked me to raise my arm. She felt my breast and pinched either side of nipple. A lot of the dark brown blood came out.  She stepped back and asked me to get dressed again. The nurse handed me some tissues to clean myself up.

Once I was dressed I returned to my seat.

"I think what you have is a papilloma which most people just live with, they aren't harmful, but since you have the discharge I can offer you a microductectomy." She ran through all of the risks involved, the loss of sensation I'd feel, the scarring I'd have. I really felt as though she was trying to put me off having the operation. I just kept nodding "That's fine." I knew I was making the right decision.

I asked a few questions, each time it was as though she was trying to make me feel stupid for asking it. She was clearly still annoyed we had come here only a few days later and not waited the 6 weeks. Finally my husband asked, "What would have happened if we had waited the 6 weeks but Leanne was still bleeding like that?" She replied that she would have booked me in for the operation anyway.

We left feeling a sense of achievement. We had shaved 5 weeks off my waiting time. My operation is booked in for 7th December but I'll need to come back on 27th November for my pre op.

Grief

Grief always hits you when you least expect it, the tears stream down your face without warning. I really miss Dad’s company on the train home from work. I miss seeing him dashing down the stairs at Central to make it in to the seat I always saved him. I miss us laughing together at the poor Moorfields commuters trying to squeeze on the train. I miss hearing the office gossip and him telling me about places on the journey back. I miss banging on the train window to get his attention on the days when he just missed me and the train zooms past. I miss him so much x 

Core Biopsy Results Day

We're back again. Only this time the anxiety is even more intense. Today the waiting room is full. We stand until another patient is called. Again my heart beats like a train. I hate this waiting room. Today as we waited a lady came out of the consultants room in tears, everyone watched as she was led off to another room to contemplate her journey.

"Leanne Nash"

We rise and I give my date of birth to the nurse as usual. Today we are taken in to a different room and I don't recognise the lady in front of me. She introduces herself as a registrar. She explains that my results have come back.

I take a deep breath.

The results have come back as a 2 on a scale of 1 to 5. This is classed as benign.

I begin to cry and explain my worries that something just isn't right. I tell her about what had happened to my dad. She tells me not to worry but I will need to come back in 6 weeks for another ultrasound.

We left but the doubt remains. I feel a real sense of unease.

RIP Dad

At 3.10 am this morning I received the call I'd been dreading. It was the nursing home that were taking care of my dad. They said it was time. We needed to go in.

 It's the worst call I have ever received. My heart was pounding. Now I had to call mum. How do I do that? How can I call my mum and tell her that we have to go and say goodbye.

Shaking, I dial the number. A heart wrenching conversation occurs and I pull my clothes on.

I kiss my husband and kids and drive to mums with tears streaming down my face. As I approach mums I try and wipe the tears away. I need to stay strong, I need to look after her today.

Mum gets in the car and we make our way there. We talk about how they might have made a mistake. Two weeks ago we were told he might only have a few days left and they were wrong then.

Deep down we knew it was coming but we desperately hoped that this was all a bad dream.

Unfortunately it was not. A few hours later he was gone. Cancer has taken Dad. Stolen him away from us.

Our hearts are broken.

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.

So I found a lump...

Well 2017 has been traumatic to say the least. My Dad was diagnosed with cancer on 1st September and sadly just 8 weeks later on 1st November he was taken from us by this disgusting disease.

During Dad's illness and whilst my husband was away on a trip... I found a lump. That same day - Sunday 8th October -  I discovered that the spots of blood that had been appearing on my pyjama top for a few months had actually been coming from my nipple.

Panic.

The following day, on my mums birthday,  I called the doctors as soon as they opened and was offered a same day appointment with the nurse. The nurse felt my breast and said she would send me as an urgent referral to the breast clinic. She advised that I would receive an appointment within 2 weeks.

As I left the surgery, tears streamed down my face. I called my husband in Belgium and told him the news. He calmed me down and I headed off to work.

Unfortunately by the time I sat down at my desk my tears would not stop. I headed to the ladies to try and sort myself out but I just felt sick and couldn't catch my breath. I was sent home.

Waiting for the breast clinic appointment to come through felt like forever, although that was just the start of the seemingly constant wait for the 'next step'.