1 Once There Was a Lump...

The diagnosis for my breast cancer was not given to me by my doctor. It was my husband Guy who gave me the news, and it was the hardest thing he's ever done.

This journey began in January 2006. I was seven months pregnant with our first (and only) child, a boy. It had taken a year and a half to get pregnant once we started trying and my husband and I were both thrilled that a little one was finally on the way.

During the month of January I found myself dreading the arrival of February. It was an irrational fear -- but I could not shake it. Something unpleasant was coming and I didn't want to face it.

The pregnancy had been blissfully normal. Everything was on schedule with our son's development. We were slowly getting the requisite baby stuff accumulated and the baby's room ready. We had a name picked out and a spot reserved at a Montessori school nearby for when I returned to full time work. I had planned only a six-week leave of absence.

I had been reading books on pregnancy, childbirth, and how to care for an infant. I even had my birth plan written out, so I felt prepared for childbirth. We had places reserved in parenting classes scheduled in February. In other words, the pregnancy was progressing normally and I was happily ticking to-do items off my parenting preparation mental checklists.

I was looking forward to breastfeeding even if it was only for the time I was on leave. My hope was to continue nursing in the mornings and evenings without pumping during the day. I didn't know if that would work but figured I could ask during the breastfeeding class in February.

I was constantly fatigued back then. I couldn't make it from the car to the grocery store without getting out of breath. Guy always let me push the cart whenever we went someplace with a shopping basket so that I would have something to hold onto.

Near the end of January I found a lump in my right breast.

I was changing clothes for bed and my shirt got stuck as I pulled it over my head. My right arm came free suddenly and I smacked myself on the breast. Whoa! That hurt!

Gently, I probed the area and found a sizable lump that hurt when I pressed on it. It only hurt when pressure was applied so that explains why I hadn't noticed it before. The lump moved around depending on where I pushed it.

I had a checkup with my obstetrician already scheduled in a couple of days, so I decided to wait until I saw her before doing anything. Of course by then I had poured through the book "What to Expect When You're Expecting" and I found the section on mastitis. I believed I had a clogged milk duct and told my obstetrician so. She wasn't sure what to think. Mastitis occurs when a lactating breast gets a clogged milk duct. It's unusual to get a clogged milk duct before the breasts begin producing milk, but it's not impossible. My doctor suggested hot compresses to help break up the clog.

I waited a week before figuring out that hot compresses meant more than a longer, hotter shower in the mornings. I spent a few nights holding a plastic tumbler full of hot water to the lump. After applying heat the lump would seem to change in shape and would even get smaller, but the next day it always returned to the same size. Over time it started to hurt more.

By the time I saw my OB again two weeks later the lump had developed a localized fever and turned a bright shade of red. It hurt to wear a seat belt. Hot compresses weren't having a lasting effect and I was tired of it.

My doctor took one look at the lump in its new condition and immediately drew back with a worried expression. "I want you to see a breast surgeon," she told me. "Sometimes cancer presents this way." She added that she didn't believe that this was cancer, but she wanted to eliminate the possibility.

In months to come that sentence would burn itself into my memory: "Sometimes cancer presents this way."

My obstetrician gave me a list of breast surgeons with the first three circled as preferred providers that worked with my OB/GYN group. I was told to get an appointment right away and to let her know if I couldn't see someone inside of a week's time.

I lucked into an appointment with the first surgeon on the list first thing the next morning. That night, I started taking the antibiotics that my OB had prescribed for the infection that we assumed was causing the feverish red spot on my breast.

When I saw the breast surgeon for the first time the next day, the antibiotics had given me some relief. The redness had gone down and the fever was gone. The lump hurt less.

When you're pregnant the medical community prefers not to give you mammograms or x-rays, so my diagnostic options were limited.

The breast surgeon used ultrasound to look at the lump and saw only a big pocket of fluid. She attempted a needle aspiration in her office to draw off some of the fluid, and was surprised at how little came out. She told me that sometimes a clogged milk duct can become an abscess and sometimes an abscess doesn't cooperate with a needle aspiration to drain it. Sometimes a small incision needs to be cut to help it drain, and sometimes surgery is needed. Since the reduction of fever and redness meant I was responding well to the antibiotics, she wanted me to finish the 10-day course of medication first and come back for a follow-up visit.

I did that. As soon as the antibiotics were done, the redness and localized fever returned. I mean, the very next day after I took the last antibiotic pill the symptoms came right back -- along with the tenderness.

When the breast surgeon suggested that she needed to cut a small incision into my breast to help drain the abscess, I wasn't adverse to the idea. I had been hurting for weeks and anything to get rid of the pain sounded good to me. This was on a Tuesday, February 28th.

Oh, man, the incision hurt. The surgeon used a local anesthetic in her office so the process of being cut itself didn't hurt much, but there was pain as the local wore off. She used the ultrasound again and again it only revealed a pocket of fluid and nothing more. The surgeon said we would check it again in two days and if it still hadn't drained she would need to perform exploratory surgery to see what was causing the mass.

I left hurting but relieved. She hadn't said the "C" word. Nobody had said anything about cancer and nobody thought that's what I had. I called my husband from the parking lot and informed him that he was coming with me to the follow-up visit with the breast surgeon in two days. If she did something like this again I wanted him to drive because I was in a lot of pain. I drove home with one hand holding the seat belt away from my torso and the other on the wheel as I tried not to cry.

So I dealt with having a 1 centimeter incision in my breast for two days. Gauze had been stuffed into the hole to help wick away the fluid and my first look at that was the following morning in the shower. I nearly threw up when I followed the surgeon's instructions and removed the bandage over the incision and then pulled out the gauze. I had a hole in my chest! It was strange and surreal, but it was an abscess and this would pass. The surgeon had seen what lay beneath the skin twice with the ultrasounds and she hadn't said anything about cancer.

The incision was made on a Tuesday. When I returned for the follow-up visit on Thursday I brought my husband with me. I knew from prior conversation with my surgeon that I would possibly need to go to the surgical center across the hall from her office so that she could remove the abscess surgically. I knew it was a possibility that we would go from her office to the surgical center to take care of things if I still needed help during that Thursday morning checkup.

The surgeon checked the incision, which hadn't drained much of anything from the abscess. She told us she believed that I had a mass that was brought on by pregnancy hormones, an event that was unusual but not unheard of.

Instead of doing what we expected and sending me across the hall that day, she told us the surgery would be performed the following morning at Seton Medical Center, a local hospital and the place where we planned to have our baby. Oh, and surgery at 36 weeks of pregnancy could cause labor to start so the baby might come early. Oh!

We left the office shell shocked. I was 36 weeks pregnant which put me at the beginning of my ninth month. The baby could come a month early? That started a flurry of panicked phone calls to the soon-to-be grandparents that afternoon. "Hi Mom. I'm having surgery tomorrow. I don't know if the baby will come early because of it or not." Yikes!

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