Four years before, at the age of 56, she had been diagnosed with breast cancer. She had none of the classic risk factors, other than simply being a woman and growing older; she’d had children early in life, breast-fed them, avoided alcohol, exercised vigorously, and she was not overweight. And there was no known cancer of any type in our family.
All of that may help explain why my mother’s gynecologist had been so reassuring a year earlier, telling her that the lump in her breast was nothing to worry about. The doctor suggested no follow-up, didn’t instruct her in breast self-examination, didn’t even advise her to monitor the lump. Most important, the doctor failed to explain that a biopsy is the only sure way to determine whether a lump is cancerous.
My mother learned the hard way. At her next annual exam, the same doctor realized that something was wrong. The lump, with the benefit of an extra year to grow and develop, now looked suspicious. A surgical biopsy quickly confirmed that it was cancer, and there was little talk of trying to preserve her breast. She got a mastectomy.
Beyond the tremendous physical consequences of cancer, there are daily frustrations that make a return to normal life all the more traumatic. My mother handled the anger, the fear, the surgeries and the medication quite well. But she became particularly distressed over the emphasis on replacing that missing breast. When she decided against reconstructive surgery she was inundated with advice about purchasing an artificial breast, which cost hundreds of dollars, as well as a special bra to accommodate it. Finding the combination cumbersome and uncomfortable, she let the prosthesis gather dust in its box. But when she tried to find a single-cup bra for women who choose to go au naturel, she was told there was no such product. All of this ran through my mind as I contemplated what to do about my lump. My gynecologist didn’t think it had the firm, irregular texture of a malignant tumor. But because of my mother’s cancer, I had asked him to be especially cautious. He sent me straight to a breast surgeon.
A mammogram and sonogram showed nothing, which didn’t ease my mind. My mother’s cancer never showed up on a mammogram. That my lump couldn’t be seen on X-rays only meant to me that it remained a mystery to my doctors. My breast surgeon agreed with my gynecologist that the lump was probably not malignant. At my request, he tried to find out by sticking a needle in the lump and withdrawing cells to analyze under a microscope. The results were inconclusive.
So there I was, with my mother’s medical history and experience telling me to have the lump removed, and conventional wisdom telling me that it would be perfectly appropriate to watch and wait. My mom’s experience spoke louder. I wanted the lump out. I was a little surprised by friends, family members and colleagues, some of them health professionals, who questioned the wisdom of cutting out a mass that doctors thought was probably not cancerous. Many urged me to get a second opinion, believing that surgery is best avoided unless it is absolutely necessary.
As a news correspondent and anchor of a health news-magazine show, I’ve reported the stories of people who ruined their health with needless surgery. I’ve also done stories about people who died or were permanently harmed because they didn’t get surgery they needed. Unfortunately, there are no rule books to tell us whether we’re making the right decision. In my own case, I thought the risk of letting a potentially cancerous lump go–and grow–far outweighed the risk of possibly unnecessary surgery. My dear husband agreed: be aggressive.
The surgery was considered very simple. I was calm, believing my doctors were probably right to guess I didn’t have cancer. The lump was located under my arm and near the surface, where it would not require a lot of digging. I rejected the routine sedation, opting for local anesthesia so that I could go straight home to my 3-year-old daughter afterward. Before I could even get dressed to leave the hospital, the results were in: benign. Not cancer.
That was in November. It now seems I’ll barely have a scar from the surgery. But I’m relieved every time I touch it or see it in the mirror. Because instead of harboring a mysterious lump–instead of trying to figure out if it’s changing size, or changing shape, or changing texture–I am reminded that I took control and removed doubt from an uncertain situation. Breast cancer may yet sneak up on me. But I will not make it easy.
