This Can’t Be Happening to Me
I was a healthy 37-year-old woman having a routine checkup. Then the doctor felt a suspicious lump in my breast.
The main reason I went to see my doctor on Friday, May 16, 1986, was that I needed a new prescription for thyroid pills because of thyroid surgery I had had as a child. I was 37 years old and felt fine. I had noticed a small lump in my left breast, but since I had had three benign tumors removed over the past fifteen years, I was more concerned about taking time off for day surgery than about what the lump might mean. My physician of ten years, Dr. James Lindsey, knew well how much I disliked going to the doctor’s office, so I knew he wouldn’t let me out of there until I had a complete checkup.
During the checkup Dr. Lindsey examined my left breast. I assumed the new lump was also from fibrocystic breast disease, the condition that caused the previous benign masses. I was surprised when Dr. Lindsey insisted that I have x-rays, blood work, and a mammogram that afternoon. He told me the results of the tests would be delivered to a surgeon, Dr. H. Lamar Jones, Jr., whom he had arranged for me to see the following Monday. I didn’t believe the lump would be anything serious. I thought that at the worst Dr. Jones would perform a simple procedure in his office to remove it.
On Monday morning I went to see Dr. Jones. He informed me that the mammogram results showed there was probably cancer in my left breast and that there was a suspiciously dense area in my right breast. I couldn’t believe what he was saying. All I had was a lump in my breast. No pain, no suffering. I think I immediately went into shock. Dr. Jones could tell that I was only half-way comprehending what he was telling me. He said that I could go to the hospital for a biopsy or he could do a needle biopsy in his office and get the results back in an hour. I was too apprehensive to wait and decided on the needle biopsy. My left breast was deadened with a local anesthetic, then Dr. Jones stuck one of the longest needles I’ve ever seen into me and removed part of the tumor, which was sent to the pathology lab across the street at Austin’s Seton Medical Center. His nurse informed me that I could sit in the waiting room or return in an hour for the results. I was too nervous to sit still, so I decided to drive around. I went to a 7-Eleven and called some friends at Texas Monthly, where I work, for moral support. I told them what was happening and asked them to pray.
When I returned, Dr. Jones’s nurse quickly ushered me into his office. From the grim look on the doctor’s face I knew the outcome of the test. I was as scared as I had ever been. The results were positive; it was cancer. I looked at him and immediately thought, “This is a terrible joke.” Cancer was something that you read about. Something that happened to other people or distant relatives. He told me that my left breast would have to be removed and perhaps my right as well. Everything seemed so absurd that I cracked a joke about not ever being able to be a topless dancer.
Since the biopsy was done only on my left breast, Dr. Jones would not decide whether to remove my right breast until I was on the operating table, where he could also do another biopsy. My left breast showed an ill-defined star-shaped mass, which usually means the tumor is not self-contained. Dr. Jones told me that there are different surgical approaches to breast cancer. No longer is a radical mastectomy—removal of the breast, chest muscle, and lymph nodes—the standard operation. Because of the nature of my tumor, Dr. Jones advised against a newer procedure, a lumpectomy, the removal of only the tumor and a section of the surrounding tissue. He recommended that I have a modified radical mastectomy, in which the muscles under my breasts would remain unless they too turned out to be cancerous. The lymph nodes under my left arm would be removed because there was evidence that the cancer had spread, and if the biopsy on the right breast was positive, the lymph nodes there would be removed and checked for cancer. Dr. Jones showed me pictures of women who had had mastectomies and pictures of women who had had reconstructive surgery. The pictures were terrible to me. The scars on the women who hadn’t undergone reconstruction looked awful.
Dr. Jones told me that he would perform only the cancer surgery. He said that I would need to consult with a plastic surgeon about the breast reconstruction and when it should take place. After seeing the pictures I knew that if I had to have the modified radical mastectomy, I wanted all of the surgery done at the same time. I couldn’t stand the thought of waking up with part of me missing. Dr. Jones suggested that the surgery be done within two weeks. He made an appointment for me with Dr. E. Richard Parker, a plastic surgeon, for Wednesday, May 21.
I went to work that Monday afternoon and informed people about what was happening, and they were wonderful. They weren’t concerned about my missing work. They were concerned about me. After telling them, I had an even more difficult task. I had to tell my family, especially my mother, my daughter, and my boyfriend. My mother completely fell apart. My father had died just two years before from a heart attack brought on by a fight with colon cancer. She automatically envisioned me dying. My daughter, Jennifer, who was eleven, was angry at first. She couldn’t understand why this was happening to me. My boyfriend was great. He said that everything would be okay and that we would get through this. One of my sisters, Angela, actually got me to laugh; she said, “Tish, there never was that much there anyway.”
On Wednesday Dr. Lindsey called to tell me he had scheduled bone and liver scans to determine if the cancer had spread. I told Dr. Lindsey that I was seeing a plastic surgeon that afternoon. He said that some doctors suggest delaying the reconstructive surgery until after chemotherapy and radiation treatments. I started to cry. I knew that after having one or perhaps both breasts removed, I couldn’t return to the hospital a year later for what I would then consider elective surgery. I also knew that I couldn’t face not having breasts for that long. Dr. Lindsey then told me to keep my appointment with Dr. Parker. I took one tranquilizer, and then on the way to my appointment I took another.
Dr. Parker’s optimistic and jovial nature eventually made me feel better. He didn’t treat me as if I were dying. He said he had done reconstructive surgery immediately after breast removal numerous times with few complications. A weight had been lifted. Since I had to go through with this, at least it would be my way.
Dr. Parker explained the latissimus dorsi myocutaneous flap technique for breast reconstruction. A section of muscle, fat, and skin would be repositioned from my back to my chest. The artery and vein would be rotated under my arm and moved in front to supply the reconstructed breast, and the skin on my back would be pulled together, leaving a scar along the bra line. Dr. Parker explained that Dr. Jones would remove the breast or breasts, which would take two to four hours, and then Dr. Parker would perform the reconstructive surgery, which would take another three to five hours.
He handed me a clear plastic bag filled with something soft and squishy. The contents of the bag were translucent and felt the way the blobs of a lava lamp must. The bag was a sample of the silastic gel-and-saline solution implant I would receive. It looked and felt silly; I couldn’t believe it would replace my breast. Dr. Parker explained that following the surgery I would need to massage the reconstructed breast three to four times a day for six weeks and then daily for the rest of my life. He stressed that massage was essential to keep the breast soft and to prevent scar tissue from restricting movement of the grafted muscle. He did not thoroughly explain the nipple-and-areola reconstruction, which would be done six to eight weeks after I left the hospital.
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