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The Greatest Fear

By Charlotte Bennardo
Web Exclusive

woman at doctorIt is too soon to feel the baby move, but I know he is there, safe and warm and loved. With this pregnancy, everything is going right; no in-vitro procedures, no high risk factors and no total bed rest like the first one.


A normal part of many changes in my body caused by surging hormones is sore breasts. I’m uncertain though, about the lump in my right breast.

My ob/gyn doesn’t appear ruffled, nor does she issue dire warnings; instead, quietly she tells me to see a breast specialist. Immediately. Is it serious? I ask. She looks at me and taking her time, tells me three other patients have the same condition; one will be okay, the other two probably won’t make it. One of those women likely to die is a new mother, 26 years old. I make the appointment as soon as I get home.


The specialist, Dr. Susan McManus from Somerset, New Jersey, is very disarming and tries to put me at ease. She rattles off numerous facts about how, at 34, I’m not as old as the ‘typical’ breast cancer patient, I don’t have risk factors like a smoking habit, an unhealthy weight, a dangerous occupation or a family history working against me. I’m in very good health, except for the lump, which has grown in two weeks from the size of a large strawberry to the size of my fist. This rapid growth is not good, she warns. Dr. McManus is honest about the chance that I may have breast cancer. She advises me to consider what changes I may have to make in my life if I need to undergo chemotherapy, radiation or a mastectomy. I can’t even begin to think about any of that, because the toxic treatments or a medical abortion will mean the death of my baby.

In the examination room, Dr. McManus does a biopsy by inserting a long hollow needle directly into the lump. The pain is so intense I break out in a cold sweat. It takes all my strength to hold my body still while she jiggles the needle around and back and forth to obtain a good number of cells for analysis. The results will take several days. I get a bandage over the poked hole and leave.

I could swear the lump continues to increase while I frantically wait for results. On the scheduled day, I call in the morning, before lunch, after lunch, mid-afternoon and late afternoon. No word yet. I am beyond panic. The receptionist, clearly annoyed that I’m calling yet again, tells me, ‘I know how you feel.’ Maybe as a breast cancer survivor she does. Not being pregnant and facing my horrendous decision, maybe she doesn’t.

“No you don’t!” I yell into the phone, “I’m 12 weeks pregnant!” She puts me on hold and after a torturous wait, Dr. McManus answers.

“It’s abnormal.” Those words rip into my brain. Abnormal. As if in a fog, I hear her voice saying something about a lumpectomy to inspect the growth and that there are a number of options I have. My mind is numb. It snaps back to the present when she advises me that an abortion will be necessary if radiation therapy is ordered. Suddenly, I feel a faintness so overwhelming I’m tempted to give in to the sweet oblivion offered. Just barely I hold on, if only to hear some offering of hope. But my body shudders with sobs. A look of distress overtakes my husband’s hopeful countenance. He doesn’t need to hear the words to know the results.

We cry, we deny, we hold each other. There is no discussion or thought about pain, scars, a lost breast or anything other than our unborn child. No matter how much we discuss and debate the options, we cannot agree. He urges me to have the abortion and the treatments, whatever it takes. He needs me, our one-year-old son needs me, he cries. To save my life, he wants me to sacrifice our baby. I cannot bring myself to concur. I want to take my chances by waiting until the baby is far enough along to be delivered, then start any treatments. A decision awaits.
Two days later we leave our son with my very anxious mother and go to the medical center in New Brunswick, New Jersey. This procedure will be done on an outpatient basis under local anesthetic. While lying on the table, my breast will be opened, they will remove the lump and run it down to the pathology lab. Instant analysis, immediate diagnosis. A mastectomy could be performed without delay. There will be no time for second thoughts.

My knees, hands and voice tremble with bone deep dread as I check in, fill out forms and answer questions. ‘Patient is nervous,’ writes the nurse on the admitting form. Surprisingly, I want to laugh hysterically. Think so?

I change into an operating gown, hair bonnet and slippers, and meet Dr. McManus in the hallway. She walks the chilly maze of corridors with me, smiling, trying to comfort and distract me as much as she can. Secretly, I clutch a little plastic figurine of Barney the dinosaur, my son’s favorite toy. Hopefully he won’t miss it for a while, as I really need to hold onto something precious this moment. Anything that reminds me of him, and the infertility odds I fought to have him, is priceless.

Once I am lying on the hard table, the efficient staff hooks me up to beeping and flashing heart monitors, IV’s, and blood pressure cuffs. They administer oxygen because, as the doctor notes, I am ‘breathing shallow.’ I don’t want to breathe deeply of hospital antiseptic. Desperate for distraction, I joke around about how someone should tape a picture of Antonio Banderas in a Speedo on the ceiling for me so I can look at something other than cold, glaring lights. They all laugh. And then they begin.

The sharp needles carrying the anesthetic to numb my breast sear like fire going in, but soon the drugs take effect and I feel nothing. I look away as she picks up her shiny stainless steel scalpel. When I turn my face back, there is a crowd of masked faces around me, eyes seriously intent. To keep from screaming my anguish, I tell jokes, I play the comedian. Some laugh, some giggle. The more panic I feel, the funnier I get. I must be hysterical this day.

As Dr. McManus spreads apart my skin, the only sensation I feel is a slight tugging, no pain. Like a hawk, I watch her eyes for the initial reaction, knowing she won’t be able to hide that first impression. She continues to pull and cut and I look away. I can’t bear it.

“It doesn’t look bad; what I’m seeing is not malignant.” The words are slightly slurred coming from behind her sterile mask, but I understand them perfectly. However, Dr. McManus warns me we must wait for the pathology lab to examine the mass before I can go. Something might be hiding in there.

The lump is sliced free and rushed out in a chrome dish, covered by a cloth. She continues to reiterate how she is not worried, and that I shouldn’t be. I clutch the purple dinosaur so tightly, it digs into my palm, threatening to split the skin. Finally, the answer comes and it is good; no cancer, just fibroid cysts mingled with a tumor, oddly enough. She wonders why these two are combined together, it is something she has never seen. I close out the thoughts of the large amounts of fertility drugs I took and unheeded warnings about unforeseen complications down the road. The tumor is gone and I don’t care about its history.

I return home, a little sore and exhausted beyond measure. The only thing I want to do is shower off the antiseptic iodine, hug my son and pick out names for our baby.

Approximately four years later, another lump appears. It’s as fast growing and even bigger than the first. Because of my previous condition, I’m quickly dispatched for a high density sonogram and a mammogram. Again, Dr. McManus evaluates me and determines the lump is benign. After several months, it dissolves. Starting with age 40, I’m strongly urged to have a mammogram every year. As a matter of fact, it’s time to schedule one. Don’t forget yours.



Where To Go For More Information
If you would like more information on
breast and other cancers, contact the following
organizations:

American Cancer Society, 1-800-227-2345
www.cancer.org

National Cancer Institute, 1-800-422-6217
www.cancernet.nci.nih.gov

Your local hospital or medical center


Risk Factors


Some factors that increase your risk of breast
cancer are:


  • Early age at start of menstruation

  • Late age at onset of menopause

  • First full term pregnancy after age 30

  • Obesity

  • History of pre-menopausal breast cancer in mother and/or sister

  • Personal history of benign proliferative breast disease

  • Urban residence

  • Not bearing children

To lower your risk, you should:


  • Perform monthly self breast exams

  • Have a mammogram and cancer screening once

  • a year if you are 40+ years old, and every

  • three years if you are 20-39 years old

  • Engage in regular exercise

  • Maintain a balanced diet

  • Know your family and medical history

Some Facts To Consider


  • According to the American Cancer Society and the National Cancer Institute, Breast cancer is the most common form of cancer in women.

  • 96% of women in Stage I (localized cancer) will survive and be considered cancer free five years later

  • 77% of women in Stage II (cancer in breast, lymph nodes, ducts and underarms) will survive

  • Only 21% of women in Stage III (metastisized, or spreading throughout the body and organs) will survive

  • Risk of breast cancer increases with age


Age Risk Factor


An average of 1 in 8 women (12.6%) of the female population will develop breast cancer, which increases with age*:


  • Age - Risk Factor
  • 30 - 1 in 2,212

  • 40 - 1 in 235

  • 50 - 1 in 54

  • 60 - 1 in 23

  • 70 - 1 in 14

  • 80 - 1 in 10

*All figures and information obtained from the American Cancer Society and the National Cancer Institute.


Charlotte Bennardo enjoys a healthy life with her three sons and husband in Bridgewater, NJ. She does monthly breast exams and nags her family to do the same. When she can, she writes in a variety of genres; from personal experiences to children’s novels to short stories.

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Mothering › Health Articles › The Greatest Fear