Last week at the hospital really reinforced for me just how scary the diagnosis stage of breast cancer is – even if the lump turns out to be a thing of nothing, the bit that gets you to there can be horrible. Also, in the last couple of weeks, I’ve had several email exchanges and conversations with people going through diagnosis, and this too has made me think about how, once you are in the realms of Actual Cancer, it’s easy to forget about how difficult the stage before was.
So today, I’m going to offer you some advice if you are in possession of a lump that you’re not sure about. I hope it helps.
The first thing is the most important. If you find a lump, go to your GP. Now. Cancer is like toothache or cleaning out the fridge or doing your tax return: leaving it a bit longer is only going to make it worse.
Your GP will almost certainly refer you to the nearest breast unit, because a GP can’t tell whether a lump is anything sinister, any more than you can. Basically, if they can identify a lump, they should refer you. This referral isn’t, therefore, a sign that something is Really Wrong – it’s just the next step in the process of finding out what’s going on.
Breast unit best practice – don’t you wish they would rename it Breast Practice? – will involve 3 tests. So, having 3 tests rather than one isn’t significant – each test gives a piece of information and it’s by putting all 3 pieces together that the consultant can tell what the lump is. So you will probably have a mammogram, an ultrasound and a fine needle biopsy.
The mammogram isn’t a big deal, although having your breast squished between two sheets of glass under pressure isn’t what I’d describe as comfortable. The mammographer (if that’s the word for them) will probably do both breasts, for comparison, and may also do a close up of the area where the lump is.
Ultrasounds involve having gel put onto your breast and then having the technician run a reader over the breast. The image appears on a screen and the technician will press a few buttons to capture a few images. (The gel will probably be cold. The doctor will probably apologise for it being cold. Hospitals are full of radiators. Don’t get me started.) If you’ve had a baby, you’ll be familiar with the process – not at all painful, but slightly bizarre.
The fine needle biopsy is putting a little needle into the lump and taking a small amount of tissue for analysis. Once the needle is through the skin there’s no pain. The doctor may jiggle the needle about a bit to break off a piece of tissue, but they do that once the needle is under the skin so you don’t feel it.
Here are some thoughts about some things you could do to make a trip to the breast clinic easier:
- Take a friend. It took me months to work out that Doing It On My Own wasn’t helping any of us.
- Take a good book. You might be there a while.
- Take your knitting. (What do you mean, you don’t knit? Tsch. You should be ashamed of yourself.)
- Take a couple of painkillers before you go. Although nothing is likely to be acutely painful, there is a certain amount of being hauled about inherent in mammograms and ultrasounds that can make you a bit sore.
- Wear a top you can easily get out of. Don’t wear a dress.
- Ask every single question that comes into your head, no matter how ridiculous it seems. Remember, the only stupid question is the question you don’t ask.
- Take a notebook and write things down. As the saying goes, a short pencil is better than a long memory.
- Make sure, before you leave, that you know when and how you will get the results. Also, make sure you get a direct line, or bleep number, of someone you can talk to if you are worried.
- Go and do something lovely afterwards.
I know I haven’t spoken to the emotional dimension of this – I’ll do that another time. But I hope this helps. Maybe other Bah! readers who are now thriving can add things that I’ve missed?