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By STEPHANIE LAW
Staff Writer Monday, August 06, 2007

Fourth in a series about a journey through breast cancer.

Six weeks ago, my life was sort of boring, but predictable. It's amazing how quickly a diagnosis of breast cancer can change all that. I went in for a routine mammogram and the next thing I knew I was dealing with the "Big C." Ouch.

I'd already gone through a stereotactic biopsy, which uses a special computer to guide a needle to the suspicious cells, and then a lumpectomy. That's when the pathologist discovered the cancer cells were a lot more pervasive than my doctors originally thought.

Here I was, sitting in the surgeon's waiting room, wondering how I got here. My co-workers convinced me I shouldn't go to this appointment alone — although, for the life of me, I couldn't figure out why. I could handle things perfectly well on my own.

I think they knew something I didn't know — such as when confronting a serious threat to one's health, one's mind tends to be the first thing to go on vacation: "Sorry, I don't want to deal with this now. I'll be back when everything is sorted out, OK?"

So my cousin went with me, to take notes and remind me about questions I wanted to ask.

Before I asked questions, though, I just listened to what the surgeon had to say. I had a lot of decisions to make before surgery and needed as much information as possible to make the correct decision. I already knew what I wanted to do, after having read a lot of information before this visit.

It was a good thing my cousin was there, because she made me listen to all the options — and there really were many of them. I could:

1. Have another lumpectomy, just a lot bigger. The surgeon had cut out a rough cube of tissue nearly 2.5 inches on a side. Of the cube's six sides, only one was free of cancer cells, so a new lumpectomy would be a lot larger. Then we'd have to wait for the lab report, and maybe go through it all again. The upside of another lumpectomy, though, is that I would keep much of the breast, but, downside, it would look substantially different from the other one.

That would mean reconstruction of one of them, unless I wanted to be lopsided for the rest of my life. And I had no guarantee those cancer cells wouldn't launch a sneak attack when I least expected it. I'd have to have chemotherapy and/or radiation and be ever-vigilant, and learn to live with the possibility of another bout.

2. Remove the entire right breast, but leave the left intact. Unless a local store sells garments for Amazons (who cut off one breast so they could pull back their bows better), I'd definitely have to have reconstruction. I'd have to have chemotherapy and/or radiation, and I still had the question of the other breast.

Although no cancer cells showed up there this time, who knew whether they'd move in. I wasn't keen on this option, either, for same reason as above: Getting rid of one problem didn't mean it wouldn't crop up elsewhere.

3. Remove both breasts. This was the option my surgeon and the medical oncologist (cancer doctor) thought was probably the best for me. I could choose to have reconstruction or not. The best thing about this option is that the surgeon would remove as much of the breast tissue on both sides as she could (usually about 98 percent), so there'd be almost nothing left for breast cancer cells to attack. Almost no fear — and no more mammograms forever (a benefit I hadn't considered).

Since I had to make a choice, Door No. 3 was the one I wanted to go through, opting not to have reconstruction at this point.

Other women make different choices, depending on many factors: Age, whether she has a significant other, how that person feels, how much of her self-image depends on her breasts.

No choice would be wrong, that's why the options are offered.

Stephanie Law is a copy editor at the newspaper and lives in Sabattus.

NEXT: Questions for the surgeon and scheduling a date

Contact Stephanie Law by e-mailing: doverfox51@midmaine.com

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