after the first steps

Photo: central park, april 2011

I’ve started my own dance now. A dance I never imagined I’d be pulled into. Heart disease, diabetes, glaucoma, cataracts, diverticulosis – all these were expected dance partners I have been working to avoid. But, with no family history of cancer – never mind breast cancer – it came as a surprise.

But, I’m ahead of myself. My dance started first as a bit of a tease. After a few months of a mammogram leading to an ultrasound leading to an MRI, leading to a biopsy the results were inconclusive. Each attempt to look closer at my potential dance partner resulted only in a somewhat coy glance over the shoulder. Inconclusive. No evidence of invasive cancer. Concern and suspicion of something called DCIS, but no clear pathology results to guide us.

Somewhere between the mammogram and the ultrasound and the MRI, I became a patient at the Gattuso Rapid Diagnostic Centre at Princess Margaret Cancer Centre. Things moved quickly after a bit of a sluggish start at another hospital that left my results sit for 6-weeks between imaging appointments despite my case having been flagged as urgent by both my family doctor and two radiologists. No need to dwell on that though.

By the time I was assigned to Dr. Leong at Princess Margaret, I was savvy enough to realize that things were getting serious. Plus, my intuition was now screaming at me; actually, more like a muffled scream into a pillow, but screaming, nonetheless.

Dr. Leong told me that I had a rather significantly sized mass in my left breast, and an extensive field of calcifications. He also said that while the pathology didn’t provide a definitive diagnosis that – and I’m 100% paraphrasing here – if something looks like a duck, and quacks like a duck and walks like a duck – it’s probably a duck.

Duck. Duck-ity duck duck. Duck me.

But the duck in question at that time was still DCIS. For the un-initiated, DCIS is Ductal Carcinoma In-Situ. In other words, the ducking cancer cells are there, but they are contained wholly within the milk ducts. This is known as Stage 0, or also sometimes as pre-cancer.

Although, having been through this part of the dance, I believe calling DCIS “pre-cancer” is misleading. It provides false hope that it’s ‘not really cancer’ – when in fact it is all the same horridly mutating and rapidly multiplying cells. Just that they’ve decided to be orderly and restrict their visit (for the time being) to the room they’ve been assigned. But make no mistake, there is always a chance those nasty little mutating MF’s decide not to stay put and instead begin a rampant race through the house, then the streets, then the whole damn neighbourhood that is ones body.

So, while my case seemed to present as suspicious for DCIS, the compilation at that time was that the area of concern was large. A mass of about 8cm and a ‘field of calcifications’ of 13 – 14cm. All in my left boob. Wow. I mean, holy crap. My breasts have always been impossible to ignore, but to hear that one of them was now almost entirely full of stuff that could be poison… well, that was a different kind of scary.

The area in my breast was large enough that a simple lumpectomy (as if the idea of cutting open a breast and scooping out some tissue is ever simple) wouldn’t do for me. Oh, no. We could only confidently grab part of the breast tissue without leaving me terribly disfigured. And if we only removed part of the tissue, who’s to say it is the part with cancer in it, if there is cancer there to find at all. The pathology on a sample might be inconclusive again and then I’d be left to wait and to wonder and to fret over every little change, or non-change.

No, the logical solution was to completely remove my left breast.

No breast tissue = no cancer cells. That’s the hope.

Only one breast was in contention to be scraped from my body and examined. The other breast was not in the same condition. No need to touch it at all.

Leaving me with one impossible to ignore breast and one impossible to ignore absence of a breast.

I gripped the table quite hard as I was getting this news. Because of Covid, I was in the room alone with the doctors, but with my dearest friend Audrey on the phone, playing the role of a voyeur of a very unpleasant act. Unpleasant images flashed through my mind. This can’t be real. Can it? I heard myself asking, “What does it mean to have a mastectomy? Do I walk around with only one breast after this?”. I remember gesturing to my chest, as if to ask how it would be worse than a disfiguring lumpectomy.

Turns out the dance card has another name on it. Enter Dr. Hofer, the head of plastic surgery for the University Hospital Network. Very long story short, I decided that during a 10-hour surgery, that Dr. Leong would remove my breast tissue, but leave behind most of the skin for Dr. Hofer to use in an immediate DIEP-flap reconstruction. DIEP is an intricate surgery to relocate my own tissue, blood supply and skin from my abdomen. A silver lining… by removing abdomen fat, it’s essentially a tummy tuck. Must look for those silver linings more than ever now.

On October 21, 2020, I had a 7-hour surgery, followed by a 4-day hospital stay, followed by an expected 12-weeks recovery time. In simplest terms, for 12-weeks, no bending or abdomen exercises and no lifting of more than 10 pounds.

I’m about mid-way through the expected recovery period… it’s not easy.

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