So, how did I get here? This is arguably the most important part of this story to share, and fortunately, very simple. I felt a pain in my right breast in late December 2019 and upon examining myself, I noticed a lumpy mass. I did not have a primary care doctor at the time as I had just moved to the area and was previously healthy – my medical history: two relatively uncomplicated pregnancies and GERD – thanks kiddos!
I quickly got a primary care doctor who recommended a mammogram. She was astute and visibly concerned. I appreciated her concern, but it made me laugh a little on the inside, because I already knew this was something benign, like a fibroadenoma or fibrocystic changes. But I was ready for the work up and then talk about resection if appropriate.
The mammogram was abnormal, and followed by an ultrasound which was also abnormal, and followed by biopsies. Then BAM -> cancer! Invasive ductal carcinoma.
*Medical Tidbit* Invasive ductal carcinoma, also known as infiltrating ductal carcinoma, is the most common type of breast cancer, accounting for up to 85% of breast cancers (1). Approximately 180,000 people are diagnosed with it each year (2). The term invasive or infiltrating means that the abnormal cells have spread outside the milk ducts and into surrounding breast tissue.
I remember receiving the notification on my phone that the biopsy results had posted. I had a few more hours left in my 11 hour shift, one of my longer shifts that usually stretched to 13 hours. I’m generally too busy to answer phone texts or messages on shift. My husband and family know to call me if they need a response from me when I’m working, otherwise I’ll see you when I see you. But I had been eagerly checking my phone throughout the day, expecting the results. I waited to look at the results until I got home. You know, just in case.
Upon reading the results, I entered this fog that loomed for the next few weeks. I was in disbelief, emotionally labile and confused. I didn’t know what to think.
I had only told my husband what was going on a few days before getting my biopsy results because I’m bad at keeping secrets from him. I literally tell him everything. I have been for the last 12 years and I was silly to think I could keep this from him any longer. But now how was I going to explain this to anyone else? I waited to tell anyone until I could figure out how.
How long had this cancer been present? Could it have been detected sooner if I performed regular self-breast exams? or if I had a mammogram sooner? Who knows. When I received my diagnosis, I was fixated on these questions. In addition to denial (I was thoroughly convinced my results were mixed up with another patients), I was stuck on the how and why. But, I will never know. I know, it’s not possible to know this information. I realize this search for answers was also a search for something to blame. Something, anything, to blame for the fact that I had cancer. Every cause has an effect, right? So what caused this?? I will never know.
Kavita Jackson, MD
- Correa P and Johnson WD (1978). International variation in the histology of breast carcinoma. UICC Technical Report Series 35: 36-65.
- American Cancer Society (2020). Breast Cancer Facts and Figures 2019-2020. Atlanta: American Cancer Society.