The post-diagnosis tests

Mammograms and armpit ultrasound

On the afternoon of my diagnosis, we were back at the hospital for further tests. I was in a daze. I felt suddenly, overwhelmingly tired. First up, I had mammograms. It was a bit uncomfortable but didn’t hurt. Then an ultrasound of my right armpit to check whether the cancer had spread. They told me everything looked good.

MRI scan

I was expecting to know more about what treatment I’d need after the mammograms, but back in that room with the awful curtains, the doctor said I was going to have to have an MRI scan too. Because I’m fairly young, and pregnant, the breast tissue was dense and it wasn’t possible for them to see exactly what was going on from the mammograms alone. She also confirmed that there was ‘no mischief’ in the lymph nodes. I silently added this phrase to the list of things I liked about her: kind, pregnant, ‘no mischief’.

The MRI was as I expected; noisy, claustrophobic, boring. It took around forty minutes and I had to stay as still as possible. When I was a teenager, my dad took up drawing, and he used to ask Mum and Rachel and I sit for him. I was good at it, I remember. I was able to tune out and not move. So that’s what I did, and it wasn’t so bad.

Armpit ultrasound (again) and fine needle aspiration

A few days later, I had a call from a nurse who said the MRI had shown up some swelling in the lymph nodes and they wanted to repeat the ultrasound of the armpit. I felt a bit defeated, then; it just seemed like it was never going to end. I wanted to shout ‘but I was told there was no mischief!’ The nurse asked me to come in a couple of days later. I was due to go to London for lunch with a close friend who was moving to the States the following week. I asked whether I could have the ultrasound on a different day, and the nurse agreed.

I hadn’t cried very much since the day of the diagnosis, but the day I went in for that ultrasound and the results of the MRI, I was a mess. I picked up Joseph for a cuddle before I left; my parents were looking after him while we were gone. ‘Mummy’s sad,’ he said, pointing to my face. I just nodded.

The woman who performed the ultrasound said she needed to do a fine needle aspiration to collect cells for testing. I was nervous, remembering how painful that test had been when they did it the first time, on the lump itself. But it was fine this time.

Next, we saw the doctor again, and she said that the MRI looked good. She confirmed that I would only need a lumpectomy (plus the removal of a sample or all of the lymph nodes, depending on the results of the fine needle aspiration) and not a mastectomy.

This felt like the first positive news in a long time. I’d be able to go in for the surgery as a day patient and recovery would be quicker. We had a date. We had a plan.



The diagnosis

When we went back for the biopsy results, part of me felt sure they were going to tell me it was cancer. But it seemed overly dramatic, so I didn’t say it out loud to anyone. Paul and I sat side by side while we waited for the doctor. ‘What do you think she’ll say?’ I asked. ‘That everything’s fine,’ he said.

We talked about stupid things, like how awful the curtains were. Paul told me he’d ordered them for every room in our house. Later, he said he’d overheard a distressed woman in the next room talking about her terminal cancer. I’d heard nothing. Maybe I just hadn’t let myself.

When the doctor came in accompanied by two other people, it was clear that it wasn’t going to be good news. They hardly needed to say that I had cancer. I was grateful that the doctor was kind and that she was pregnant, roughly as far along as me. It was reassuring, somehow.

I was sent for blood tests and asked to come back that afternoon for a mammogram and an ultrasound on my armpit, to check the lymph nodes. ‘It’s April Fools’ Day,’ I said, as we walked through the corridors. ‘Imagine if they’d started laughing and told me it wasn’t true.’

And we went home. I remember walking into our bedroom and thinking, the last time I was in this room, I didn’t know I had cancer. Things were spinning a little too fast.

It was a Friday, and Joseph and I were due to spend the weekend with my parents. Paul had some friends coming to stay. That night, we lay facing each other in bed, and he apologised for the bad timing of these plans. I told him it was ok, that we’d be together again on Sunday night. ‘And forever,’ he said.

A couple of days later, I was lying flat on my back in Joseph’s bedroom while he blew raspberries on my tummy ‘to make the baby sister laugh’. He’d just had a bath and was naked. His skin was soft against mine and we were laughing, and I felt like the luckiest person in the world.

The tests

GP appointment

First stop, GP. I hadn’t seen this doctor before. She was young and friendly, quite matter-of-fact. She examined me and told me that she didn’t know what the lump was, so she was going to refer me to the breast care centre. The appointment would be within two weeks. This, in itself, was nothing to worry about. Everyone gets seen that quickly. God, I love the NHS (or what’s left of it).

Ultrasound and fine needle aspiration

I went to the breast care centre alone, which turned out to be a mistake. The letter said I could be there for up to three hours, so we agreed that Paul would stay at home and do the nursery pick-up. In the waiting room, I saw an older couple holding hands. He had a bandage covering the part of his face where his nose should have been, and it looked like he probably didn’t have one. I watched his wife covertly, thinking that it would be too cruel for her to have breast cancer.

A nurse took me to a changing cubicle, gave me a shopping basket for my clothes and looked me up and down to see what size gown I would need. And just then, something cracked in me and I was painfully aware of the fact that I was pregnant, alone, and being tested for breast cancer. I started to cry and I couldn’t stop. The nurse held my hand, brought me tissues.

I cried through my appointment with the doctor, and when I lay on my back to be examined, the tears slid into my ears. She sent me for an ultrasound, and I cried through that too. The woman performing the ultrasound said she wanted to do a fine needle aspiration to remove some cells for testing. She said they don’t use an anaesthetic for it; that it feels like having blood taken.

So I was shocked by how much it hurt. Later, I was told it was because of the position of the lump. How close it was to the nipple. But while it was happening, I didn’t understand. I closed my eyes and tried to stay quiet. And when I got outside, feeling tender and sore, I sat in the car and phoned Paul, and cried some more.

The core biopsy

The results of the fine needle aspiration were good and not so good. The cells they’d tested were benign, but the doctors weren’t happy that they’d seen enough, so they wanted to do a biopsy to be absolutely sure.

Paul had had a biopsy in the past and he told me it felt like being punched. But I knew they were going to use anaesthetic this time, so I wasn’t too worried.

It did feel like being punched. I was told they’d need to use the biopsy gun either two or three times; it ended up being four. Throughout, a nurse held my hand and asked me questions about Joseph and the baby. I remember telling her that he was insisting on calling the baby Emily, after his favourite train in Thomas the Tank Engine. It was a big improvement on Dave.

Before the fourth time, they asked me whether it was ok to do it again, and I told them to do it as many times as they needed to. I was ready for some actual results and desperate not to be called back for more tests.

And then I put it all to the back of my mind. It was Easter weekend and we were seeing our families and doing egg hunts. I thought it was possible that the whole thing was almost over.

The lump

I was getting dressed on the 29 February when I noticed a small, hard lump in my right breast, just beneath the nipple. Paul was in the room with me. ‘There’s a lump in my breast,’ I said. We both had a look and agreed I should get it looked at by the doctor. We got on with things. We were sort of rushing. We needed to drop Joseph off at nursery and then head to the hospital for our 20-week scan.

An hour or so later, I was sitting in the hospital waiting room. I was thinking about names for the baby. I was certain it would be a boy. I wanted to call him Benjamin. Harper Lee had died recently and I wanted to pick a middle name that was a tribute to her in some way. I wondered, idly, whether Paul would agree to Benjamin Atticus, or Benjamin Boo. I knew he wouldn’t. And then I remembered the lump, and I thought, quite simply, that I might have cancer.

We were told the baby was healthy, growing well, and a girl. I was stunned and delighted. I spent the journey home thinking about girls’ names, something I’d never really allowed myself to do before. Later, we picked Joseph up from nursery and told him the news. We asked him what we should call his baby sister. ‘Brother,’ he suggested, then ‘Dave’.

This was what my life was like. Busy, chaotic, full of laughter. We’d moved out of London after ten years to be closer to my family and slow things down a little. We had an energetic toddler and were expecting a second child. We didn’t have time for cancer.

And what is the 29 February, anyway? It’s a non-day, a bonus day, a day that only happens once every four years. A funny sort of day for your life to take a turn.