A Delayed Screening, a Breast Cancer Diagnosis, and Membership in a New Club

The chip in my breast
Before I actually got in to see Deborah Axelrod, MD, I had to get through the organized but unhurried intake process at the NYU Clinical Cancer Center in New York City, and then bide my time in a crowded waiting area. Cancer does depressingly brisk business.

In the decade and a half since I’d last seen her, my surgeon had burnished an already fine reputation. I felt lucky to have her on my case—at least until she agreed with the radiologist’s recommendation. “I know this is not what you want to hear,” she told me, “but we’re going to have to do a surgical excision. We need to see what’s in there.” She was right: It wasn’t what I wanted to hear. Nevertheless, my procedure was scheduled for August 9.

The advantage to having had the Mammotome was that a small chip had been left behind as a precise marker of the microcalcifications. Early on the morning of the 9th, I was back at the radiology practice for phase one of what is technically called a “surgical excision with wire localization.” Translation: A wire would be inserted into my breast to guide the surgeon to the chip.

The tiny area of insertion was cleaned and numbed. And a few mammograms were taken to check the positioning. I seem to have scoured from my memory exactly how the wire got in my breast, though I remember the surreal experience of walking the couple of blocks to the hospital afterward, bare-breasted under my thin sweater, with a length of hairline-fine wire protruding from my skin.

As I settled under a warm blanket on the operating table at NYU Medical Center, I was remarkably at ease—even more so after the anesthesiologist released Demerol into my veins. His was the last face I saw before I slipped into oblivion, and the first I saw when I came out of it, an hour later, in recovery. Dr. Axelrod appeared at my bedside with a bit of good news: She had every reason to believe I was dealing only with LCIS. She would see me back in her office in a week.

The news, part 2
I walked into the NYU Clinical Cancer Center at 10:40 on the morning of August 15. When I walked out, I had cancer.

When a nurse handed my pathology report to Dr. Axelrod, she was seeing it for the first time; it was fresh from the lab. “OK,” she said quietly. “This is not what I thought it would be.” She handed the report to me. I scanned it quickly; popping up from the page were the letters DCIS—ductal carcinoma in situ.

Here’s what flashed through my brain: No husband, no kids, no job, and I have cancer? “This is not a good time for this,” I said to my surgeon. And then I sobbed.

“You’re looking at this as the glass half-empty,” she said, not unkindly. “You need to look at this as the glass half-full.” DCIS, she told me, was cancer at its earliest stages—often called stage 0 because it is noninvasive. “You’re lucky you caught this now. If you caught it a year or two years or five years from now, we would be having a different conversation.” It would be a few days before I saw her point.

Back out on the street, I felt purposeless. What was the protocol here? Do I head home, hit a bar, go to work? I slowly wandered uptown before I settled on the last option. My head was filled with thoughts of an old friend who had battled myeloma a few years before. I had thought then that he was incredibly brave for picking up the phone himself to let those in his life know what he was up against. I wasn’t sure I had that strength in me. What I would shortly find out is that you just do what you have to do.

The first few days, I spilled the news selectively; telling my family was the hardest. But talking about the DCIS had a positive effect—it became more real. And more real seemed more manageable. Of course, I’d also come to realize what a huge safety net I had under me: My cancer was not life-threatening, for one thing. Everything I was going to do would keep it from becoming life-threatening. And then there was this: As word leaked out, I got phone calls, emails. An ex-boss—hard shell, soft chewy center—called to say, “We’re going to beat this.” We’re. Another ex-boss scrambled to arrange an extension of my health coverage; I was a week away from my severance running out. And then my very temporary freelance assignment was extended by six months. No husband, no kids? I had a community. In fact, I was overwhelmed by the number of people who reached out a hand to me, personally or professionally.