Breast Cancer Chronicles: Hidden Breast Cancer That A Mammogram Cannot See

I met with the surgeon last week. He examined me and then, after asking me more questions than I can possibly count, gave me his proposed plan of action designed to beat this breast cancer, and actually asked me what I wanted to do. Imagine that!

He told me that the first thing we would need was an MRI with contrast. He explained that in 10% of the cases (I later read that the statistic is closer to 20%) of breast cancer, there are hidden cancers. Yes, my lump is small, but it is necessary to make sure that is the only cancer we are dealing with. Mammograms can miss cancer, a fact which I didn't know. He is concerned that I may have a hidden cancer either in the same breast, or the other, and an MRI will tell the story. The hospital system that I work for has ten hospitals, all equipped with MRI technology, plus a dedicated MRI center, yet they cannot schedule one until the 11th of September. Surgery will take place the week after, if they can get it scheduled.

If there is cancer in the other breast as well, I will end up needing a double mastectomy. If not, I have options. I can have a single mastectomy with no radiation or I can opt for a lumpectomy, followed 5 weeks later, by radiation therapy 5X a week for 6 weeks.

I asked which option he prefers and why. He told me that the success rate is equal, but that the lumpectomy and radiation is what he would recommend. Both because it is more conservative, but a lumpectomy also carries less surgical risk. Less anesthesia, less risk of post-op infection (I am a diabetic and do not heal well). Both will involve exploring the lymph nodes to look for any indication that the cancer has spread. Both will also invole taking tamoxifen ( a chemotherapy drug) for the next 5 years.

I will also be meeting with the oncological radiologist and the therapeutic oncologist.

I hope that I am up for it. I haven't had what I would call a "Fairy Tale Life" unless one is talking about Grimm Fairy Tales, but I have had a great life that has always been filled with love and, well, LIFE!

I always say, "You gotta love life!" Everytime something bad happens, it is just what I say. Call me crazy; my kids do...but it has always been my way of pushing back and fighting whatever has seemed impossible or beyond my ability to fight.

I have even said it this time. Now you can commit me, because this is NOT gonna be good.

I remember when I was a little girl and my mom would always say to me (because I was a shy, quiet, little wuss): "Survivors are not born, they are made, and it is my job to make you into a survivor. You are going to be strong, because you will have to be and I am going to teach you how to survive life." My mom was tough until the day she died from breast cancer, but she was also loved by everyone who ever met her because she was funny and kind.

Just recently, I was talking to a high school friend from 40 years ago and he told me something that I did not know. He said that he remembers coming to my house and how my mother treated him like a person, not a kid. He said that he very rarely talked to grown-ups, but he liked talking to my mom. I wish she was here now to remind me that I can do this. She would tell me that she knows that I have at least a few good fights left in me.

The surgeon and I talked about what the effects of the radiation may be. Everyone reacts differently. Some people are affected in small ways, others become very ill. Apparently, at the very least, I am going to have a serious case of sunburn...

In the course of my daily work, I see literally hundreds of hospital bills and I have recently seen several bills that relate to the treatment of breast cancer.

The MRI that I will be having is $7000.00. That does not include the charge for the radiologist to read the MRI.

The lumpectomy (provided it is only a lumpectomy) runs right around $37,000.00. That is just the hospital bill. It does not include the surgeon's fee or the anesthesiologist's bill.

I do not know how much daily radiation therapy for 6 weeks will cost, but I am sure it is not cheap. I am most fortunate to have health insurance.

For the millions who do not and lack the resources, there are many hospitals, most notably, Catholic and other non-profits, that budget a certain (usually several million dollars each) amount of money every year for free treatment. Certainly, it is not enough to cover the cost of treating everyone who lacks insurance, but these facilities exist and provide ecellent care. If you have breast cancer and no insurance, seek out a patient advocate group. They will guide you and assist you in accessing the resources you will need.

Apply for Medicaid. I know that Medicaid is a hot button political issue, but I truly believe that this country is still full to the brim with people who willingly care about saving each other.

I am not looking forward to the next several months, but believe me, even when I have that sunburn, I am just going to say: You gotta love life!