#1 : A breast-beating diagnosis

16th December. It’s my birthday. I have missed my period. Okay, let me clarify – my tubes have been laser-singed, hacked and chopped after my son was born. No chance.

My breasts feel tender, maybe as a side-effect. Unrelated activity:  Someone sends me a breast self-examination video. Some coincidences are willed high above.

I do a breast-self-examination. Just like that.

Tiny. Hard as a marble. Painless. Can’t see it from the surface. But can feel it.

7 days later.

Damn! Lump’s still there. Right breast. Definitely needs a check. I worry. For two minutes. Then, forget. Remember again on new-years-eve.

2nd Jan

Happy New Year sounds trailing off. Photos of new-year’s eve parties making their way to facebook. Resolutions. Resolution-mocking memes. Time to get back to work.

Sharp business jacket. Yellow. My favourite colour. On the way to Majumdar Shaw Cancer Center. Getting a doc’s opinion. Hope it doesn’t take long.

10:00 am. The watch glints in the slant of the 9:00 a.m. sun through the car’s window.

How long will the check-up take? Office by 1:00? Impatient. Tap my fingers on the arm rest.

Radio plays. Chittiyan Kalayian Re. Meri white kalayian re. I make mental checklists. My hobby.

Need waxing. Need to lose weight. Need a new maroon lipstick.

Christmas tree needs to be packed. Mistletoe removed. RSVP to that brunch pending. Kids’ uniforms and bags checked. Daughter’s 13th birthday coming up in three weeks. Theme. Theme. Theme? Some teenage popstar theme? Damn! I am clueless.

Majumdar Shaw Cancer Center

6th floor. Spacious. Elegant décor. Posters about how small and insignificant cancer is and how indomitable human spirit it. Yaah..yaah…blah blah. I hate inspirational posters.

Not many people in the waiting lounge. We wait.

Could it be cancer? …….Naaah! No-one in the family has it. Some stupid fleshy lump, I guess. I need to lose weight. That’s it.

We are called in.

Dr Archana Sanjiva Shetty. Young and pretty. Fresh like a daisy. Examines me.

There is a lump. Yes, I can feel it. But, it could mean many things. Get an ultrasound. We will see then. She smiles.

I smile. Business-like.

Ultrasound wait. Lots of people. Stomach churns a little. Could it be c_ _ _ _ _ _ ? Hush! Bad word ! Bad word. Don’t even think.

My name is announced. I don that silly robe which could put the entire nudist colony to shame. Cold blobs of gel are squirted on the breast. The hard, rude probe follows. An indifferent sonographer. A staring nurse. About four minutes of snooping around mammary-land.

Okay – it looks like cancer only. Phlegmatic, indolent announcement. Loud. Care-a-damn loud.

What? WHAT? What did she say? My ears feel like a throat jammed with peanut butter.

I stare. I start shivering. I don’t know why. But I shiver.

I could have cried. Maybe, yelled. Or, shrieked. Held her by her shoulders and done a filmy, ‘nahin,nahin, nahin… keh do yeh jhoot hai?’ So many options.

But I choose to shiver. Violently. The voices in the background grind into an invisible mixie.

Rrrhrrrhrrhhrhh.

Now, don’t cry-vry here. Only biopsy can tell if it is cancer. Go get a mammogram and then see Dr Shetty again.

She dumps some paper towels on me.

Rrrhrrrhrrhhrhh.

Not sure how but I manage to get back into the yellow jacket. I walk out. My husband waits in the distance. He looks blurry.

Rrrhrrrhrrhhrhh.

I walk towards him. Still shivering. A shuddering washing machine on wheels.

He is looking at me.

I glide like Richie Rich’s robotic maid, Irona. A shivering Irona. I say, weakly,

She says it looks like _ _ (I just can’t say the C-word) uh…. she says it does not look good.

I clutch his arm with cold, Venky’s frozen-chicken fingers.

My legs are giving way now.

He holds me firmly. Does not say anything. He has been like that only for the 20 years that I have known him.

Rrrhrrrhrrhhrhh.

He walks me to the Mammogram center. My heart is silent. Very quiet. No pounding.  No hammering. Just quiet. Sinking. Sinking very deep. My legs have grown new joints. They bend every which way.  He holds me from under my arms and helps me walk. Must be tough: we both weigh approximately the same. We don’t talk.

Deep-breathe. Deep-breathe. He tells me.

I breathe noisily through the shivers.

We wait on those rows of chairs. Chairs stuck together on a single long rod. People sitting on them joined by fate. It’s a long wait. How long? Don’t remember.

Rrrhrrrhrrhhrhh.

My turn comes. I can’t bear to go inside alone. Did not have a great experience the last time I went for an examination alone few minutes ago, did I?

I beg – let him come in with me. Please. Please.

Huh? She looks puzzled. She does not allow.

The test is short. She does not convey any verdict, thankfully. She hands the report. Jelly legs. School-bag –heavy heart. Back to 6th floor. Dr Shetty studies the reports. Kind face, I scan.

We need to do a biopsy. Can you come back at 2:00 pm?

Kind voice. Gentle. So soft. Like she might hurt me with the harsh ‘c’s and ‘d’s in her chosen sentence.

I finally cry. Fat tears. Spheri-fying from dazed eyes in rapid plops.

She holds my hand.

Even if it is cancer, it is totally treatable, Rachna. You will be fine.

Cancer? Totally treatable?  That did not go together.

More plops. Husband holds my shoulders. Always been a shy guy. Can’t expect hugs. Awkward chiropractor is the best he can do.

We come home. To start back at 1:30 for the biopsy. Home looks different. Splintered frames. Why is it so quiet? Why so quiet? I splash water. I call a friend. I cry. I howl. She is too shocked to say anything sensible. I lie in my bed. I am shivering.

Shoulder-holder is beside me. He is quiet. He is holding my hand.

2:05 p.m. We are back at MSCC. Dr Shetty explains the procedure. Local anaesthetic shots. Gun-shot collection of samples. Am led to the Minor Procedure Room. A kind nurse is there. They handle me like China. The breakable one. Pokes and jabs. Not too unpleasant. I have a high threshold for pain. I don’t panic. That’s me.

Your report will be ready in three-four days.

The next few days stick together like badly-made sabudaana khichdi. Indistinguishable from each other.  The world is looks faded as if washed in cheap detergent. I am in a daze. We pack in movies. Where has all the colour gone? Dinners. Distractions. Malls – the trusted panacea.  We take our children along (12 and 8 years old). They don’t know anything. We don’t tell my parents. What to tell?

Rrrhrrrhrrhhrhh.

I make some phone calls now and then. To my sister. In-laws. My rakhi-brother. Friends. I cry. I howl. I laugh bitterly. Assurances pour in. Prayers. Some blame the doctors. The medical system. You are fine. They are doing all these tests-vests only to make money. Thieves. Should be jailed.

Then we discover Bi RADS on my report. My rating is 4 C. That means, chances that malignancy will be established in the biopsy are 80%.  I cry again. Snot, tears, sweat. Loud wails. In the office conference room. With two friends. They cry too. We pray.

I await the imminent. It comes in four days.  Dr Shetty holds my hand and assures me again:

It is totally treatable.

I don’t want waxing.

I don’t want to lose weight.

I don’t want a new maroon lipstick.

I just want to live.

ooty

Our last carefree photo before the diagnosis – December 30th, 2014, Ooty

BI-RADS

The BIRADS acronym stands for Breast Imaging-Reporting and Data System which is a widely accepted risk assessment and quality assurance tool in mammography, ultrasound or MRI. Part of the initial implementation was to make the reporting of mammograms more standardised and comprehensible to the non-radiologist reading the report.

Category 1: Negative

There’s no significant abnormality to report. The breasts look the same (they are symmetrical) with no masses (lumps), distorted structures, or suspicious calcifications. In this case, negative means nothing bad was found.

Category 2: Benign (non-cancerous) finding

This is also a negative mammogram result (there’s no sign of cancer), but the reporting doctor chooses to describe a finding known to be benign, such as benign calcifications, lymph nodes in the breast, or calcified fibroadenomas. This ensures that others who look at the mammogram will not misinterpret the benign finding as suspicious. This finding is recorded in the mammogram report to help when comparing to future mammograms.

Category 3: Probably benign finding – Follow-up in a short time frame is suggested

The findings in this category have a very high chance (greater than 98%) of being benign (not cancer). The findings are not expected to change over time. But since it’s not proven benign, it’s helpful to see if the area in question does change over time.

Follow-up with repeat imaging is usually done in 6 months and regularly after that until the finding is known to be stable (usually at least 2 years). This approach helps avoid unnecessary biopsies, but if the area does change over time, it still allows for early diagnosis.

Category 4: Suspicious abnormality – Biopsy should be considered

Findings do not definitely look like cancer but could be cancer. The radiologist is concerned enough to recommend a biopsy. The findings in this category can have a wide range of suspicion levels. For this reason, some doctors divide this category further:

  • 4A: finding with a low suspicion of being cancer
  • 4B: finding with an intermediate suspicion of being cancer
  • 4C: finding of moderate concern of being cancer, but not as high as Category 5

Not all doctors use these subcategories.

Category 5: Highly suggestive of malignancy – Appropriate action should be taken

The findings look like cancer and have a high chance (at least 95%) of being cancer. Biopsy is very strongly recommended.

Category 6: Known biopsy-proven malignancy – Appropriate action should be taken

This category is only used for findings on a mammogram that have already been shown to be cancer by a previous biopsy. Mammograms may be used in this way to see how well the cancer is responding to treatment.

Next Week : # 2: My Surgery

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52 thoughts on “#1 : A breast-beating diagnosis

  1. Thanks for sharing your experience Rachna, I am sure it will give strength to many. My mum had cancer, I was there with her when they first diagnosed her at Tata Cancer Memorial in Mumbai, I saw my world collapse. I remember telling her, she was very brave to smile through it all, reading your post I realize what she must have gone through.
    Take care Rachna, the worst is over 🙂

  2. You are so courageous.. it takes a brave person to recount their worse fears/experiences and share it with others. I am shivering as I read it !! I wish you a speedy healing and quick recovery to your normal life. Whenever in doubt, think of your husband and kids and be strong. You can will it away .. that’s what I believe in. Tell yourself everyday, you are stronger then the cancer.. and you’ll be fine . I can just see it !!

  3. No words Rachna. It was really tough for me to go through your vivid write up without a tear. I know you are brave and strong and truly an inspiration to the crest of us. God bless.

  4. Rachna u r brave.We ladies are only brave bcoz entire family depends on us specially our children. So we have to live at any cost. I have lost my dad due to LEUKEMIA so I know a single disease can ruin the entire family. Take good care of urself and live ur life to the fullest!!!God bless…

  5. Congratulations Rachna on coming through as a winner.
    Have read all the quotes on the 2nd floor (the oncology department was here before it shifted to the current floor) & 6th floor of MSCC when waiting with my mom when she was diagnosed with thyroid cancer a year and half back. Still visit the place every 3-4 months for her checkup.
    Btw we share the same birth date.

  6. You are very courageous and a winner to have written about it! God bless you! And I would like to mention your supportive husband as well. This is what makes the life worth living for. Take Care!!

  7. Rachna, I suddenly seem to value life a bit more than 10 mins back. You are extremely brave .Thanks for making me realise one more time not to take life for granted. Take care.

  8. Rachna, by putting words to the last 8 months… you have brought awareness and support to so many… thanks for being yourself… take care….

  9. Cancers if caught early are treatable these days, and I am sure the prognosis in your case is a favorable one. Don’t let it overwhelm you and face it like any other challenge you have faced. Look it in the eye and emerge victorious. I am certain that this is what a courageous lady like you will do.

  10. I couldn’t sleep after reading it…you are a fighter and I know you will come out a winner in this battle too…it takes a lot of guts to do what you are doing..loads of love and hugs you brave girl…get well super soon!!

  11. I admire your courage Rachna, for being able to write about it with such clarity, for sharing every emotion you are going through. This comes as a huge shock and like so many others, couldn’t stop my tears. Wish you even more strength. Lots of love and hugs to you.

  12. Rachna,
    what a brave step to pen down all you have gone through ! definitely an inspiration to others ! keep up the fighter spirit that you have . wishing you happiness, good health and good luck ! As someone said – the worst is now over so enjoy your victory against the disease and may your strength help and inspire many others to fight and win this battle…take care !

  13. Have always pictured you as a funny, carefree,happy kinda girl..could not think of you in all this pain…But always knew you will fight it out brilliantly. Keep up the faith. Wish you a speedy recovery.

  14. You are so brave Rachna.Hope you recover very soon and keep up the indomitable spirit.Thankyou for making it so real .Very proud of you.

  15. Hi Rachana—–good that you have had an early diagnosis—-well the big C is always so scary—–but it’s totally
    treatable—so take it easy—-I’ll pray for your speedy recovery—–sure yur spirit soars!!!!!

  16. Dear Rachna, I am an old friend of your sister Anamika. We went to IIMC together.Your article is profound and touched me deeply…all my prayers are with you. Its a tough place you are in right now, but it too shall pass. At rough times like this the most important thing is to keep faith. You are brave and strong and you will come through this much more stronger. All the very best- hugs Leela

  17. Thank you for sharing your experience – so vivid and honest. With so many well-wishers and people praying for you I’m sure you will make it through fine. My prayers are with you.

  18. Rachna, your brave spirit shines through your story. An early diagnosis means faster cure and recovery, I am praying for your speedy recovery as I write this comment.Sending love and healing light your way, stay strong and positive, you will come out of it, take care.

  19. I think of you as a person with this indomitable spirit! You are surrounding by an extremely loving and supportive family and hopefully through this blog a world full of wellwishers!! So write on…my friend and three cheers to you!!

  20. Rachna, ever since I have known you in Japan you have shown strength and positivity. You have gone through a lot and always come out strong. This too shall pass. Hang in there and we are always there for you. Lots of love Ambanis

  21. Rachana. I am really proud of you for sharing this. Thank you. Hope you are fine now. Hope the benignity has left and has left more cheer and your lovable hubby is till handling you like fine China. Stay strong. My prayers are with you.

  22. God bless you and your family:-) I could connect with you Soo well on this, my mom had undergone the same thing and I could feel her emotions, fears scilence. Take care:)

  23. Rachna, it is a poignant piece. Written as if smirking at the danger which stared you in your face. Courageous & Captivating. Impregnable armour. You will prevail.
    Pavan Choudary

  24. Laughter is the best therapy. You’ll find a cure to this as well as you are a great therapist. Cancer ki aisi ki taisi.

  25. Sweetheart, you are BRAVE and just too funny…sure, the big C is a setback, but then what is life without a few bumps…my mom too had cancer but unfortunately it was misdiagnosed by Allahabad doctors…get well soon dear Rachna and keep entertaining us with your sense of humour.

  26. Rachna hats off to u to go thru such a terrible time but decided to inspire people.I am sure u will be absolutley fine.My love n prayers to u

  27. Kudos to you Rachna, you are a biggest source of inspiration to me and to my family. Admire your courage and my prayers for you , supportive Alok and loving A & P.

  28. Hello dear Rachana,
    First of all you are brave indeed… Don’t worry. It is going to be treated…

    You know my sister’s husband is having brain tumor of 3rd stage…from the age of 29 yrs…but he is still fine only because he doesn’t take it seriously…he just doing all his sittings….chemo and radio… as normal …very normal way… even we relatives get strength from him… had two time brain surgery….but every time he goes in operation theatre without wheelchair…. By walking…and says to staff that I’m OK….
    All this is only because…. His willpower is very strong…he strongly thinks that I will be ok… This is only his effective medicine… So…from nowonwards…. leave worrry…please…is the first step of your fight….come up with new thought that I will win over this…. always have positive attitude.. it really helps a lot…search on net also for every afford….natural way are also very helpful and shows its effect….. So fear please take it as a task…which you have to do with very courage… Prayer and deep best wishes for you….. Hope you will try this mental streanthaning therapy… And be your own doc…to overcome from this…

  29. Hi Rachna ,
    Your blog blew my mind. It’s just incredible how you have penned down your fears & emotional trauma ……. would love to meet you in person some time in near future …… and go out for a lunch together ☺️

  30. Hi Rachna,

    I chanced upon your link last week, the day after I was told I may have BC. I had just done my mammography and your explanation of the score kind of helped me understand what I was looking at. Since then it has been confirmed and I will go into chemo this coming week. Thank you for your post and I like your attitude towards it and it gives me lots of hope. A lot of what you wrote resonates with me so well specially about leaving letters for the kids and hate the line of thought where I m missing from the pic. Wish you a speedy recovery and I believe like others have said it’s about our will power. Hugs and wishes.

  31. We are bday buddies !! and I really hope the worst is over for you. C word is something I have dealt with very close ones and lost them. I just hope you have a very long life ahead with your shoulder-holder and loads to talk to your daughter. Loads of prayers and love !!

  32. Hi Rachna, My sister sent this link to me. When I read it , it seemed like the day 4th Nov 2014 , the day I was diagnosed with Breast Cancer. I had also planned my day pretty much like you but things were not the same after the ultrasound. Have spent 8 months in and out of hospitals with chemo, surgery and radiation all done.It is a life changing experience and there will be times when its ok to be vulnerable and cry, you can’t be brave all the time. But there is also Hope and have faith . You are young , things will come out for the better. Just be strong , there is no other option available 🙂

  33. So impressed with your courage and candid recount of your pain and anxiety. So impressed with Alok. …The strong, silent support. God bless you both.

  34. I don’t know you (though I vaguely remember reading a review of diapers and denial), but had to say thank you. Thank you for sharing your journey- because while there is so much information on the is ease itself, there is o little on how it is to actual have to cope.

  35. Dearest Rachna,

    Firstly a big hug your way. My mum was a cancer survivor for 15 yrs… She passed away 6 months back. Reading your blog, I have lived through every moment u have written. I was there with my mom, all the way from blood tests till chemotherapy.. I could relate to every single word u have written. Lots of healing vibes your way. Be strong. Take care.

  36. Hi Rachna, wish you the best. My wife had a brain tumor and passed away due to it. Some of what you write gives me an idea of what she probably thought and felt. Her approach was to put her head down and do whatever it took to beat the tumor. We never discussed any other possibility or how to deal with it. There is nothing good about a cancer diagnosis. We dealt with it the best we could because we had no other choice. Good luck again.

  37. Rachna,
    Just when you were in the middle of your chemo treatments, I was getting my diagnosis. Someone shared your completely hairless blog with me – it left me sleepless for 3 days. It was early days for me, you see. I was having trouble accepting the verdict.
    On and off, when I could stomach it, I have been following your blog. I am so glad your journey on that path is over. I’m awaiting my 5th taxol after 4 FECs. And my surgery will be in June.
    I was wondering if I could touch base with you about Kiran Mazumdar Center and the surgery and reconstruction experience you had. My email id is Supriya.subramanian@ gmail.com.
    If you’d rather not, I’ll totally understand. All of it is behind you now and I know that being reminded of a painful phase in one’s life can be hard.

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