Denial

Picture this: Having a casual conversation with your spouse, whilst randomly checking your 3rd-trimester-milk filling-breasts, and actually finding a lump. You stop mid-sentence. That isn’t supposed to be there…everything you’ve heard & read since puberty tells you to panic. So you do a Google search—something like “lump in breast pregnant” or “third trimester breast lump.” Initial search results will reassure you that it’s likely a blocked milk duct. Don’t worry, this is common in the third trimester, and your OBGYN can address it. Phew—thank heavens it’s probably nothing.

Those were the shoes I was wearing in early October 2020. My husband and I were soon heading out of town on a mini baby-moon, and I figured I’d deal with it when we got back. I called my OB’s office when we returned, and one of the nurse’s agreed that it could wait until my appointment the following week.

The appointment arrives, and I honestly almost forgot to even mention the lump. That day was just a routine ultrasound and quick check-up. The doctor checks it and upon initial assessment suspects a fibroadenoma. My nursing expertise isn’t in this area so I must have made a face at that word—she explained that was fancy for “benign mass.” Okay good—that was close!

Then I receive a call the next day, with the doctor telling me she’s ordering an ultrasound to be safe. She explained that upon finishing her notes from the previous day, she thinks it’s possible…not likely, but possible…that there’s something else. My stomach drops. Why couldn’t this just be simple?

Ultrasound day arrives. For reference, it was 10/26/20, roughly 3 weeks after finding the lump. I’m nervous as hell, but am holding onto all the well wishes of friends and family—"they’re just being cautious, you’ll be okay!” On this day, my nursing knowledge proved itself valuable, but also dashed hopes of blissful ignorance. They found the mass…it had ugly, unclean edges, combined with an unsavory shape. I knew that wasn’t good. They knew I saw it. When they told me to wait in the room until a mammogram room was available, I was stoic, falling apart only once they left the room. Tears start falling. My fingers start firing out text messages. I have only a few minutes before I’m walked into the room with a machine I’ve never seen before. Ah, so this is the famous “boob squisher.” Images were taken, and I’m told to wait again while the radiologist reviews them. He comes in to speak with me…another negative sign in my opinion…why weren’t they just letting me leave? He tells me he’s going to recommend that my OB order a biopsy. We discussed a couple of bullet points in the “good sign” column, and then some in the “bad sign” column. I leave the appointment in low spirits, now barely clinging to those “you’ll be okay” sentiments. Confession—I try my best not to be negative, but I also try to see the worst-possible-outcome at the furthest distance I can, so it doesn’t hit outta nowhere.

Biopsy day arrives. For reference, it was 11/3/20, now roughly a month after finding the lump. I’m scared, but hopeful. All this hubbub is surely a mistake, and here was the exam that would prove it. Sample taken, appointment over, I leave with the hope of hearing something before the weekend hits.

Three days later, on November 6th, 2020…I get that fateful call. I’d just left the Starbucks at work taking a quick break from a busy shift. I see it’s the OB’s office, and I know this is it—for better or worse. The lady on the phone tells me that results are in, and my OB wants me to come in to discuss results. I stiffly respond “OK,” explaining I’d need to disperse my patients amongst coworkers and head south. I call my husband, and I crumble. Right there, in the middle of a busy hospital cafeteria, aware people are looking at this hysterical RN, but with no energy available to care. I knew it. It was cancer. Those edges were ugly for a reason.

HOW I got home safely to meet my husband, I still don’t know. I think I was just on autopilot. We head south together to my OB’s office. As often as I kept saying “babe I know it’s bad…why else wouldn’t they just tell me over the phone?” I also kept repeating “well okay maybe it’s bad, but not terrible, and they want to discuss better health habits.”

Arrival at the OB office did little to keep that hopeful flame lit. Even the staff’s facial expressions were crestfallen. I’d been seeing these people for so many weeks for pregnancy-related appointments, that I’d gotten to have miniature conversations with most of them. They recognized me by face and first name in most cases. I couldn’t sit still during the wait to see my doctor—my bouncing leg probably burned off my lunch caloric intake. Once we were taken back I just kept deep breathing, it’s the only thing that held me together. When the doctor came in, she remarked she was glad I brought someone with me, and once again—I felt apart. Hard. She didn’t need to say the words “the biopsy was positive for cancer,” but to cover all bases, she did. Then hugged, and cried with me.

Within minutes, we were discussing a final fetal ultrasound, labor induction, and setting up a consult with a surgeon to discuss coordinating port placement after giving birth. Metaplastic Carcinoma with squamous features was nothing to be trifled with, and we needed to get moving quickly. She made sure I had a copy of my pathology report before I walked out toward the lobby. I strode out tall, with a straight-but-red face, and it felt like every passing staff member silently saluted me.

So why the title “Denial” if my instincts told me I had cancer? In the blur of days that followed is when denial of the specific diagnosis came in. Surely what I was reading online—low survival rates, conflicting info on treatment response, and high reoccurrence rate—could NOT apply to the type that I have. Surely, obviously, the pathology lab was mistaken.

Spoiler alert: They weren’t.