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A few months before your 31st birthday you'll be lying in bed holding Animal Farm in one hand and idly examining your boobs with the other. With a start, you'll notice something that resembles a robin's egg rolling around under the skin of your left nipple. You'll keep touching it for the rest of the day, and when your boyfriend comes over you'll ask him to look at it. He'll say, "Yeah, hmm." He'll dump you the day after you find out you need surgery to remove it.
You'll make an appointment with your gynecologist, and she'll have the same "Yeah, hmm" reaction your dude did, only she'll also hand you a slip of paper ordering you to go to the hospital for a mammogram. You've never had a mammogram, so you'll be kind of freaked out but mostly curious whether it's as bad as you think it'll be.
When they finally get you in for an appointment, you'll find out that yep -- it's actually worse than you imagined. Your breast will be smashed impossibly flat, between two thick plastic (cold!) plates. You'll wonder if the thing in your boob is going to burst from the pressure. What's even in it? Can it burst? Can your whole boob burst? It feels like it might.
A few days after that they'll call to tell you the test was inconclusive, because you have dense breast tissue and that makes mammograms not work or something and now you'll need an ultrasound. This will be the best news.
It will be followed by some not-so-great news. The next thing the nurse will say is that they need to schedule a biopsy. "Don't worry, it's a quick appointment. We just use a needle to take a sample of the lump in order to figure out what it is." You'll repeat this to your therapist, and she'll order you to bring a friend because she has secret knowledge of what is about to happen to you.
At the appointment you'll be so grateful your friend is there to hold your hand while a technician uses the ultrasound wand thing to aggressively smash the lump down and hold it in place while she jams a needle in and out of the lump, which is now, months after you discovered it, the size of a Ping-Pong ball. This goes on for about three minutes. You'll watch the needle going in and out, in and out, on the black-and-white ultrasound screen. You'll feel the tugging, get nauseous, and silently cry. The tech will say, "Well, it's not a cyst, or liquid would've come out." She'll tell you to come back in a week for the results. Going online will provide enough scary breast cancer-related articles to keep you fully freaked-out 100 percent of the time during this wait.
Again, the test will be inconclusive! It is a tumor, not necessarily not cancer. Since the tumor has been growing it's possible that some other corner of it is cancerous and they can only test every part of it by taking it out entirely and examining the whole thing. You'll get a sheet of paper to take to another part of the hospital to make your surgery appointment. This part of the hospital will have the word "Oncology" written on every door and wall and window and will feature a glass display case containing two mannequin heads modeling beautiful wigs, a few bras that look like Ace bandages, and a variety of prosthetic boobs. You'll call your mom and she'll promise to come stay with you until you're better.
You cannot eat or drink anything starting the night before the operation, not even water. You love water so much! Like you're pretty much constantly drinking water ever since you quit smoking, unless you're drinking wine, but even then you usually also have a water going. Your coworker who sits nearest the water cooler once told you that he's pretty sure you drink more water than everyone in the office combined. This "no water" rule will be psychological torture.
So you'll go to the hospital first thing in the morning and they'll put you in a gown and slippers and have you wait two hours in the waiting room. You'll start to cry from anxiety and thirst. Your mom will laugh at you and call you something adorable. Finally they'll summon you into an office and ask you, "What's your name? Where's the lump?" to be sure they don't mix you up with another patient. You'll meet your nurse, your anesthesiologist, and your surgeon, who'll want to know if you'd like it removed the easy way by cutting right over the lump, which will leave a good-sized scar on the side of your boob. You have side titties and you are proud of them, so you don't love this option. They'll tell you they can cut around your areola, which will leave a much less noticeable scar, but once they get in there they may find that they need to cut into the side anyway so you could end up with two scars if they go that route. Up to you! You decide to chance it.
You'll kiss your mom bye and walk yourself down a long hallway into an operating room. You will not be expecting this to be such a serious-looking operating room. There'll be a huge metal table, giant spotlights, and about eight people buzzing around in scrubs and gloves. You'll lie on the table and the dude will put a needle in your arm. Your surgeon will ask you what music you want on, you'll say rap, and he'll say they only have Eminem. You'll pass out. That afternoon your mom will tell you that while they were waiting for you to come to, the doctor briefed her on the surgery and said, "We really had to dig, but we got it. I think."
Whoa, That Hurts!
You'll spend the next two nights sleeping upright on a couch because every time you lie on your side or back, your boob -- although completely bandaged -- will flop a little and a shooting, searing pain that feels like the whole thing will split apart jolts you back upright. You'll take Vicodin for the pain, forgetting every time that it makes your stomach hurt and disrupts your sleep and generally makes everything but your boob feel awful. You'll spend a week trying to avoid getting the bloody bandage wet in the shower. They'll take the bandage off and say that your scar is "looking good!" even though it's totally not looking good; it's looking like a bloody, twisty half circle. And occasionally really pokey stitches will come out of the side of your nipple. The doctor will tell you this is normal. He'll also tell you the lump was a benign tumor called a fibroadenoma and nothing to worry about, except you'll probably get one again, so come back for checkups every six months or so. You love your boobs, but hey, if they had to chop the whole thing off to find out you're not going to die of cancer, you're totally fine with that.
It'll take a few months for the soreness to ease up only for it to be replaced by an oddly familiar robin's egg mass rolling around under your left nipple. It'll turn out to be scar tissue this time. Next time, who knows?
Don't panic! Only one out of 12 breast lumps turn out to be cancerous, says Susan M. Love, MD, clinical professor of surgery at UCLA's David Geffen School of Medicine. Still, call your doctor; every lump should be checked out.
What Could It Be?
A cyst is a fluid-filled sac that develops most often in women in their 40s or 50s. It's harmless but can be painful. Your doctor may be able to tell it's a cyst by feeling it, but if it's deep, it can feel hard like a tumor and you'll need to have an ultrasound, says Dr. Love. A cyst will usually go away on its own but the doctor can drain it if it's painful.
A fibroadenoma is a benign solid tumor that is most common in women in their 20s and 30s. The cause is unknown but is likely due to hormonal ups and downs. Imaging can confirm that it's not a cyst but you'll need a needle biopsy to determine if it's benign or malignant. For most women, a fibroadenoma goes away on its own. If there's any doubt about whether it's cancer, your doctor may recommend surgery to remove it so the entire tumor can be analyzed.
A malignant tumor also feels like a hard lump. The only way to discern if your lump is malignant or not is to have a biopsy. Ask about a core-needle biopsy, which is more reliable than a fine-needle biopsy because the doctor takes a larger chunk of tissue for analysis.
-- Amelia Harnish
Originally published in Ladies' Home Journal, March 2012.