Living with Triple-Negative Breast Cancer
(#7 in a series)
This is my last full day with two breasts.
That thought played on a loop in my mind the day before my scheduled mastectomy. I couldn’t pass a mirror without staring at my chest. I wanted to soak it in, to capture the feeling and hold on to it forever…
Emotional Processing of Mastectomy
It’s one thing to explain the physical process of mastectomy and recovery. It’s quite another to find the words to express the emotional process. We human beings process things according to our own life experiences, our own hopes and fears. I know what it’s like to lose a breast, but I cannot presume to know how other women deal with that loss.
Indeed, my own processing of this event was a product of my age (51) and place in life (happily married, childbearing years behind me, multiple sclerosis). The cosmetics of it all, while not unimportant to my self image, didn’t cause turmoil or depression. I was unhappy about losing a breast, but confident in the decision to have the mastectomy, as well as the decision not to seek reconstructive surgery now or in the near future.
Femininity and sensuality begin in the spirit, and losing a body part would not change that unless I permitted it to. I knew I would still feel feminine and — dare I say it — sexy.
The full agreement and support of my husband, children and extended family certainly made my ordeal easier to bear than it might have been otherwise. The emotional processing of losing a breast does not end after the surgery, but evolves over time.
Goodbye, right breast, you shall be missed. Thank you for taking one for the team. Now let’s get on to saving my life. (We can end breast cancer by 2020)
Upon arriving at the hospital, we were quickly ushered into a room and introduced all around. It hasn’t always been my experience with health care, but at this hospital, every nurse, every technician, every member of staff we crossed paths with was professional and caring. They didn’t treat me as a case; they treated me as a human being who was about to experience profound change.
Prep time included the injection of a dye that would find its way to the sentinel lymph nodes — four injections in the areola and eight throughout the rest of the breast. As unpleasant as it was, the doctor who performed the procedure was careful and compassionate.
About Sentinel Lymph Nodes
From the National Cancer Institute: The sentinel lymph node is the first lymph node to which cancer is likely to spread from the primary tumor. Cancer cells may appear in the sentinel node before spreading to other lymph nodes. SLN biopsy is a procedure in which the sentinel lymph node is removed and examined under a microscope to determine whether cancer cells are present. SLN biopsy is based on the idea that cancer cells spread (metastasize) in an orderly way from the primary tumor to the sentinel lymph node(s), then to other nearby lymph nodes.
A negative SLN biopsy result suggests that cancer has not spread to the lymph nodes. A positive result indicates that cancer is present in the SLN and may be present in other lymph nodes in the same area. This information may help the doctor determine the stage of cancer and develop an appropriate treatment plan.
Greeting us with her customary hugs, my surgeon, Dr. M, took extreme caution to mark the correct side, her confidence and bedside manner of tremendous comfort. As they wheeled me to the operating room, my heart went out to my husband, who had the unenviable task of awaiting word that his wife was well… or that they’d discovered worse news.
The surgery team did a thorough job of going over the pre-surgery checklist before putting me to sleep. The hours in recovery were hazy. I recall knowing that I’d lost a breast, but that I was happy to be alive. I felt in surprisingly good spirits and had little pain.
When my husband and I were finally reunited, I gave him a great big smile, sensing his immense relief. As it turned out, he had company in the waiting room. A surprise visit from my eldest son helped him pass the time and would make the next few days much better.
Oh, those hospital nights. I was awakened every two hours for maintenance to the drain, blood pressure/temperature checks, and antibiotics pushed through the IV. About 27 hours after walking into the hospital, I walked out, flanked by my husband and son.
Clipped to the inside of my tee shirt was one drainage tube. It came out of my right side and was held in place by a couple of stitches. The long tube ended in a drainage bulb to capture blood and other fluids. The tube would stay in place for a minimum of one week, during which we were to clean it several times a day, measuring and recording the amount of liquid captured.
Still to come would be the removal of the bandages on my chest, an event I wasn’t looking forward to. More importantly, in a few days we would have the pathology report on the lymph nodes and the cancer would be staged. That would be very useful to the oncologist who would formulate the next stage of treatment. Many questions remained, but we were relieved to have this first phase of treatment behind us.
From the Mayo Clinic: A simple mastectomy without reconstruction may be completed in approximately two hours. A single incision across half the chest usually allows the surgeon to remove the breast and examine the lymph nodes.
After the surgeon completes the mastectomy, a plastic drain is placed to draw off fluid. The end of this drain is attached to a pocket-sized suction device. The patient is instructed in the care and monitoring of the drainage until the drain is removed a week or more after surgery.
Most patients do not experience excessive pain following simple mastectomy. It is common to use some pain medication for the first few days after surgery and then an over-the-counter pain reliever as needed. Expect fatigue following surgery. Simple mastectomy is emotionally and physically draining.
Living with Triple-Negative Breast Cancer Series
#1 The Lump in my Breast: Meeting the Enemy
#2 Most Breast Lumps are Non-Cancerous: Would mine be?
#3 The Mammogram, the Ultrasound, and ‘the Look’
#4 The Biopsy and Breast Cancer Confirmation
#5 A New Twist: It’s Triple-Negative Breast Cancer
#6 Before the Mastectomy: Planning for the Future
Access the up-to-date Living with Triple-Negative Breast Cancer Series
Take Action! Sign the petition: We can end breast cancer by 2020
Author’s Note: This is article is part of a series chronicling my first-hand patient perspective of life with Triple-Negative Breast Cancer. Without being overly self-indulgent, I hope to convey the raw emotion that comes with such a diagnosis… and the process of living with and beyond it. Entries will appear in Care2 Causes and in Care2 Healthy & Green Living. Follow on Twitter @AnnPietrangelo