I have a two-inch scar on my right breast. After my surgery last summer, Atticus said he didn’t notice it and I was as beautiful as always, but he is besotted with me and biased so I sought a different opinion from my friend Betsy. When I pulled down the collar of my blouse and yanked my bra to one side to show her the angry, purple jagged line, her eyes widened, and she tried to conceal her taken-backness by remarking in an upbeat tone that I looked “dangerous.”
I look less dangerous now. The scar has faded to a light brown. When I run my fingers along its contours, I feel a puckering of the skin, and a slight crater where breast tissue used to be. When I move my fingers to the right of the crater, I feel familiar lumps. At least I think those lumps are familiar. But I’m not totally sure. Is it normal breast tissue that just feels pronounced because it’s lying next to a crater? Or is it weirdly, malevolently lumpy there?
A routine mammogram a year and a half ago detected a mass in my right breast that appeared to be a fibroadenoma. Fibroadenomas are benign breast lumps that often shrink over time. They are not cancer and will never turn into cancer.
No matter how benign your lump appears, however, no radiologist will guarantee that you don’t have cancer. They will give you choices: wait six months for a follow-up mammogram; get a core needle biopsy to remove a section of the mass; get an excisional biopsy to remove the entire mass.
My radiologist referred me to a breast surgeon, who, being a breast surgeon, recommended surgery.
This was around the time that several debates about breast cancer were raging. A study was released that questioned the efficacy of mammograms in detecting cancer. There was also controversy about the overuse of surgery to remove fibroadenomas–which are reasonably easily identifiable and benign. Finally, there was speculation that biopsies could even cause breast cancer.
The more I read up on the studies, and particularly the treatment of fibroadenomas, the less I believed a biopsy was warranted. Plus, there were downsides: risks associated with any surgical procedure; a mangled breast; the impact of a breast biopsy on my ability to get health insurance. At the time, I was insured by a COBRA plan, but what would happen when COBRA ran out? What if my rates doubled because of a biopsy that turned out to be negative? What if I could no longer get insurance due to a “previous existing condition”?
So I chose to wait six months for a follow-up mammogram to determine if there had been any change.
Six months later, indeed there was. The previously detected lump was smaller, but there was a new, questionable mass behind it. After mammogramming and ultrasounding my poor right breast within an inch of its life, the radiologist told me the second mass appeared to be another benign tumor called an intraductal papilloma. But because I now had two masses, and the first one partially obscured the second, the radiologist and the surgeon told me in no uncertain terms that I had to get a biopsy.
At this point, I was convinced I had cancer. I was convinced I had cancer because I was divorced. Divorce, according to any number of studies designed to keep divorced people up at night, is the #1 cause of wrecking the health of you and your children. More than tending crops in Sub-Saharan Africa. More than dodging bombs in the Middle East. More than being sold into sexual slavery in Thailand.
If I had stayed married, I reasoned, I would have been a beaten-down clinically depressed Stepford Wife who might one day have stuck her head in the oven, but so what? I would not have ruined my children’s lives and and I would not have cancer.
Since I was convinced I had cancer I chose the excisional biopsy; better to remove those malignant lumps entirely, in one fell swoop. And if I did not have cancer, undergoing needless invasive surgery that might mangle one breast was due punishment for the fact that I had ruined the lives of my children by getting divorced.
The surgery itself was a cake-walk. I had no ill effects from the anaesthesia and my discomfort was so mild I didn’t even need Tylenol. But I spent the next five days before I got the lab results steeling myself for the sure promise of an early death.
Only the test results were negative. Both tumors were benign. I did not have cancer.
The biopsy also revealed the presence of atypical lobular hyperplasia, a group of abnormal cells that while neither cancerous, nor even pre-cancerous, are thought to increase a woman’s odds of invasive breast cancer–by how much is unclear, although the risk appears to jump exponentially when one is compulsively surfing medical web sites late at night.
I was told that if I wanted to be aggressive, I could take tamoxifen, a medication that blocks the effects of estrogen in the breast tissue, but has a host of unruly side effects, such as strokes, blood clots, other kinds of cancer, and early menopause. Since I didn’t even have pre-cancer, I decided to forego this route and opted for routine mammograms instead.
My annual mammogram is around the corner, on June 9th. I’m trying to be zen about it and not attach to the outcome. I don’t want to believe that bad divorces give people cancer and I’d like to think that there are plenty of grains left in my hourglass–although if I die, at least Prince can’t haul my ass into court.
If I sound paranoid over getting a routine mammogram, it’s because I am. What this past year-and-a-half has taught me–that the rich can get away with not paying child support; that wealthy people can sue you and not have to pay your legal fees; that there is really no way to talk sense into angry ex-spouses who are determined to sever their children’s bond with the other parent; that a sane, fit mother can lose custody of a child simply because she lacks the funds to hold onto her legal rights–has dampened my faith in justice and made me leery of ominous events that can smote you arbitrarily out of nowhere.
That said, Atticus and I have decided to seize the day. Yesterday we booked a family vacation to Maui that we can ill-afford but desperately need. In August, I will lounge on a chaise by the hotel pool, smoothie in hand, my scar peeking out from my bathing suit neckline. I will glance over at the lounge chair next to me and take Atticus’s hand. We will watch our youngest two squeal as they zip down water slides, splashing into the water below.
I will lean back in my chair and try to wrap this moment around me. For now, we have health, laughter, love, and beautiful children to raise. For now, we are scarred, but alive and thriving. I hope, for many years to come. But for now, at least. For now.