On a day like this 5 years ago it was a Wednesday not a Tuesday. I was probably drinking coffee not an oat milk chai. I was living in London, not Barcelona. And I was going for an appointment at the hospital not to work, unlike today. 5 years ago, in a small room in hospital in East London, Ms. C broke the news that I had indeed breast cancer. I was there with Nick, my ex-boyfriend and Fausto, my best friend. The breast cancer nurse, whose name scapes me now, was present too.
A few months ago, I was going through papers and found the letter that Ms. C sent to my doctor, the general practitioner I went to first so she could have a look at THE lump. This is what she wrote…
“Dear Dr. D
I saw Ms Panades today after our brest multidisciplinary team meeting this morning.
Unfortunately I had to give her the bad news that the lump in the left breast is confirmed as breast cancer – C5 with malignant cells on cytology and core biposy grade III infiltrating ductal carcinoma- The axilla lymph node looked abnormal on ultrasound scan and the cytology report confirmed metastatic involvement (C5).
At the present moment the lump is about two-cm clinically and on ultrasonographic measurements. She is young with relatively dense breasts and we wait MRI scan for a more accurate measurement and to see whether any other focus elsewhere.
Because of the C5 grade in metastatic lymph node, I have arranged staging investigations – including bone scan and CT chest/abdomen – which will be done this coming Friday (8th= and Monday (11th). We will then re discuss staging investigation and MRI result in the next breast multidisciplinary team meeting (13th) and Ms P will be see in clinic that afternoon. Temporarily, we may be able to five her a space on out operative day 21st May.
Ms P asked that if it is only a two-cm grade III cancer with modal involvement what treatment? We would be able to offer breast conservation surgery with axillary clearance- As it is a grade II node positive cancer and she is relatively young chemo/radiotherapy would be required but we will await hormonal and Herceptin status o see whether she is suitable dor adkvant ormonal or Heceptin therapies. He wanted to discuss fertility issue so I will refer her to our gynecologist.
Ms P is still in a dilemma about what to do and whether to have the treatment in London or Barcelona. She has just split with her partner who she used to live with several years, her parents undergoing divorce with the house up for sale and, unfortunately, her grandmother has just passed away. Presently, her employer may not allow paid sick leave but she will sort this out and let us know o her social circumstances next week. On further questioning, shy says one of her aunts (?) likely womb cancer in her forties and her brother testicular cancer and treatment at the age of thirty-two. There is no breast cancer or definitive ovarian cancer otherwise.
Ms Panades is still relatively young and may think about genetic testing. However, at this current stage, there is too much on board for her and she want to concentrate on the cancer treatment first-
I will keep you informed of the outcome from our next MDM discussion and management.
I am happy that 5 years on I am still here to read this letter, to realise how much good has happened since then and to look forward to the time ahead of me.