What to Expect When You’re Given a Breast Cancer Diagnosis

What exactly is my body experiencing from a medical perspective? I thought I would share so that anyone who is going through a breast cancer diagnosis can be informed. I remember being handed a laundry list of things I needed to do before I could receive chemotherapy, and everything was new to me. I hope I can help others by laying out exactly what happens, at least in my case.

  1. Self Breast Exam – Once a month, male or female, you should feel your breasts. This is how you will know if something is out of the ordinary. I found my lump, and I knew because there was a hard spot on my breast. Also, the hard spot hurt when I pushed on it, similar to a bruise. It’s a myth that cancer doesn’t have any pain. Keep an eye on the lump for changes in its size and composition. I waited about a month, and then I went in. Don’t wait. Go.
  2. Clinical Breast Exam – My gynecologist was the first person I scheduled an appointment with to check the lump on my chest. She palpated the lump, and she recommended I see a radiologist for an ultrasound and a mammogram just so we could be sure of whether it was fibroadenoma or something else. Fibroadenoma is a benign condition that is common in women under 30.
  3. Ultrasound – A radiologist performed an ultrasound on my right breast. They use warm jelly and take images of your breast. It takes about 10-15 minutes, and it doesn’t hurt.
  4. Mammogram – This is the fun test where they squish your boobs! Honestly, because I am smaller, the test did not hurt as much. It’s important to just remain still and although you feel some pressure, it’s not painful if you can keep calm and relax your body. This takes about 10-20 minutes.
  5. Biopsy – After noticing a lump in the ultrasound and mammogram, a biopsy is usually performed. The chest is numbed with some cream, and the radiologist injects a needle into the space where the lump is to draw a sample of the tissue. She also places a chip in you so that there is evidence of where the tumor is. This tissue is sent to the lab and ultimately what determines whether the lump is cancerous or not. IF YOU ARE ASKED WHETHER YOU WANT A BIOPSY OR NOT, ALWAYS SAY YES. THE BIOPSY IS THE MOST DEFINITIVE TEST FOR WHAT EXACTLY IS IN YOUR BODY.
  6. Blood Test – One of the first things your oncologist will ask you to do is get a baseline blood test. This test is used to look for tumor markers. You’ll have a few vials drawn and the results will be kept in your file.
  7. MRI – An MRI is done of your chest to be able to examine the tumor in more detail. You cannot eat after midnight for this test. You get a locker, and you have to remove everything including jewelry. You lay on your tummy that has little holes for your breasts, and you go into a skinny tube. They give you some headphones to cancel out the noise, and for about twenty minutes, you have to lay completely still. They inject you with some dye to help the cancerous tissue to be clearer in the results. Loud beeping noises occur, and I highly recommend just closing your eyes the entire time. I actually closed my eyes before they sent me through the tube, and I imagined that I was in a vast, open space. When the noises starting happen, I danced to them in my head. I tried to find rhythms to the noises, and making my own art through the experience was helpful.
  8. PET Scan – A PET scan is similar to an MRI except the results are way more detailed and show the oncologist more than your chest. The PET scan was done on my head, chest, and pelvis area to determine if the cancer was isolated to the tumor or spread to other places in my body. You cannot eat after midnight for this test, and when you arrive, the first thing they do is take you to a quiet room where they inject you with glucose. Cancer likes glucose so when you go through the test, the cancerous areas will light up. You have to let the glucose filtrate through your body for an hour. They give you a nice reclining chair, a blanket, and they play ambient music for you. I fell asleep, and in an hour, they woke me up and took me to the testing area. I had to remove my clothing and keep nothing but a hospital gown on. You lye on your back with your arms above your head and you slowly go through a skinny tube. They played classical music while I was in the tube, which I found calming. Again, you cannot move or the test results will be voided. For this time, I found myself doing meditative chants – “My body is strong. My body is a fighter.” I said this over and over. Towards the end of the test, my arms fell asleep and I asked if I could lower them. They let me place my arms over my chest, and that position felt better. Immediately after the PET scan, I drank a smoothie and ate some lunch!
  9. Heart Echo Test – Because I received the AC regimen, the oncologist wanted to make sure my heart was up for the challenge. The AC regimen may be too taxing on your heart after 8 treatments, so knowing what it’s like beforehand is good. The test involves you laying on your side with your chest exposed. They put the warm jelly on you and they basically do an ultrasound of your heart. It takes about an hour. Make sure you use the restroom before because once you’re in there, you cannot go! (Lesson learned).
  10. Goserlin Shot – A goserlin shot is recommended to shut down your ovaries. For women who have more time, they may want to see a fertilization clinic and harvest some of their eggs before chemotherapy. The process takes up to 30 days to prepare the body for extraction, and I just didn’t have that kind of time, given the aggressiveness of my tumor. So I opted for the goserlin shot. You have to receive this shot at least seven days before you start chemotherapy. They inject the shot into your tummy, and you don’t have a period. You are basically put into menopause for the duration of your chemotherapy treatment. The chemo washes over the ovaries so that you can have a higher chance of being fertile after treatment – 80%. I receive this shot once a month, and the main side effects I experience are hot flashes. They usually last for the first week when I get the shot, and then they go away.
  11. Port Placement – A port is placed into the top of your chest (opposite to the side where the tumor is) through an outpatient surgery. The port is plastic and looks like a pin cushion. It’s about the size of a dime, and there is a tube connected to it that the surgeon hooks up to your jugular vein. The port serves like a pin cushion, so when I go to chemo, they place the needle into the port and this is how I receive the medicine. In other words, I don’t have to be injected intravenously through my arms. There is a numbing cream that the oncologist will give you to numb the area before chemotherapy. I don’t feel a thing, and my arms stay nice and unbruised. I highly recommend the port!
  12. Genetic Testing – My breast surgeon guided me through a genetic test for about ten different genes that are associated with breast cancer. It’s a small tube that you spit into, and then they send it off for evaluation. You cannot eat or drink 30 minutes before this test, and the results typically take 2-4 weeks to come back. Knowing whether or not your cancer is associated with a gene mutation is key for determining treatment options. I am BRCA 1 positive.
  13. Chemotherapy – Chemotherapy does not hurt!!! They give you a nice bed with a warm blanket. Treatment consists of drawing blood to check your counts, hydration, medicines, steroids, and then the chemotherapy. Based on the type of chemotherapy you have, you’ll either fall asleep or you won’t. For example, right now I am on Taxol and they give me benadryl before so I always fall asleep. When I was on the AC regimen, I did not fall asleep. The AC regimen is red so that’s kind of strange, but I don’t let myself focus on the color. Taxol is clear. The entire process of receiving treatment takes 4-6 hours.
  14. Blood Transfusion – Only once did I have to do a blood transfusion because my blood counts were too low. They take a sample of your blood to check what type you have, and then you receive the transfusion. No pain – felt 100 times better!
  15. Immunity Support¬†– So for the AC regimen, I had to take a shot called Neulasta 24 hours after treatment. Neulasta is like a super immunity boost, and the main side effect is body aches. For Taxol, I self-inject a shot called Neupogen and it’s less intense than Neulasta. I typically self-inject Neupogen for 2-5 days after treatment to keep my counts up. Like Neulasta, Neupogen makes me a little achy. You feel like you’ve worked out or something but you haven’t, and your energy levels are low.
  16. Prescriptions for Side Effects – Your oncologist will most likely give you prescriptions for a variety of side effects including anxiety, nausea, vomiting, and constipation. You’ll have to fill these prescriptions at your local pharmacy, and you use them as needed. I use the anxiety meds every day. I used the nausea, vomiting, and constipation meds a lot during the AC regimen to keep my symptoms at bay. There’s a rapid dissolving nausea medicine that works instantly, but you have to put it under your tongue and it doesn’t taste that good. I found myself getting more nausea over the taste of this medicine, haha! So I switched to a different kind that you can just swallow. It takes longer to kick in, so I had to be on top of my game. Taxol is way easier to manage and I don’t use any of the anti-nausea or constipation medicine.

In the beginning, the most important things to do are the MRI and PET Scan. Then you should determine whether you can harvest your eggs or need Goserlin. Then the Heart Echo Test and Blood Test. If you are about to go on chemo, you need to schedule your port placement a week in advance so that you have time to heal. Once chemo begins, then you deal with things like genetic testing, blood transfusions, and immunity support. You should also make sure you’ve linked up with your local pharmacy and filled all of your prescriptions.

Soon,¬†I’ll have more information about preparing for a double mastectomy and reconstruction. For now, I hope this info is helpful to anyone going through a breast cancer diagnosis or anyone who is curious about the process!

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