Breast Cancer–Discovery, Decisions, D-Cups and Diet
My knowledge about Breast Cancer began at age 42 when my BFF was diagnosed. Hers was a rarer form known as Paget’s Disease—the cancer cells collect in and around the nipple. Only 5% of all Breast Cancers are Paget’s and most occur after age 62. She thought she had a skin condition due to being in a swimsuit at the lake all summer. She was surprised when she was sent to get a mammogram instead of a referral to a dermatologist. Her mammogram showed that she had DCIS –Ductal Carcinoma in Situ. The way she described it to me was that the technician showed her the images taken in the mammogram and pointed out silver streaks which indicated clumps of cells.
And so, began her journey and battle. Unfortunately, along the way, if something could go wrong, it did. Initially, an infection at the site of the biopsy occurred, then the drain tube was removed too soon, and she experienced swelling under her arm and even down her arm at certain times. When all was completed, she was unhappy with her reconstruction results. But she has been cancer free for 14 years and I benefited from watching and listening to everything she went through. We walked in the Susan G Komen Breast Cancer 3 day walk so that another mom would not have to tell her young sons that she had breast cancer.
I can tell you that telling a 23-year-old son is not easy either. I was diagnosed with High-Grade DCIS in 2015—one month after turning 50 years old. *** 2020 I am a 5 year Cancer Free Survivor!
Here are the details as best as I can remember—there are some things I would love to forget and some things I probably have pushed out of my memory on purpose.
Discovery
Sept 2015: I have my first 3 D mammogram. It was the first time Solis offered it and being very confident that I was doing everything right (maintaining proper weight, eating healthy foods, exercising regularly, drinking red wine) I agreed to the new advanced technique. A few days later I was called back into the clinic to have another mammogram. I was surprised when the technician took me to the “regular machines” and said, “What we need to see we can see from these images.” So, a few more squeezes in the big metal photo booth and I was told to not get dressed but to wait to see if more images are needed. I am still thinking “that stupid 3 D machine messed up and they are just making sure there is nothing here”. However, when I was asked to come into the room and have a look, I started to wonder. And when she pointed out the silver streaks, I knew I had breast cancer. I did not tell anyone at this point I just made the appointment for the biopsy the next day.
A Breast Biopsy is a modern day torture device (far worse than a mammogram machine!)—you lie down on a table that has a large hole in it and position your boob to hang down through the hole. A medical staff person then proceeds to insert a needle into your breast to remove cells. Yes, there is some local anesthesia applied but you are sore afterward and since mine was on the left side and I was driving myself home, the seatbelt was killing me!!! This was on a Wednesday and I already knew what they are going to find, but I waited a couple of days and got the phone call on Friday morning.
“High-Grade DCIS” was the diagnosis—and I need to schedule to meet with a Breast Specialist. My husband was not home at the time, so I had to call him and give him the news over the phone. But my son was home and all I could think about was how I wished I wasn’t the mom telling my kid I had cancer. At this point, we didn’t know much beyond it was in the left breast in multiple spots within the milk ducts.
The next week I meet with Dr. Mary Bryan at Texas Oncology. She is very patient and calm and explains the situation I am facing. 1) multiple spots in multiple ducts but most concerned about a specific one that was fairly long (I was small breasted/a B cup at this point) 2) high grade means it grows fast 3) premenopausal so still lots of hormones (estrogen)in my system. She thinks my best treatment is a mastectomy –as she very nicely explained to me…by the time, they take enough margins to be sure they get all the cancerous cells, they will have removed my entire B cup breast! She can tell this hit me like Mack Truck. So she says, go get an MRI and we’ll be able to see more the length and location and make a decision then.
I scheduled an MRI at a facility that was supposed to be female-focused—unfortunately for me, they were more focused on Botox injections and other “procedures” than on my MRI. The owner actually asked me if I wanted to get Botox for the wrinkles in my forehead when she stopped by to apologize for my MRI getting stared 1 hour late!!! I still have wrinkles along my forehead, thank you very much!
Later that night I got a call from Dr. Bryan saying that the MRI confirmed what she had seen in the mammogram and that her suggested treatment was the same—complete removal of the breast.
And now is when I reach out to my BFF with the news. And I start researching options—I figured if I was going to have surgery I should get to decide not just when, but exactly what type of surgery.
Decisions
The only surgery and times I have been in the hospital include a tonsillectomy when I was 5 and don’t remember any of it and the birth of my son which was natural so not really surgery. I had no reference as to what surgery and recovery would be like! I didn’t even know how I would react to being under anesthesia for an extended period of time.
Dr. Bryan’s office provided me with a list of several of the local reconstruction surgeons and I called a couple of girlfriends that I knew had gotten boob jobs. Not all cosmetic surgeons do reconstruction, so I was able to narrow my list down to two doctors.
The first doctor I went to see specialized in a process to move excess fat from your belly or thighs and use it to rebuild your breast tissue. I had always said if I was going to have a boob job, I wanted them to move the extra fat from my thighs up to my boobs. Then I would have thinner thighs and bigger breasts—the perfect body! Unfortunately, since I was within my ideal body weight range, there was not enough extra fat to reposition. I must have looked like I didn’t believe him when he told me this, so he continued to tell me how the process would go.
First I would start off face down on the operating table so they could “harvest” the portion from my thighs and lower butt, then they would flip me over and the breast specialist would do the actual mastectomy and then he would come back into the OR and finish the repositioning. All together I was looking at more than 8 hours under anesthesia, stitches on both my breast and thighs, unable to bath for several days and lots of bruising. I felt nauseas after that meeting!
The second doctor I met with is very committed to helping women that are having reconstruction due to Breast Cancer get their desired results. He is very compassionate to patients while also being very demanding of staff and at times his patients (If he says don’t do something, don’t do it!!). On our first meeting, I shared with him that I had looked at having the other procedure and he just laughed and said, “you’re not the typical candidate for that”.
He then explained the procedure of placing tissue expanders after the mastectomy and then replacing those with silicone implants during a second surgery. I had read a lot on the internet, so I thought I knew and understood more than I actually did.
I had at this point decided to do a double mastectomy to reduce my chances of having breast cancer in the future—no breast tissue = no breast cancer; better recovery time at 50 years old than what I would have as I got older; and knowing that my BFF had never been happy with her results (one enlarged breast and one removed and reconstructed breast). I still hoped that somehow, he could keep the nipple on the one breast that didn’t have cancer. His response when I asked was “Have you ever tried wrapping a present when the bow is already attached to the paper? It almost never ends up where it should.” And so the decision was made for complete removal of both breast and reconstruction to begin immediately.
All of this happened during October—Breast Cancer Awareness Month! My wedding anniversary is also in October, so we took a short trip to get away and I remember sitting on the bed saying “I hate that I don’t have an option besides surgery. You can fix heart issues with medication, you can take insulin for diabetes, but my only choice is to go under the knife.” There would be other nights I would cry not because I was scared of dying, but because I was scared of the surgery. I have never liked hospitals—the smells, the sounds, the schedules—it all makes me extremely uncomfortable and extremely stressed out.
But I knew I didn’t want to wait since we didn’t know how fast growing the cancer was and I didn’t want to give it time to spread into my lymph system. I had my 2 doctors picked and I decided that since business was slow during the holidays, I could have the removal procedure in November and that Friday the 13th would be an appropriate day. I planned to be out for 4 weeks and since I worked from home, and things would be slow, I could ease back into my schedule in December.
Here are some things they explained to me, but I didn’t really understand until it was happening:
- T-Rex arms (much harder to do than you expect—seems easy enough, NO IT IS NOT)
- Don’t lift more than 5 lbs (a gallon of milk weighs 8 lbs, 2 dinner plates is almost 5 lbs)
- Jackson Pratt Drains (beneficial but disgusting and will be in longer than you would like)
- Saline Injections and Tissue Expanders (take it slow to avoid pain)
There is some preparation for the surgery that you do at home including placing an anti-nausea patch behind your ear to help when you come out from the anesthesia. This patch can also make your vision a little blurry which I experienced later. The surgery went fine and there was no evidence of cancer in the lymph node, so I was CANCER FREE!
After surgery I seemed to be fine, a little hyped up from the drugs and very chatty, but everything was going well the first day. I ate, friends brought over shaved ice for my sore throat (I learned that having a tube placed and removed from your throat can cause soreness!), I visited with family and friends. I wasn’t really in pain YET.
That night the nurses were very attentive, but I could not go to sleep. I tried reading a book and that’s when I discovered the blurry vision. They removed the patch and decided I could have a muscle relaxer along with the pain meds in my IV to help me sleep. I think I got around 2 hours of sleep and then time for the nurses shift change, breakfast delivery, and doctors making rounds.
The dining staff brought in my breakfast tray and I naturally reached across to the get the coffee cup and had barely taken 2 sips when my reconstruction doctor arrived and saw the drain on the right side was full of blood. That reach across the table for my coffee cup had caused a stitch to break and he was frantic. He yelled at me! He yelled at the staff! And he put me in a sling to hold my right arm next to my body!!!
My husband arrives on the scene and immediately says “you are acting like a bull in a china shop”. I tried to explain I didn’t do anything!! I didn’t realize T-Rex arms applied to feeding myself. They made it sound like I had intentionally done something that would harm my recovery. I later explained to both my husband and doctor that no one in that room wanted to be out of there more than me so anything I had done was purely accidental.
Good news, the bleeding stopped very quickly, and there was no permanent damage. But I did spend the next week with my right arm in a sling. Being right-handed that was a challenge so my son decided he would feed me while I was at the hospital. I put a stop to that as soon as we got home.
The pain worsened over the next day and one nurse was brutal with the drain clearing—it felt like fluid was being sucked from my toes she squeezed and pulled so hard. By the third day, I was released to go home to recover.
As much as I did not want to be feed, I am grateful that my son was living with us at the time. My husband had to do all my personal care—bathing, dressing, clearing the drains, doctors’ visits. And my son did all the house stuff—cooking, cleaning, grocery shopping, even Christmas decorations. Friends brought over dinners, but he usually made breakfast and lunch for me. Since I could only exercise my legs, he and I would take his dog for a walk every morning which helped me not to go stir crazy. My BFF also came down for a few days to distract and entertain me. It was a true team effort! I returned to work after 4 weeks but only because I worked from home and appearance did not matter.
D-Cups
Although I was not a candidate for moving excess fat from my thighs to my breast, my thighs could apparently be balanced with larger breasts (according to the cosmetic surgeon)! Through a series of saline injections into the expanders, the skin stretches. And each woman can decide just how much expansion you want to do. I kept saying I would be happy with a C-cup and even bought a couple of new bras in a C cup (these would later be too small). I scheduled my implant surgery for the weekend before Spring Break knowing again that business would be slow. Recovery from this surgery was much easier-less than a week! There are no nerve endings, so you don’t have pain and they just reopen the scars from the mastectomy to exchange the new implants for the expanders. The doctor decides which of the implants fills the newly created space the best and everyone I know has ended up with larger breasts afterwards (C cups are now D cups!). I guess the doctors want to make sure you are getting your money’s worth!
And now for the final touches—again I researched my options. The surgeon explained a procedure he performs to rebuild a nipple and then a tattoo is applied around it. He has very good results, but I didn’t want another surgery. I saw an article about medical tattoos and found an artist in Dallas that did them. It was almost a full year from the time of my mastectomy until I finished my journey with a 3D medical tattoo. At least now when I look in the mirror, I am not just seeing scars- there is a normal look to my breast. I can even shower at the yoga studio without being embarrassed if someone sees me. I still don’t feel anything! I jokingly refer to them as “Barbie Boobs”. No offense to Barbie! They look good and will always be perky but without any feeling I say they could catch fire and I wouldn’t know it.
If you are facing Breast Cancer a couple of things you need to know
- Your experience will be unique. Research as much as you can. Talk with others that have experienced it, but in the end—this is a solo fight. You must fight it and beat it! Mentally, Physically, Spiritually. Fight Like A Girl
- Don’t see your breast by yourself the first time—you cannot be prepared for the shock. All those pictures of other women’s breasts do not prepare you for seeing your own breast without nipples and with scars.
- Remember that being CANCER FREE is the most important outcome. Too Big, Too Little, One a little higher than the other, these are only little annoyances. The most important is that YOU are HEALTHY, and YOU are HERE to enjoy your family and friends. Unfortunately, we lose a few friends/family/moms/daughters to this horrible disease, so if your battle ends in victory, celebrate!
Be grateful for the technology we have that both detects cancer and allows you to reconstruct the breast. You are not the same after breast cancer, but you can still be GREAT.
Diet
I have a BS in Dietetics from Texas Tech University and a Nutritional Therapist certificate from The Health Sciences Academy. I have been interested in nutrition and cooking since high school. I enjoy cooking classes, reading cookbooks and meal planning. I strive to always eat a healthy diet and hope these tips will help you recover faster if you are in the battle. A warning, I get a little “geeky” with some of the nutrition information below, but your diet is one of the areas you have control so use it to your advantage. Additional information can be found in The Cancer Survivor’s Guide by Neal D. Bernard, MD and Jennifer K. Reily, RD.
First, there is a proven advantage to being thin or losing weight in terms of survival. There are lot of studies that prove better outcomes for women that are near their ideal body weight. The reason for this is simple–ESTROGENS. Body fat acts like an estrogen factory and estrogen has shown to encourage cancer cell growth. So how can you lose weight after diagnosis and treatment?
- Exercise: 3-5 hours per week of average pace walking. This is more than the often suggested “15-minute walk after dinner”. I promise you will feel better if you get out and walk! I did as soon as I could, and it helped clear my head and lift my spirits.
- Reduce your fat intake: Fats and oils are the densest source of calories, so reducing these will help reduce your overall caloric intake.
- Increase Fiber: Fiber helps your body eliminate excess estrogens. The liver filters estrogens from the blood and sends it through the bile duct and into the intestinal tract. Fiber soaks them up and carries them out of the body!
- Increase Fruits and Vegetables: Beta Carotene and Vitamin C rich diets are proven to increase survival rates. Strive for 5 or more servings per day.
Breast Cancer taught me that every day is an occasion to be celebrated! We don’t know how many days we are going to get, so let’s make the most of today!
Gretchen Carter
BS-Dietetics, Texas Tech University, 1986
Nutritional Therapist, The Health Sciences Academy
