Storm in a B Cup

Sometimes when writing this blog I fret that I am not covering all the issues from every angle. Breast cancer is a diverse disease. The type, grade and stage of your tumour will dictate the treatments and choices available to you. I have realised that I can only write Chemo Chic from my own perspective. What I love is raising discussions. If you have anything at all to say about any of the things that I write about I encourage you to use the comments sections to get stuck in.

You will recall that when I was diagnosed I was given a choice. I chose not to have a mastectomy. Instead I opted for a wide local excision or quadrantectomy with latissimus dorsi flap reconstruction. I had to weigh it up. A mastectomy would have meant losing my breast completely. Having no breast means there is no chance of the tumour returning in that breast. The quadrantectomy meant that I got to keep most of my breast and not have a silicone implant in my body. But now I will have to be monitored forevermore.

As it has turned out I’ve developed an ongoing seroma in my back as a result of the LD flap reconstruction. It is unusual and could not have been foreseen. As far as I understand, any surgery may give rise to complications. I feel content with my decision.

And that’s my point. With the advice of our consultants and the experience of others we reach a decision that we can personally live with. Some women have to have a mastectomy because of the size of their tumour. Some women choose a mastectomy, or even a double mastectomy because they just want to totally minimise the chance of the tumour recurring. Some women are advised against immediate reconstruction. Some choose never to have reconstructive surgery. We’re all different.

In recent months I have noticed that my right breast is now much smaller than the left (reconstructed) one. I broach the subject with Mr Hadjiminas. “Can’t you do anything to match this breast up with the other one?” Just in case you were wondering, I’m suggesting that maybe he could make the small breast bigger, not the other way around.

“What? No! It’s because you’ve lost so much weight. Eat more.” 


I already eat for England yet the kilos just fall away.

I can’t help feeling self-conscious about my odd breasts but under clothes it doesn’t really show. The same cannot be said for women who have had a mastectomy without reconstruction. For those women a substantially new wardrobe may be required.

From time to time I have looked at lingerie and clothing ranges designed specifically for those experiencing what is kindly termed ‘breast asymmetry’. With a few notable exceptions I think I can safely say that most of it falls into the category of “you wouldn’t wear it if you weren’t experiencing breast asymmetry”.

But today I discovered an American clothing line called Chikara. Don’t ask me what Chikara means. Designed specifically with ‘breast asymmetry’ in mind, the Chikara range uses clever ruffles, knots and layering to disguise the unevenness of one’s boobs. The clothes are stylish: simple and sculptural. I think any woman would love to wear them.

p.s. Here's some pretty good mastectomy swimwear...

Nicola Jane 50’s retro swimsuit

Nicola Jane bandeau bikini

Nicola Jane psychedelic one-piece

Woman Zone halter-neck bikini

Woman Zone cut-away one piece

Woman Zone panelled swimsuit

And one last thing...

Knitted breasts and other mad stuff on Etsy

Major Surgery

Yesterday I had the axillary clearance and LD flap reconstruction. What that means is that they took out all the lymph nodes from under my arm and then re-built my breast using a muscle from my back.

You probably didn’t want to know that much. I know I don’t.

Nick and I checked into the Harley Street Clinic at 2 p.m. I felt familiar with the drill by now. Don the gown and paper pants, roll up the pressure stockings, fill in the menu cards, on with the telly, order tea for Nick.

Nurse Ann came to take my obs and swabs. Nick’s tea arrived and I handed the menu cards to the housekeeping lady. “I don’t think you’ll be needing those,” said nurse Ann, “you’ll be spending the night on ITU.”

Mr Hadjiminas arrived with his black felt-tip pen. After he had drawn the big arrow and X marks the spot I asked, casually, “the nurse said I’m going to ITU, that’s not right is it?” “Oh yes, he replied, “It’s quite a big procedure. You’ll be in theatre for about five hours.” That shook me up. I looked him in the eye, “Mr Hadjiminas,” I said, “I know that you’re going to do your finest work. I just want you to know that I intend to be the next cover girl on that photo album of yours.”

***

When I came round Nick was smiling at me. “Hey honey,” he said. “Hey honey,” said I. Sometimes that is enough.

***

Nick left to collect my sister Miranda and my six-year-old niece Eloise from the Heathrow Express at Paddington. Miranda was flying in from Moscow where she works as a diplomat. A most wonderful, kind and funny nurse, Caroline, took care of me whilst he was gone. “You have a good attitude,” she said, “You should recover well.” “Do some people have a bad attitude?” I asked her, “You bet they do,” she replied, “some people just moan and complain and feel sorry for themselves.” I wondered about that. I was so happy simply to be alive. What with that and the free morphine, moaning seemed a bit surplus to requirements.

It must have been late, maybe near midnight when the gang got back. I was overjoyed to see Miranda and Eloise’s faces. If they found the situation upsetting they didn’t show it. Miranda positively beamed at me. Eloise climbed up onto my bed, ignoring the mass of tubes and wires. “I made you a card aunty Lily.” On the front was a pink garden full of hearts and flowers. Diamonds glittered in the sky. Inside was an inscription: “Dere Leely I hope that you are not filing to sick. I woil be siying you agen. we wel visit you. and you get to play A game of Spot the difrins.” On the facing page was a drawing of two cats, wearing pink dresses. One cat had a bow in its hair, the other did not. One cat was wearing pink slippers whilst the other cat’s slippers were red. There were several other observable variations. So at one a.m. Eloise and I sat up in bed in the intensive care unit playing ‘Spot the difrins’. That was one of the high points of my life so far.

Scanned from Bottom to Top

This week has been a whirlwind. On Wednesday I phoned Bupa to get authorisation codes for a battery of tests and procedures. Then I cancelled all my appointments for the rest of the week. Yesterday I had an MRI scan of my breasts. If you’ve never had an MRI it’s a bit like being in 2001 – a Space Odyssey. They slip your body into a claustrophobic white tube and then play all sorts of loud, discordant thrumming and whanging noises. It reminded me of a Laurie Anderson concert.

This morning I had a CT scan of my lungs. After that Nick and I went to meet Honoria, who is to be my breast care nurse at the Harley Street Clinic. She’s small and blonde and wears lashings of eye make-up. I could tell straight away that she’s quite wonderfully batty. We sat and chatted in a room that was full of boxes of underwear – mastectomy bras and the like. Nick’s eye fell upon a knitted silk camisole. “That’s nice darling,” he said, “you should get one of those.” “Those are for people having radiotherapy, “ said Honoria.

Next up was a radioactive injection in preparation for the big one - a bone scan this afternoon. The technician warned me about radioactive contamination. No kissing. No fraternising with small children. Wash your hands twice after peeing and don’t touch your clothes. And please use the special toilet reserved for radioactive people.

There’s quite a bit of hanging around, waiting for the injection to do its work before I have the bone scan. Eventually I feel the need to use the special toilet. I pee and then wash my hands twice. But then it occurs to me, what if some of the other radioactive inmates failed to wash their hands? How do I get out of here without touching the radioactive door handle?

The bone scan is quite a procedure. I have to lie perfectly still whilst a rather prehistoric looking giant box camera about a yard square photographs my body in sections. I guess they use huge pieces of film. Each exposure takes several minutes.

Now Nick and I are in Mr Hadjiminas’s consulting room. He looks at me, “Good news,” he says, there was no cancer on the CT scan of my lungs. Then, “Not such good news,” the MRI scan a showed second tumour in my left breast. “Oh” I say, “and what does that...” my voice trails away. “It means you’ll have a mastectomy,” says Mr Hadjiminas, helpfully. I gawp at him for a bit. I look at my fingernails and then sit on my hands. “But I don’t want a mastectomy,” I say. “It’s for the best,” replies Mr Hadjiminas, and he’s off: “We save the nipple and the skin. And we can do reconstruction at the same time.” Mr Hadjiminas warms to his subject, “and it means you won’t need to have radiotherapy. If there’s no breast, there’s no possibility of the cancer recurring.” I realise that I’m out of my depth. What I really want to do is stick my fingers in my ears and sing “la-la-la”. I don’t know what I’m talking about but something almost subconscious prompts me further. “Is there any alternative?” I ask. I sound desperate.

Mr Hadjiminas looks thoughtful. “Well yes, there is,” he says. “We can do a quadrantectomy.” “And what is that?” I ask. “Well, we take away about a quarter of your breast and the sentinel lymph node, then we have to look at all that in the lab. If we’ve got all the cancer out and the margins are clear then we can do reconstruction surgery three days later. We use a muscle that we take from your back. If we find anything in the sentinel lymph node then we remove all the other lymph nodes from under your arm at the same time." Suddenly, Mr Hadjiminas is just as fired up about this procedure. “And does that mean I will still have feeling in my breast?” I ask. “Yes it does,” he replies. “And will it look alright?” Mr Hadjiminas reaches for his photo album. It is full of pictures of women’s breasts.

He opens it to a spread that obviously displays some of his best work. Before showing me the photo on the right hand page he judiciously covers the left hand page with a piece of paper. I guess it’s the 'before' photo. In any case, whatever lies beneath that piece of paper cannot possibly be as horrifying as what I'm imagining. The right hand page shows a photograph of a woman's torso. She has the most beautiful pair of breasts. "Those are fantastic tits," blurts Nick. “Not as fantastic as mine,” I say, a touch frostily. “Oh, I don’t know...” “Anyway,” I say, slapping the desk decisively, “that’s what I’m having.” Then I suddenly feel that maybe I’m being too forceful. I don’t know what is the best treatment for me. Mr Hadjiminas does this every day. He’s trained for decades. How can I tell him what to do? “I mean, is it ok to do that?” I ask, sounding a bit sheepish. “I wouldn’t even offer it to you if it wasn’t ok,” replies Mr Hadjiminas, “but if the margins are not clear then we will have to do a mastectomy anyway. That’s the risk.” “It’s a risk I’m prepared to take” I reply.

We all look at one another. That, it seems, is a done deal. Honoria puts her coat on. Mr Hadjiminas looks at his watch. It’s after six and it’s Friday. “What about the bone scan?” I ask. “Oh it’s not ready. Probably fine. The full report hasn’t come through. We’ll let you know on Monday.” I look at them both. I cannot possibly endure the anxiety of waiting two days for to find out if there is cancer in my bones. I must insist. I tell them the story of Gaby.

Honoria takes her coat off. Mr Hadjiminas sits down and picks up the phone. “Please bring Miss Lily’s scans and report across as soon as they are ready.” We all settle down to wait.

After about twenty minutes a porter appears with an A4 envelope. If the giant camera was anything to go by I was expecting an envelope the size of the table. Mr Hadjiminas pulls out a piece of film. On it are a series of images of a teeny-tiny skeleton, about two inches long. “These are all clear” he says.