Dear Doctor, what happens at the breast lump clinic?

The first appointment at breast clinic. We weren’t too worried. “You are a young woman with no family history of cancer, it’s probably just a fatty lump but get it checked because if it keeps growing you might want to get it removed.” We said it all so casually.

The appointment came within two weeks of seeing her GP, the GP wasn’t worried either but referred her to rule out cancer. Generally the breast doctors do see everybody quickly within two weeks. The local hospital didn’t have any slots so she chose a hospital about 40 mins away but the travel seemed ok if it meant she would get it out of the way quickly, we thought it would be a one off appointment.

I went to breast clinic back in my medical student days. The way the clinic works is quite efficient, it’s like a one stop shop. First of all you go in and tell them your story, they examine you. Next you go through and have an ultrasound scan or mammogram which scans the breast and the armpit. Lastly they take a biopsy of the lump to check what it shows. It takes a bit of time but its a straight forward process.

I could tell my friend was a bit nervous before the appointment date, but I told her she would be fine. It’s just one afternoon get it done with I had said. She had a friend to go with her, we would have the answer by that evening and life would go on as normal. No big deal. Her clinic experience made me realise how easy it is for us healthcare professionals to just assume patients know what is going on.

Here is what happened at that first breast lump clinic appointment, in my friend’s words…

Run my friend said I will put a ticket on your car. I ran towards the main entrance. I’m looking for the breast care unit I asked at reception, just go straight down the corridor take a right at the end she says. I half run down a corridor that never seems to end. Am I going the right way? I stopped to turn back, I saw my friend had caught up to me, there on your right, she pointed. I saw the sign for the Breast Care Unit. Fifteen minutes late. I apologised and was told to take a seat. There were a lot of people waiting, so I knew it was going to take a while.

I was glad I had my friend to talk to at that point. She seemed worried for me, I can’t remember what we talked about. I just remember looking at people and wondering, have they just been told they have cancer? Am I going to be told I have it too? 

The thought was playing on my mind. I’ll find out today I guess but I kept telling myself it will be fine. Forty minutes had passed, we still hadn’t been called. I’m just going to get something to eat, my friend said, do you want anything? I was hungry but I couldn’t eat. She seemed to be gone for a while and I knew they would call me whilst she was gone. I wanted her to come in with me but it wasn’t meant to be. I was called in. 

I followed the nurse to a room. She told me her name and asked me to take off the top half of my clothes, as expected. She asked me to point out the lump. I felt the lump as I showed her, it seemed to have grown, it was so obvious. Then she asked if she could feel it, to make sure I really did have a lump. That annoyed me, they way she said it felt as though she didn’t believe me. She told me to lie down as she felt and decided yes there was definitely a lump. She marked the lump in pen with an X. That’s fine, she remarked, pop your clothes back on and go back into the waiting area. 

 I felt like everyone was looking at me as I walked out. My friend still wasn’t back but it was ok, I needed five minutes alone. I was called back in ten minutes later. I saw another nurse, she wanted to scan my breast. I undressed again. She then called in an important looking doctor who introduced herself. We just need some pictures on the computer to measure the size of the lump. She applied the cold gel, I looked at the computer monitor, it was just like a baby scan but of my breast instead. I notice she measures the lump at 3cm. That’s pretty big, I think to myself. They then left the room and I was left lying there for about twenty minutes, it felt like more. I got up with the gel still on me, I texted my friend apologising that I may be a while. The lump was still up on the screen. I took a picture and sent it to my doctor friends. I was curious to see what they think it could be. I think I was looking for some answers, noone had told me anything. Everyone had been telling me they didn’t know what it was but it wouldn’t be cancer, you’re too young and you don’t have a family history. It will be fine. I lie back down and waited another ten minutes.

Finally someone comes in and wipes off the gel,  gives me a gown  and says just grab your belongings, we need to do a mammogram. I was a bit afraid at this point, my mum had a routine mammogram recently and told me how painful it was. I was expecting them to do this at the appointment, I wasn’t too worried at this point about it being cancer. I walked into the room and took off my gown. The machine did look a bit scary. I asked the lady if the scan results were ok, she said they can’t really say and they just needed me to do this. I was pushed hard against the machine in all kinds of random positions, my arms and breasts were pushed in and squeezed down tight. I was glad it wasn’t as painful as I thought it would be.

After the mammogram I was told to put my clothes back on and take a seat in the waiting area. I went back out thinking we were done for the day. I saw my friend who was a big comfort at that point, I’m not sure what’s going on is all I could tell her. At that point I felt a bit worried. I had a lot of texts from family asking how it went. I replied saying this could be bad news, I just had a feeling. They would have known if it was a harmless cyst by now. I had noticed the uncertainty on the doctor’s face.  I told my friend I think it’s bad news and she told me not to worry, it would be fine. At that point I was called back.

I went to the room furthest down the corridor and I thought to myself, the further I’m going the more chance it could be cancer. I followed the nurse down the corridor and once again was given a gown to put on. The lady who did my scan entered with another important looking doctor and two nurses. We just need to do a biopsy she said. I didn’t know what that was. We will be numbing your breast, she continued, don’t worry it sounds really loud but it won’t hurt. I whispered to the nurse next to me what a biopsy was. She explained they needed to take a tissue sample from the lump. The doctor showed me a little tool which looked like a razor. He pressed this little white cube into my lump, at which point it made a snapping sound and stung a little. They didn’t catch the tissue first time so it was repeated again. A few seconds later he was telling me how well I did and started asking me about any medications I was taking.  The numbness was fading away already and I really began to feel the pain. The pain of everything, the mammogram where my body had been pushed and squeezed, the prodding and poking and the pain from the biopsy. I told the nurse who advised me just to keep taking painkillers and again I heard them four words, it will be fine. 

I wanted to cry, what are you doing to me and why?! They put a dressing on my breast and told me to wait outside yet again. When I walked out my friend looked concerned, I told her what they did and showed her my breast with the dressing. She told me her grandma had the same thing done once. I quickly asked her if her grandma had breast cancer. No she replied. I’m not sure if that was the truth.

 We waited another five minutes before the nurse called me again. You can bring your friend with you if you like she said. oh no here goes I thought. She took us to a nice room and sat us down. She told me that during the appointment the two different consultants had two different opinions and I would need to come back for the biopsy results next Thursday. She then gave me a look…that look. Just make sure you bring someone with you next week she said. I just chose to ignore her. Not me I thought I’m not even 30 yet, it doesn’t make sense. I won’t have breast cancer they hadn’t mentioned the word all the way through the appointment so it must not be. We walked out into the heavy rain ready to go home.

 


 

Click here to read my article on what to do if you find a lump and what the lump could be.

Click here to read about my friend’s experience when she found a lump.

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