Breast cancer: lumpectomy and lymph node biopsy - Feb 2021

 Kia ora tatou, nau mai, harae mai.

Today I'm writing about my recent lumpectomy and lymph node biopsy. To recap, in late 2020 I noticed a slight puckering in my breast and was given a breast cancer diagnosis in December 2020, and scheduled for surgery in mid-January 2021. As I talk about in this post this all happened at the same time as I was having major abdominal surgery, so it's certainly been a lot to deal with all at once. And so, four weeks after my hysterectomy I found myself back in hospital for the lumpectomy.

This procedure happened in the city so we had booked two nights in an Airbnb in Lyall Bay as the traffic is often nightmarish in the mornings. It was a great call, and coincided with beautiful weather so we had a lovely beach walk after dinner. However, while we were enjoying our Airbnb the hospital had a fire and the subsequent water damage caused no end of issues with the lifts, alarms, and general anxiety levels on the day of the operation.

We had been instructed to arrive at 10am so had a relaxed morning. We checked in at Surgical and were taken down to Radiography to have hook wires inserted into the tumour. We waited a long time and then learned that they had been expecting us at 8:30am! Happily, due to my anxious insomnia I'd eaten a snack at my last allowable time of 2am, so the hunger wasn't too bad - I was grateful my last food hadn't been at 7pm. I decided to treat it like a long distance flight - boring, uncomfortable, but with a good end result.

Once in with the radiographer she talked through what was happening, and I realised I'd muddled this stage up with the next stage when the surgeon was explaining it. If you find yourself in a similar situation, ask to record the consultation as our brains do strange things after a cancer diagnosis.

In order for the surgeon to know exactly which tissue to remove the radiographer guides a metal wire with a hook on the end into the tumour, using ultrasound as a guide. Then when they open up the breast they can trace the wire right to the middle of the tumour - really clever. In my case the tumour was barbell-shaped, so two hooks were inserted, one into each ball.

Not my boob - but shows a wire in place

Then, with a boob sprouting wire whiskers I went next door for what I was repeatedly assured was a GENTLE mammogram. I didn't believe them as my sole experience of mammograms was excruciating, but on a scale of 1 to I-hate-you it came in as a solid 6, so that was ok. The mammogram was to confirm that the wires were in the right place, which happily they were. The long ends of the wires were clipped and taped down and then I headed back up to Surgical.

Another long wait in which we were driven to playing I-spy in a featureless room, another few rounds of "what is your name, do you have diabetes, which body part do you expect to be operated on?" and then I was deposited into a surgical purgatory - a comfy chair with the most amazing blanket. This thing was made out of paper and was attached to a machine that blew warm air into it - it was like being cuddled by a warm cloud. I didn't even mind that I was starving and thirsty, I could have snoozed there all day.

I met the various stars of my surgery, confirmed that I hadn't developed diabetes in the last ten minutes, and then padded into theatre. It looked a bit like a set on a hospital drama and everyone was very nice as they did their various preparations and sent me off to sleep. What felt like seconds later I woke up, still on the operating table, with everything all done and dusted. The anesthetist had done a great job and I woke up happy and chatty, and not at all nauseous.

Looking back I assume the reason they woke me on the table was because there was a queue for Recovery room beds, and the reason there was one person on each side of me was to stop me rolling off the table, but I naturally assumed they were FASCINATED by my drug-addled chat about the NHS and god knows what else. Cringe.

It's all a bit hazy from that point on, but there was two different levels of Recovery area, everyone was very nice, there were shift changes in both areas so I was very sure of my name and procedure by the end of it, and eventually I was released into the care of my partner and we headed back to our Airbnb. We were very glad to not have to drive all the way back to the cottage. It's amazing that such a huge day with all the different things that happened to my body occurred and then I was sent home at the end of it!

Apparently we had fish and chips on the front deck and enjoyed the sea air, but I'm not clear on the details. :)

In addition to the lumpectomy I also had a sentinel node biopsy where they inject blue dye into the breast and then see which lymph nodes it drains into first. These "sentinel nodes" are then removed and sent off to be checked for microscopic cancer cells. If cells are found in these nodes it indicates that the cancer may have spread to other parts of the body.

As clever as all this amazing technology is, for me and my blue boob it meant much hilarity as my wee changed from bright blue to teal and very slowly back to normal. My first "number 2" looked like I'd recently eaten a large number of Smurfs, but I can assure the reader I most certainly did NOT. My boob went through a number of colour changes with the bruising coming through a magnificent purple; and now, a few weeks later, we seem to have settled on a murky yellowy green with the dye still hanging around a little.

Smurfs: friends not food

The lumpectomy side of things healed well - I've noticed a hard mass under the scar which is all to be expected apparently as they had to move tissue around to fill the gap. However, the node side of things has caused the most grief - it was ok for the first few days but then the nerves started to wake up and rejoin and it's caused pain in my armpit and my upper arm. But it's all doable. I was able to deal to it mostly with Panadol and Neurofen and just the odd foray into opioids when it got a bit much. I am pretty much off the pain relief now and I'm looking forward to driving again today - first time in six weeks!

The other day I had a call from the surgeon to say that the sentinel node biopsy showed NO CANCER CELLS in my nodes - hurrah! That was my biggest worry and it's such a relief to know that it's limited to my breast only. The less good news was that there was evidence of DCIS in the tissue they took so I have to go back in for them to remove those pre-cancerous cells. This was a known risk, and should be a much smaller procedure than the last as there will be no hook wires or blue dye needed, and my lymph nodes won't be touched.

The surgeon said this cancer is "very survivable" which I take as medical-speak for "you'll be right, mate". And I will.