Discussing Breast Cancer

My husband and I arrived at Yale just past dawn on Tuesday morning, May 2nd, 2006. We pulled into the valet parking circle and I couldn’t help but think it would have been so much nicer if we were arriving at a fancy restaurant for brunch instead of the hospital where both my breasts were being removed.

First, we headed to the admission office. Just days before I’d been there for pre-op testing. Now it was time for the real deal. My leaded heart hurt just as much as my caffeine-deprived head.

After we’d check int, we headed upstairs to the surgical floor. We were guided to my cubicle, passing family after family in their own personal cubicles, and I was given a gown to change into. With the curtain pulled closed, I stripped off my clothes, the last bit of comfort I’d feel for days, and sat barely covered in the wanna be lounge chair they provided.

The first thing the nurse noticed when she walked in to check on me was that I still wore my wedding ring. I was purposeful about that, having left off all other jewelry, but my wedding band … “that has to come off,” she said.

That was when the tears started. I handed the ring to my husband and noticed he was filled to the brim with tears as he took them from my shaking hand.

They provided blankets to keep my body as warm as possible as they prepped me for surgery. There were residents with clipboards and nurses with notebooks coming in and out of the cubicle and everyone was checking things off and writing things down and all I wanted to do was sit there quietly with the man I loved.

Then the anesthesiologist came in to start my IV. He was very kind, very warm, and in a way, I wished he’d been as cold and clinical as the minions that had been there before him. His bedside manner made me feel human and important and that opened up the floodgates of fear and anxiety that I’d been working so hard to contain. I nearly exploded with pre-op emotion and adrenalin.

When it was time to get me to the OR he allowed me to sit in a chair instead of lying down on a gurney so that I could see where we were going. My husband held my hand and walked beside me for as long as he could … then the anesthesiologist showed him the waiting room and we had to quickly say goodbye.

I really wish he could have come to that room with me.

Breast Cancer, Double Mastectomy, Surgery, Reconstruction

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My parents showed up at the house early so we didn’t have to wake the kids. All three were still asleep in their beds as my husband and I got ourselves ready. I took a shower, the last one I’d take for weeks. I didn’t put on jewelry or make up but I did put on my most comfortable sweats.

I explained to my mom that my oldest needed a snack and a drink and lunch and a drink and my middle child needed a snack and a drink for preschool. I explained that I usually let them choose what they wanted for breakfast; easy on the syrup if they chose waffles, no chocolate milk if they chose a kids cereal.

I explained to my dad the drop off and pick up procedures at the elementary school and the preschool.

I explained my youngest child’s nap time schedule and strategy.

And I cried. I didn’t want to walk out the door. I knew I’d be in the hospital for days, not because of the double mastectomy but because of the reconstruction. The TRAM flap was a huge surgery that warranted a possible five day hospital stay.

I was going to miss my babies. I knew they were going to miss me.

I left a white index card on each child’s pillow with a few easy to read words to express how I love them (so much) and how I’d miss them (so much). I signed it with a lipstick kiss. Long lasting color.

That lipstick is still on those cards still in their dresser drawers one year later.

I couldn’t have coffee so my head started to hurt as much as my heart as my husband pulled out of the driveway and began the half hour drive to Yale.

Breast Cancer, Double Mastectomy, Surgery, Reconstruction

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This month’s book club selection was Geralyn Lucas’ memoir. The book has enjoyed lots of hype; check out its spin off website. (The Lifetime movie based on the book is available on that site for download. FYI, I saw the movie and I’m not sure the book was better. It was more in-depth, and more honest, though I’m not sure that’s a good thing.)

Geralyn was 27 when she was diagnosed. She had a killer job at 20/20, one she earned and deserved, and a doctor husband, who she probably also earned and deserved. She began wearing red lipstick in college and each time she put it on she felt her confidence rise. Red lipstick gave her power. So much power that she wore it to her mastectomy surgery and her topless photo shoot for SELF magazine’s annual breast cancer handbook. That was the overall theme of the book — a good theme indeed.

I feel bad, really bad, for saying this … but her job, her husband, her connections … they all made Geralyn a bit unreal to me. (Barbara Walters sent her three dozen white roses while she was in the hospital for heaven’s sake, not something many of us can relate to.)

Also, Geralyn was way to wrapped up in physical beauty to begin with for us to have much in common. I should have expected that, it says right on the front jacket of the dust flap that she was “a young girl with cancer in a beauty-obsessed culture.” My looks have never defined me and hers sure as heck have.

In the first chapter, Geralyn wrote, “First my breast will be cut off. Then my hair will fall out. And when there is nothing left to strip, maybe there will be a revelation of a different beauty underneath.”

Amen, I thought, bring it on! I wanted to read about her revelation. But I didn’t. Instead I read about her implants and her personalized tattoo — her recovery process all seemed so vain. I was just so happy to be alive after my double mastectomy/reconstruction, I really didn’t care if I was still turning heads (Geralyn was proud that she’d always turned heads before, that was part of who she was).

Now before you start getting all turned off by the book, there were great anecdotes inside, however, and I thought it was easy and entertaining to read. Like this one from Chapter 4: “If a one-balled-man and an about-to-be-one-boobed-woman can somehow end up dancing in a taxi in a city of millions and figure out this hidden truth within the span of a seven minute cab ride then somehow I will survive this ordeal.” I loved that line. I also loved the truth to which she was referring … that “any luck thrown our way we need to grab and try to believe good things will happen.” it’s a great truth. A truth deeper than physical appearance meaning the world.

I wanted Geralyn to be as empowered as she claimed to be as she lost her hair but instead she clung to the very last piece with utter dependency.

I wanted Geralyn to write more about the trouble she had with her husband during that time and help me understand that she was able to make love to him the night she came home from the hospital, draw apart from him after that, then come together to have a child with him … I wanted more from her there and I didn’t get it.

In Chapter 12, she wrote she “had definitely discovered” her “inner cleavage” but she didn’t show me that she had. As a writer, I kept thinking … show me Geralyn, don’t tell me.

Perhaps the most meaningful line in the entire book was written in the afterward: “Sometimes I think about what would have happened had I not done that breast exam and saved my life. All the moments and all the lipstick shades I would have missed.”

That’s powerful. I love that she laced the lipstick analogy throughout the entire book and even ended with it in just that way. It’s a powerful analogy about power.

I just didn’t feel she really, really believed what she was writing.

I realize I have to write this post before I tell you about my mastectomy surgery. It’s the post about my reconstruction decision.

See, after you decide what cancer-eliminating surgery to get, you have to decide what reconstructive surgery to get, and there are a lot of options.

Quite frankly, not reconstructing was not an option for me. I wanted a shape after my surgery. I wanted breasts. I LOVED my breasts, not something I’ve talked about much before, but trust me, I LOVED them.

I remember my first pink silk Sassoon training bra (remember the tagline, “OOohh La La Sassoon” and the little ‘okay’ symbol on the tag? No? Well I do. Clearly.) I was too young for breasts but not at all too young for the fantastic pink silk training bra my mother bought me.

I remember the first time my newly developed breasts were noticed. I was walking from one building to another on the first day of my senior year in high school — I was a September baby so I was not even 17 — and Gerald, the president of the student council, stopped me with a ‘WOW,’ reaction because apparently I’d developed over summer vacation. I may not remember actually developing, but do remember that first day of school my senior year.

I remember the competition that the guys on my floor freshman year in college introduced between my roommate and I: whose were bigger? People actually walked by our door and voted on our memo board and we didn’t complain (actually, the tally was right on our door … how could we have allowed such graffiti to take place?). My roommate won, eventually, and if you saw her now you’d never even imagine I could be in her league.

I remember the day the boys who lived across the hall from us named my breasts after themselves because they liked them so much. Stephen claimed the one on the left, the sweet, quiet breast that was always in the shadow of the other. The one on the right became Andrew, the slightly bigger of the two, slightly rounder and ironically the one to cause me trouble one day.

I remember that same year when Craig, a fraternity brother at the beloved Phi Delt, nicknamed me ‘Cleavage’ because he said when he looked at me, that was all he saw. Actually, I remember the v-neck white t-shirt I was wearing when he nicknamed me and the exact party we were at … the FIJI paint party … amazing what neon paints can do to a white t-shirt in a neon light in a fraternity bar room.

I also remember breastfeeding my two sons, using my breasts the way that God intended me to use them for, and I remember the peaceful feeling that gave me, the nourishment that gave them, the overwhelming feeling of togetherness that gave each of us.

Yes … I loved my breasts and the identify they gave me. They weren’t being taken from me completely.

It wasn’t even that hard to choose an option b/c I’d already had radiation therapy to one side … the plastic surgeon recommended a pedicled TRAM flap and I said yes.

Little did I know how complicated that surgery would actually be for me.

Breast Cancer, Health and Wellness, Mastectomy, Reconstruction, Surgery, Women’s Health

The more I blog about breast cancer, the more I realize it is easier to share information about breast cancer related studies and products or services than it is to write about topics that are painful to revisit.

Some aspects of my journey have been easy to share … like my first cancer diagnosis in 2003. That was DCIS, easily treatable with a protocol treatment plan. Kind of a no-brainer. Not that it wasn’t hard in many, many ways. But looking back, it was manageable, and not so hard to write about.

I’ve shared a few posts (like with this one) about my recurrence, my IDC diagnosis last Spring and the decision I had to make related to my mastectomy surgery.

Those posts were harder to write.

I have yet to tell you the details of that surgery … that’s the seriously hard stuff to revisit. Rock hard. Cement hard. Concrete hard. (Wait, which is harder, cement or concrete? It’s as hard as that.)

That stuff is coming up next. I’m sorry I’ve been putting it off. I didn’t even journal my way through last year. A therapist would have a field day with that.

Today I’m headed to Yale for a follow up with Dr. Lannin, the surgeon that removed both my breasts. I thought perhaps that was my sign that it was time I shared what my double mastectomy was like.

So that’s what I’m going to do.

Tomorrow.

Lance Armstrong has had a tremendous influence in the world of cancer survivorship. His story is so inspiring — his childhood passion for bicycle riding enabled him to become a world champion cyclist by age 25. In 1996, he was diagnosed with an aggressive form of testicular cancer and endured an equally aggressive treatment. Then he went on to take six consecutive Tour de France victories. His survivorship is almost supernatural. But he’s human and making a huge difference for others who have to take a ride with cancer.

One trip to his website and you are united with all survivors in their fight against cancer. That’s Lance’s mission over there. A united front. A united army.

It’s important to fight against breast cancer because it’s personal; it’s our cause to fight for and we can pour all our passion into it and that’s what we are meant to do. But there are times we need open our hearts to the world of survivorship and acknowledge everyone’s battle. Tout le cancer suce, if you’ll excuse my French … all this talk about the Tour de France has me translating!

Head to Lance’s site and check out some survivor stories. Read his blog. Join his army (the petition is online). Shop his store. Purchase an infamous yellow wristband (to wear on the days you aren’t wearing a pink one!).

You may not be riding in a Tour de France after your battle with cancer but you can still live strong.

Since cancer had come back in my right breast after surgery and radiation and hormone therapy … it was clear that my right breast needed to come off. Apparently it wasn’t just prone to developing cancer cells, it enjoyed growing them, and was good at it. That made at least a single mastectomy a must in everyone’s eyes. I couldn’t help but chant in my head … “we must, we must, we must remove my breast.”

Even though my left breast wasn’t involved with my breast cancer recurrence, I had the option of removing it. It was considered a perfectly reasonable option. An option. That meant I had a choice to make.

My husband had no doubt in his mind that a double mastectomy was the way to go. He didn’t want to ever, ever go through the stress of a diagnosis again. “Why wait to find out that the cancer was back a third time in your left breast,” he voiced to me when I found myself in a quandary.

I, on the other hand, could have been talked out of a double mastectomy. I was still in a bit of denial. I really didn’t like the idea of unnecessary surgery and I wasn’t sure it was necessary to get rid of both breasts. Sometimes I wasn’t sure the pathology was right. I often found myself imagining the results had been switched ’soap opera style’ and I never even had breast cancer in the first place let alone a second bout of it.

But I was at high risk for developing breast cancer in my left breast since my right breast and I had a personal history with the disease. I read the results of a great study posted on breastcancer.org about just this decision. In a moment of clarity and reflection on how hard my diagnoses were on my family, I realized it was the right choice for me to try to make sure we were never, ever in this situation again.

And that meant … a double mastectomy.

On Monday, April 3rd, 2006, I headed to Yale for another Stereotactic Core Needle Biopsy of my right breast tissue. The same breast that was surgically treated then radiated not three years prior. (Persistent little buggers, aren’t they, those cancer cells?)

In an earlier post, I explained my first biopsy so I’ve no need to bore you with the details in this one. The only difference between my first biopsy and this one was (1) the location (Norwalk Hospital vs. Yale) and (2) the fact that I’d already had bad news once so I no longer lived in denial, I no longer felt it couldn’t happen to me, and as a result I was an emotional wreck.

Fortunately, a nurse practitioner from my surgeon’s office joined the crew of technicians and stood next to me speaking to me with a soothing voice and rubbing my back the entire time. Seriously, that’s what she did, and it made a difference. I felt cared for, and safe, and though I was scared, I knew I’d be alright even if it proved to be cancer again. And it did. I had a breast cancer recurrence.

A few days later I got the call from Elspeth Knill-Selby, A.P.N., Affiliated, Surgery. Invasive Ductal Carcinoma and DCIS cells were found in the tissue sample. Most likely it was still caught early (Stage 1), but we’d need full pathology done to confirm that diagnosis. Pathology that would be completed after a mastectomy and a sentinel node biopsy.

All that information was given to me over the phone. Now some people don’t like getting information like that over the phone. But in my case, honestly, I’m so busy with my kids and I have a strong relationship with Elspeth. So I didn’t mind that aspect of the diagnosis at all.

What I did mind was that I was facing some hard decisions: a single mastectomy of the involved breast, a double mastectomy, reconstruction and if yes, what kind.

I’ve been putting off sharing the details of my recurrence because recurrence itself is so hard to face, even after the fact. I also don’t want to worry anyone unnecessarily … not everyone has a recurrence after an initial bout of breast cancer. Many, many people are lucky that way. I was not. This week I’ll tell you about my recurrence.

After my treatment for DCIS in 2003, as I said before, I went on Tamoxifen and intended to stay cancer free. After all, my breast cancer was Stage 0, my surgical margins were good, my radiation treatments were clinically ‘by the book.’

Good doctors monitor you closely and I did my part by making and keeping my scheduled appointments.

A few months after my treatment (March 2004) I had a clean mammogram. That was a huge sigh of relief — everything looked sunny, not a calcification to be seen. I didn’t have to have another mammo for a year. The weight on my shoulders was lifted. That year was fantastic. My energy returned and physically I felt great.

Mentally, however? I was afraid of recurrence. They didn’t have good data for young survivors — i didn’t want five or ten year recurrence rates, I wanted twenty or thirty year rates and they don’t exist for women under forty. One of my doctors told me that since I was diagnosed, odds were I’d get cancer again in my lifetime. “The good news,” he’d tell me, “is that we’ll be on top of it when it happens.”

That’s such a frustrating concept. After you’ve been diagnosed with and treated for breast cancer, you’re always waiting for the other shoe to fall and hit you in the head. You always expect it, you just don’t know when it’ll happen, so you’re never quite … at ease.

My March 2005 mammogram was different from the previous year, but not suspicious enough to warrant a biopsy. Six months later (September 2006) I had another mammo, no different from the March mammogram so still not suspicious enough.

Both times I felt I’d been given a recess but not a permanent vacation from the worry.

Then came the March 2006 mammogram … and the other shoe finally fell from the sky.

I said it the other day: I had a recurrence while taking Tamoxifen. But, I was pre-menopausal, an important factor if you are making a decision on whether or not you should take the drug yourself.

It is important to realize that research continually shows the benefits of Tamoxifen. Here’s a link to the Washington Post coverage of a new study published in the Journal of the National Cancer Institute. The study followed women at high risk for the disease who had first undergone a hysterectomy and ovary removal then began taking Tamoxifen. Astounding results — the rate of breast cancer cases were significantly lower for the women taking the drug.

This proves a few points to me. If you are at high risk for the disease, and are ER+, then Tamoxifen might be for you, even if it means you have to endure side effects like hot flashes and night sweats.

Consider the choice … life with side effects vs. possible death by disease. A “no brainer” if you ask me. but then again, I’m a two time survivor.

It also proves to me that drug companies need to start focusing on finding something with the same efficacy for pre-menopausal women with this blasted disease. More and more young women are battling breast cancer than ever before (thanks to early diagnosis, in part, I’m sure).

That’s my plea this morning. Help us. Please.

Yesterday was no exception. I see my medical oncologist every three months now and each visit is pretty much the same:

First a wait in the lobby. A peruse of the magazines. A few new booklets published by the National Cancer Institute: Facing Forward Series: Life After Cancer Treatment and When Cancer Returns.

Then a nurse calls me in. She takes my pulse, measures my blood pressure, records my weight (in kilograms but I always ask them to show me the number in pounds, too, sucker that I am), give me my gown, you know the ones, open in the front, blah, blah, blah.

Then the nurse practitioner comes in, asks me a myriad of questions about a myriad of possible symptoms. She gives me a quick physical, including a clinical breast exam, then says the doctor will be with me shortly. I take out my cell phone and start playing bejeweled to pass the time.

Eons later my medical oncologist comes in, we talk about the same things I just reviewed with her nurse practitioner, except I always seem to give my doctor more information, like I’m holding out on the poor nurse practitioner.

Then I head to the clinic to get blood drawn before I go.

They filled two vials, a light green one and a lavender. It would have been fine if the student nurse (I assume she was a student) didn’t miss my vein the first time needing someone else to step in and try again.

It’s amazing to me that at one time in my life I was nervous before giving blood at The Red Cross. HA!

Then I headed home. That’s it. Short. Predictable. But I’m wiped out.

Someday I should tell you about the neighborhood I used to live in, on the other side of the fence, that I can never return to, ever. The one where breast cancer doesn’t exist.

If you want to learn what it would be like to face breast cancer as a single woman in your early thirties than read Cathy Bueti’s memoir, “Breastless in the City.”

In the book (as it was in her life), Cathy’s breast cancer diagnosis and treatment was intertwined with her search for love. Most of us at least faced breast cancer with our spouse by our sides — not Cathy.

See, Cathy’s husband was killed in a car accident when she was 25 years old. Nobody should be widowed that young!

Then she got breast cancer … can you imagine?

Right away the introduction to the book intrigued me … “The probability of becoming a widow at the age of 25 is infinitesimally small; the probability of developing breast cancer around the age of 30 is far less than one in 10,000. If we really think about this, what is the likelihood that these two events would happen to one woman?”

As I reached the end of her story, not only did I want her to thrive as a survivor, I wanted her to find love — I think she deserved to.

But let me take a step back.

Cathy’s breast cancer story is not unlike many others: she found a lump when she was in her early thirties, she went to her doctor, got a mammogram, needed a biopsy, found out it was Invasive Ductal Carcinoma (IDC), she’d need a lumpectomy, perhaps radiation, perhaps chemo … she got a second opinion (something I always, always recommend), and though the two doctors concurred, she still opted for a mastectomy with reconstruction (a wise, wise personal choice because there was indeed lymph node involvement!) … she chose the TRAM flap and MAN don’t I know what she was talking about in terms of her recovery … then needed six months of chemotherapy.

Cathy’s description of the post operative ‘trauma’ and the side effects of treatment were so similar to my own: “The first thing I remember after surgery is feeling as if I’d been run over by a truck! I guess I am still alive, I thought. From my breasts down to my thighs, everything felt like a combination of a burning pain and numbness.”

Yup. I definitely felt that way after my double mastectomy/TRAM flap. Almost exactly that same way. Except that I’d most likely use the phrase ‘hit by a train’ in my memoir (still unwritten, of course, but maybe some day).

Here’s another experience you might recognize as your own: “As I knelt on the floor hugging the bowl, it felt as if all my insides were going to come out. I was shaking, sweating, and wondering how the hell I would get through this. I screamed and pounded my hand on the side of the bowl. Then I started crying. I felt completely alone.”

It was painful to read about someone else’s pain but even more jubilant to read about someone else’s survival — and of course by the end of the book she gets there.

I have to say that the other thread of the book, Cathy’s trials and errors in the dating world, weren’t as easy for me to relate to. Not that I didn’t date but I never utilized online dating services — Cathy’s method of choice.

After dating EIGHT different guys (yes, I counted) I started to wonder if she would ever find another soul mate. Poor Cathy, I kept thinking each time she’d start dating another loser … this sucks. These guys were total schmucks.

I’m so glad this was our April book club selection. I enjoyed reading about Cathy. I love survivor stories in general and this one brought an entirely new issue to light … dating through breast cancer treatment.

I’ll bet you’re wondering if Cathy ever did find someone to share her life with. Well, you’ll just have to read the book yourself to find out, I’m not giving away the ending.

Now it’s your turn … if you read the book, tell us what you thought in the comments below (just don’t give away the ending!).

Yes, please do. Not just here, mind you, but over at Newsday (just remember to come back, ya hear?).

Columnist Lauren Terrazzano is a staff member at Newsday. She was diagnosed with cancer two years ago (she was 36 at the time … that makes her a year younger than me). She’s been writing about her life experiences in a new column … Life, With Cancer.

Lauren has my respect and admiration … even my love if you can imagine loving a complete stranger.

I have much in common with her. Neither of us have reached our fortieth birthday. Both of us have cancer. Both of us are writers. But Lauren’s cancer is lung cancer and her cancer is terminal.

She offers this advice in a recent column … “What matters is the present moment. Not two to three months. Or two to three years. Or two to three hours. Just now.”

I can’t agree more. Love you, Lauren. Thank you for blessing us with your words.

Back to my story … a few weeks after my partial mastectomy, I had a consultation with my Radiation Oncologist, Dr. Bruce Haffty, of the Department of Therapeutic Radiology at Yale.

Dr. Haffty was all about science. He walked into the room for that initial consultation, opened my gown, and began to scan my breasts and study my chest in a completely clinical way. Suddenly, as if he remembered I was human, he stepped back, smiled and said, “I’m sorry. My name is Bruce Haffty. It’s nice to meet you,” and he shook my hand.

Dr. Haffty then asked me if he could open my gown and take a look. I consented, of course, that was why I was there. Later that day I realized it was okay that a doctor who would be looking at technological equipment and computers and clinical printouts and measurements was just a little bit … cold. Radiation therapy is methodical, precise and to some degree, impersonal.

FYI, Dr. Haffty is now practicing at The Cancer Institute of New Jersey — Yale’s loss, CINJ’s gain if you ask me.

A simulation of my treatment protocol was scheduled for September 11th; my first set of films were to be taken on September 16th; my first day of radiation was to be September 17th. My 36th birthday was to be September 18th.

As I laid topless on the table during the simulation, in a room straight out of a Star Wars set and in front of five or six people I hadn’t met, the tears just rolled down my face. I had no physical pain that day, the red laser beams of lights that were mapping out an action plan on my chest didn’t hurt at all, but my emotional well-being was suffering greatly.

This was cancer treatment. I had cancer. It was real.

See, up until that point, I was spending a large amount of time denying anything would change in my life. A day of outpatient surgery can come and go and life can go on as if nothing would really change. But that … that radiation therapy … the simulation, the x-ray films, the 33 sessions in the radiation clinic and the physical side effects of those sessions … that was all very, very real.

Those tears I shed on that table were not the last my treatment team would be seeing, I thought, unless I came up with something to get me through my treatment.

In previous posts I shared what led me to get my initial diagnosis of breast cancer … now I’ll share what led me to get a second opinion.

During that fateful phone call on Thursday, July 17, 2003, when I received my diagnosis, the surgeon explained she had booked an OR for the following week to perform a lumpectomy. The fact that she did this without consulting me first terrified me. If I was truly Stage 0, why the rush? Didn’t I have options? Besides, I had a vacation planned … if this wasn’t an emergency, couldn’t this wait until I returned from my vacation?

I called back the next day and questioned the receptionist; she recommended I do some research on my own over the weekend, starting with a quick read of the book, “The Breast Cancer Survival Manual,” by Dr. John Link, “a step by step guide for the woman with newly diagnosed breast cancer.”

Of course I got the book that night and started reading. After reading the acknowledgments and the introduction I read the most important chapter of the book. Chapter 1: Second Opinions.

At that point I recognized that the surgeon I’d scheduled the biopsy with was a general surgeon, not a breast surgeon, and the hospital she was affiliated with was not a renowned cancer hospital.

I needed and wanted a second opinion even if it would take time and money. And it needed to be with a cancer specialist. I owed that to my children.

On Monday, I consulted US News & World Report’s List of the best cancer hospitals. I’m only an hour North of New York City, so I visited the Memorial Sloan-Kettering Cancer Center website, the number one cancer hospital on the list, and found an 800 number. I called.

The woman on the phone from MSKCC recommended I make an appointment at the Yale Cancer Center, another one of 39 National Cancer Institute Designated Cancer Centers and the only one in Connecticut. She said they’d gladly see me at MSKCC and discuss my case, but since I had young children and was in close proximity to Yale, a hospital they regarded as excellent, I should start there. If I was unhappy with the service and attention I received at that consultation, however, thought they doubted I would be, I should call back and get an appointment at MSKCC.

I called Yale first thing the next morning. My surgery was scheduled for Thursday, remember, only two days away, and I wanted a second opinion immediately!

Amazingly, the oncology department had a cancellation for Wednesday afternoon. I snagged that appointment. I scrambled to the various offices to collect my mammogram films and biopsy report and headed up to New Haven.

The medical oncologist, Dr. Gina Chung, was surprised I entered their system through her. Usually with cases like mine, initial appointments were made with a breast surgeon, because that’s the ‘first step.’ But coincidentally, Dr. Donald Lannin, the Executive Director of the Yale Comprehensive Breast Center and Professor of Surgery for the Section of Oncologic and Endocrine Surgery happened to be on the floor.

Some things happen for a reason. If you’ve never believed that before you start to believe that after a cancer diagnosis.

Both doctors spoke with my husband and I that day. They both agreed with my previous surgeon’s recommendation to start with surgery — but explained it should be more of a partial mastectomy rather than a lumpectomy because there was no lump, just some milk ducts filled with cancer cells. They both agreed I should go there because of their credibility as a cancer treatment hospital.

Then they explained that Elspeth Knill-Selby, A.P.N., Affiliated, Surgery, would call me to schedule the partial mastectomy. After my surgery we’d meet again and go over the resulting plan for treatment based on the pathology results. He told me to rest assured that a few weeks wouldn’t make a difference, so since I already had vacation plans, it could wait until I got home.

I made the decision on the spot to switch to their care.

Before I left, they asked if I’d be willing to let them review my case in their Wednesday afternoon clinic — I jumped at that, immediately seeing the benefit of affiliating my case with a teaching hospital. I’d have the best and the brightest minds looking at my films, my biopsy report, and eventually … my pathology.

I went home, canceled the surgery that the original general surgeon had scheduled on my behalf. Elspeth called me to schedule a subsequent surgery with Dr. Lannin on August 18th.

I relaxed … having done my homework and taken control I felt far more empowered than I had expected.