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800px Breast self exam 1

1. What the fuck was that? I ran my hand over the side of my breast. A lump.

2. I took a few steadying breaths and assumed the breast self-examination position: right arm extended upward, elbow bent next to my ear, palm cupping the nape of my neck. I’d been doing regular self-exams since my 20s when I worked on Journal, a photography book about surviving breast cancer, which inspired me to finally really start living my dreams. Definitely a lump, I concluded and keeled over in the shower.

3. But I have somewhere to be in an hour.

4. I called my partner, Melinda. I explained that I’d felt a lump. I tried to sound calm. I tried not to scare her. She was at the office. Later, she told me I was screaming. “We need to call my gynecologist,” I said/screamed.

5. Melinda three-way called the doctor. Somehow they fit me in that afternoon. “Don’t panic,” the receptionist said before hanging up. “Think positively.”

6. What does that even mean?

7. It could be cancer. I was in my mid-thirties. Statistically speaking, I was young for breast cancer. According to WebMD, women under age 40 accounted for only seven percent of breast cancer cases in the United States. I’d never been tested for the BRCA1/BRCA2 genetic mutation that Angelina Jolie made famous, but nor did I have reason to suspect I’d inherited it. Breast cancer didn’t run on my mother’s side.

8. It’s probably a cyst.

9. According to the Centers for Disease control, I wasn’t immune. No woman was. We were all at risk. Especially those of us who lived in dank, polluted cities like Manhattan, who ever took the pill, who didn’t have children, or drank, or started menstruating early.

10. What did it mean to think positively? Was it limited to focusing solely on the lump being probably, most likely nothing or that cancer wouldn’t happen to me?

11. I brushed my long hair and tried not to think about losing it. But my friend has clippers, I recalled, and she was a survivor.

12. My doctor felt the lump, too. She called it a mass and told me to have a mammogram and sonogram immediately. “Both,” she said, “tell them it is diagnostic — not a regular screening. That will get you in faster.”

13. Once a lump could be detected in a younger woman’s breast, which was usually denser, meant — if it was cancerous —  it was potentially advanced, aggressive. “Go right away,” my gynecologist said, handing me a referral sheet with the area circled over a clinical drawing of breast. “It’s better to know.”

14. Melinda called the radiologist office. At the word “diagnostic,” an appointment became available for 7:30 the next morning. We sat on a park bench outside the Natural History Museum. I unbuttoned my denim shirt and let her touch my spot.

15. “I like our life,” came out with a sob. “We’ve got this,” Melinda said, as her eyes filled with tears. “We can handle it.”

16. When I let myself consider the possibility of such a life-altering situation, I also became aware of all of the relationships and resources I had to help me live with such a diagnosis. I wasn’t going to delude myself with the thoughts that age or eating farmer’s market food or being white somehow inoculated me from cancer. I had a lump. It wasn’t negative thinking for us to do the tests and prepare ourselves for the possibility. Positive thinking was less about focusing on cancer not happening, and more about being able to manage it — if it did.

17. The next morning, I shook beneath a rose-printed robe in the waiting room. Melinda wrapped a pink blanket around me.

18. “First one?” asked a woman, reading a well-thumbed issue of MORE magazine. I nodded. “It hurts,” she said, “Anyone who says otherwise is lying, but it’s quick.”

19. “Mammograms don’t hurt,” my technician said as she stuck two stickers on each of my nipples. They were printed with a floral pattern swirling around a tiny metal ball, branded N-SPOTS, and that apparently helped orient the x-ray.

20. The compression was uncomfortable. It felt similar to pushing on a bruise. “Hold your breath,” she said. “Go to a happy place.”

21. Corsica.

22. While we waited for the sonogram, Melinda and I discussed in upbeat whispers that breast cancer was highly treatable. If caught early, women have a 98 percent survival rate, according to the National Institute of Cancer. For women over age 35, they offered a Breast Cancer Risk Assessment Tool on their website that estimated risk by assessing seven factors: Age; Age at first period; Age at the birth of first child; Family history of breast cancer in mother, sister, or daughter; Number of past breast biopsies; Number of breast biopsies showing atypical hyperplasia; Race and ethnicity. My estimate was almost negligible.

23. Yet, young women do get breast cancer. The Young Survival Coalition estimated that 250,000 were currently battling breast cancer and 13,000 new cases would be diagnosed this year in the United States. Breast cancer was the leading cause of cancer death in women ages 15-34 and the leading cause of all deaths in women ages 40-55. I knew, because I was freaking myself out by reading some run-walk donation brochure.

24. The mammogram technician called me back for additional X-rays. Not to worry, she explained, younger women commonly had dense or fibrocystic breast tissue that was completely normal but did make the mammogram images difficult to decipher. Using a smaller, circular plate, the size of a fist, the technician compressed each breast for another four positions. This time it felt as though my proverbial bruise was being kneeled on.

25. Eighty percent of lumps are not cancerous, I chanted to myself, back in the waiting room for two more hours, until my name was called.

26. “Relax, sweetie,” the sonogram technician said in a soft Spanish accent. “That’s a cyst if I’ve seen one.” I felt as though I might levitate off the examination bed with relief. “But you do have a few of ‘em.”

27. The radiologist joined her and squinted at the screen. After another five-forever minutes of imaging, she physically examined area and must have felt my heart pounding in my chest. “I want you to see a specialist.” She explained that I had a cluster of cysts, probably benign, which would most likely dissipate on their own. “But they’re complex.”

28. I booked the first available appointment with the breast specialist — five weeks away at the end of October “Till then, think happy thoughts,” her receptionist said.

29. The season turned pink. Breast Cancer Awareness Month had me constantly aware that I might be facing a diagnosis whenever I watched football, shopped for lipstick, or flew Delta Airlines. Melinda and I took at trip home to Minnesota and were greeted at the airport by Caribou coffee honoring their beloved roastmaster, who had died of breast cancer with Amy’s Blend, proceeds benefitting CANCERCARE, which I misread as cancer scare.

30. As Melinda and I ticked through the days, we came to realize that positive thinking was recognizing the abundance of love and care in my life that would — if necessary — help me face the results, whether they came back negative or positive.

31. They were negative. Cry.

Amy Deneson is a writer in New York. Her work has appeared on Bust.com and in The New York Times Modern Love column, Toast, Salon, Observer, and Curve magazine, amongst other publications. Follow her at amydeneson.com

Top image via Wikimedia Commons

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