Michelle’s Breast Cancer Journey

My experience with Breast Cancer began in March 2021 after the discovery of a very small blood blister, not much larger than a pin head, on my left breast.

I wasn’t particularly concerned at the time but did note that it was an unusual place to get a blood blister. After a little prodding and squeezing, (as you do), I got dressed and made a mental note to keep a check on the blister.

A couple of weeks later, with the blister unchanged, I made an appointment to see the GP to have it checked. The blister was drained by the GP who said he didn’t think it was of any concern but as a precautionary measure, was referring me for a mammogram and ultrasound.

The small blister reappeared a couple of weeks later so I returned to see the doctor who advised me that the ultrasound and mammogram results had identified a complex cyst in my left breast. To further investigate, the doctor then referred me for an ultrasound guided core biopsy. I still wasn’t overly concerned as I’d had a benign cyst removed from my right breast 8 years prior and on numerous occasions had been advised that I had fibrocystic breasts (lumpy tissue in my breasts). I also recalled that the sonographer had mentioned that he didn’t think that the cyst looked nasty.

Due to COVID-19 and the impacts on staffing and availability of appointments, I was delayed until late May in having the core biopsy procedure. I attended the appointment and then returned to work with little more thought given to the cyst or the results.

Several days later in a long phone call to a close family friend, I briefly mentioned I’d recently had a biopsy procedure. She asked if I had received the results back or made a follow up appointment. I said I hadn’t but expected that if there were any issues with the result, I would be contacted.

A week or so later, my persistent family friend texted me to ask if I had received the biopsy results. I was surprised that she had even remembered as I hadn’t given it much thought myself. Clearly she was prioritising my health more than I was. I texted back saying that I hadn’t received the results and I would ring the doctor for follow up.

Almost one week later, my caring and persistent friend messaged me again saying she didn’t want to be a bother but wondered whether I had received my results back. I was embarrassed that I hadn’t yet followed up so didn’t reply immediately. To be honest, I did have good intentions of making a follow up appointment (if only to satisfy my dear friends enquiries) but due to my busy workload and my assumption that no news meant no bad news, I hadn’t made the follow up appointment an immediate priority. However, I was now motivated to book an appointment ASAP and obtain the results before my dear friend could send me a third enquiring message.

The following day I rang the medical practice to make a follow up appointment and was advised that the doctor no longer worked at the practice. I booked an appointment with a different doctor and opted for a phone consult appointment for convenience and because I expected that it would be a quick conversation to confirm that the results were fine.

At the appointed time the following day, I closed my office door and took the call from another doctor at the clinic. After initial pleasantries, the doctor proceeded to tell me that the biopsy report had come back and unfortunately the result was “query breast cancer”.

I don’t remember much more about that phone conversation other than the doctor acknowledging that a phone consult wasn’t an ideal way to deliver the results and that he would write a medical certificate for me to take the rest of the day off work. I thanked the doctor and hung up.

I sat motionless at my desk. My throat tightened as I tried to process what “query breast cancer” might mean for me. I imagined the next 5, 10, 20, years that I had expected to experience and the thought of having those years prematurely ripped away from me. I then imagined having to tell my 3 children and what I could possibly say to lessen the trauma to them. I imagined each of their faces as I delivered the bad news to them and the thought utterly crushed me and I began to quietly sob at my desk, trying not to let any of my colleagues in the surrounding offices hear me. My mind was racing. How could this be happening? I was a 47 year old mother of 3 and had kept my self reasonably fit and healthy with very few sick days in my life. I felt like I’d had my breath squeezed out of me and I could feel intense grief welling up within the pit of my stomach.

I must have sat there silently and motionless for about 30 minutes, trying to recover from the initial shock. I dried my eyes, composed myself and prayed for peace to replace the intense fear and panic that was threatening to consume me. I pulled myself together, and made the decision to stay positive and expect the best and deal with anything less if it should occur. I then quietly left work and started planning the practical and immediate next steps.

I can’t really remember the details of the weeks immediately after that phone consult. I remember deciding not to tell my children at the time in order to protect them at least until I had further investigation to determine whether I did in fact have breast cancer. I also didn’t want to burden my family at this stage. I decided that initially I would only confide in my older brother whose son had survived leukaemia some 15 years earlier and my dear persistent friend who had prompted me to follow up my results (and who I was now so incredibly grateful to).

From that point I was referred to a Breast Surgeon and in July 2021 underwent a hookwire excision (otherwise known as a lumpectomy) to remove the cyst and determine whether I had breast cancer.

Once again, my persistent friend was soon following up with me to check in on whether I had received my lumpectomy results or made a follow up appointment.

After the lumpectomy, I was phoned by the consulting suites and advised that I should follow up with my referring GP for my results. On August 10^th, I attended an appointment with the same GP who had initially referred me and he advised that the surgery results confirmed that I had breast cancer in the form of 3 invasive malignant hormone receptive tumours and encapsulated papillary carcinoma present within DCIS. The report also identified that the margins were not clear on the lesions excised and therefore removal of further breast tissue was recommended. The GP referred me back to the surgeon for further excision.

After further review by the surgeon, I was offered two options. Removal of further breast tissue or a mastectomy with an option for immediate breast reconstruction. I would also need removal of a sentinel lymph node to identify whether cancer had spread and may need chemotherapy and radiotherapy along with hormone treatment.

It was around this time that I shared the news with my family. As a parent, I found it heartbreaking to have to tell my children that I had breast cancer. I still remember when I sat down with them and explained my diagnosis and the next steps towards removal of the cancer. Of course I softened the news as much as I could and focused on the process to remove the cancer towards being cured and getting on with a healthy life, but I still remember the mixed look of shock, confusion and fear on their faces. They were all so brave, strong and supportive for me throughout the process and ongoing.

I also shared the news with the rest of my family with my older brother kindly managing communication for any questions or concerns that family members had so I didn’t need to continually discuss my cancer diagnosis and treatment options. My family have been amazing and have provided much practical and emotional support along the way.

On the advice of the Breast Care Nurse, I then commenced 2 Facebook Messenger groups, 1 for family and one for close friends. This was an effective way to keep concerned family and friends informed and greatly reduce the amount of time I spent communicating updates and repeating myself.

Over the months since my lumpectomy, I had connected with a nurse colleague who had kindly reviewed and redressed my lumpectomy wound.  She shared with me some of her own journey with breast cancer. She was one of the few staff members who I had disclosed my breast cancer diagnosis to and since receiving my diagnosis, seeing and speaking with a vibrant, happy and healthy breast cancer survivor filled me with courage and hope as I faced each step on my journey. She made a point to regularly pop into my office to check in on me and answer some of the questions I had about symptoms and treatments. I doubt she understood the significance of her encouragement and support to me at that time, but I was so grateful to have someone who had been where I now was, walking alongside me and encouraging me through my journey.

After much research, discussion and consultation, I opted for a mastectomy and DIEP flap breast reconstruction surgery and was referred to St. Vincent’s Hospital.

As COVID-19 impacts and restrictions were significant at the time, I had to attend many of the pre-surgery scans and appointments alone over the 6 weeks leading up to surgery. I was grateful that an exemption was granted for me to have a support person (my older brother) attend the initial consultation appointment with both the breast surgeon and plastic surgeon at St. Vincent’s Hospital.  I attended several consult, MRI, CT scan, lymphoscintigram and Pathology appointments in the weeks leading up to my surgery.

COVID-19 had also significantly impacted surgery lists, so it was an anxious time as my surgery dates were cancelled and rescheduled a few times with my surgery date finally being confirmed as October 19^th 2021 at St Vincent’s Private hospital, 10 weeks after receiving my breast cancer diagnosis.

The week of my surgery, I was advised that I had been appointed a different plastic surgeon due to newly implemented COVID-19 precautions, resulting in the splitting of surgical teams into two separate teams. This was quite distressing to me as I had built rapport and trust with the plastic surgeon that I had attended several consultations with in the months prior. Fortunately, upon hearing about this change, my originally appointed plastic surgeon successfully advocated to be reassigned to my surgery, so I ended up being allocated two plastic surgeons and the breast surgeon for the procedure (in addition to the many other medical team members required to participate).

On the morning of my scheduled surgery, my brother dropped me off at the front doors of St. Vincent’s Private hospital (unable to enter due to COVID-19 restrictions). I was admitted, gowned up and prepared for surgery. At 7.00am I took a quick selfie of me in my surgical gown, smiling and thumbs up and sent it off to my family and close friend groups on Messenger to provide them with reassurance that all was well.

In the moment just before being taken to Theatre, a potential COVID-19 risk was raised. This resulted in an unexpected and anxious 30 minutes where clarification was being sought about the current (and constantly changing) COVID-19 protocols and whether my surgery could still proceed that morning. I was trying to stay calm whilst desperately hoping and praying my surgery wouldn’t be again cancelled. Surely not when I was so close, with surgeons at the ready!!! After much discussion between the medical team, they agreed that if I produced a negative result on a RAT test the surgery could proceed. The result was negative and I was immensely relieved to be wheeled in to theatre for surgery at around 8.30am.

At 3.30pm that afternoon, my family were contacted by the hospital to advise that surgery went well with no complications and I was being taken to the recovery ward.

I spent 5 nights in hospital, being well cared for by the nursing staff and learning how to best manage movement during recovery and avoid compromising the healing process. No visitors were allowed due to COVID-19 restrictions which I think was harder on my family than on me. I enjoyed the company and support of many lovely nursing staff. I was then discharged to home for 6 weeks recovery and gentle exercise before starting 4 rounds of chemotherapy between November and late January 2022.

During my recovery my friends and family provided amazing support. I’m not great at accepting help but I knew the risk of damage to my breast reconstruction and my abdominal wound if I tried doing certain household chores. A friend reminded me that now wasn’t the time for heroics and that I shouldn’t rob those who care about me of the opportunity to support me in my time of need. With the point taken, I swallowed my pride and humbly accepted the help that was generously and abundantly offered to me over the following months.

Support came in many forms including meal rosters, barista coffee drop offs, prayers, fuel card voucher, care packages, shopping collection, kid collection, house cleaning, wound dressing changes, selection and delivery of library books, flowers, gifts cards, text messages. I was overwhelmed with the amount of care and support I received from many kind and caring people.

On October 26^th, I received my surgery results back with the wonderful news of no evidence of cancer in the sentinel lymph node that was removed. I was so relieved and shared the update to family and friends via my Messenger groups.

Chemotherapy was soon to commence to further reduce my risk of cancer returning.

I started chemo in November 2021 and I decided to try the additional treatment option of a cooling cap which can sometimes minimise the amount of hair loss. It added an extra couple of hours to the chemo treatment but I thought it was worth trying to keep as much of my hair as I could.

Whilst the cooling cap did help to slow down the amount of hair loss in some areas, particularly in my fringe area, 2 weeks after my first round of chemo I began to lose my hair on the crown and back of my head. I thought I was prepared for the hair loss and had even purchased a few scarves in advance and attended a few virtual workshops on scarf folding and makeup during cancer treatment. I remember thinking “it’s only hair and it will grow back”.  However, when I started noticeably losing my hair I quickly realised that I was easily recognised as someone experiencing cancer and I wasn’t ready or comfortable to share that with the general public. I immediately phoned Cancer Council Victoria who recommended a few wig suppliers within the region. The very next day, I drove to Melbourne with my 16 year old daughter by my side to help me select a suitable wig. Fortunately the cooling cap had saved most of my fringe so I was able to blend my own fringe with the wig which made the wig look more natural. To test out how authentic my wig looked, I went to visit my Mum and to my delight, she had no idea that I was wearing a wig until I removed it some 20 minutes after my arrival. I’ll never forget the look of confusion on her face when I removed the wig whilst her back was turned and she turned around to see me with very patchy and thin hair.  We had a good giggle together that day. I went on to wear the wig from December 2021 until July 2022 when my hair had grown back long enough to cut into a short pixie cut hairstyle.

I had a few other side effects from chemo including hot flushes, nausea, joint aches and fatigue which were all manageable with the support and advice from the wonderful Oncology staff, Breast Care Nurses and the ongoing support from family and friends. I returned to part time work in January 2022 between chemo rounds and as side effects lessened and was back to full time work (maybe a little too quickly) after chemo finished.

Soon after, I commenced the recommended 5 yearly hormone therapies to block estrogen hormones that can contribute to cancer growth. This includes a monthly implant injection in my tummy and a daily oral tablet. I was invited and selected to participate in a research project testing a potential new treatment for the type of breast cancer I’d been diagnosed with (ER+ HER2-negative early breast cancer). The purpose of the study is to compare the effects of the potential new treatment (Giredestrant) to the effects of other approved treatments currently in use. Given that I have a daughter, I felt strongly about participating in potential improved breast cancer treatments. I shared the treatment information with some of my nursing colleagues and after further research decided to participate.

Soon after returning to full time work,  I thought I was going a little crazy and found it really challenging trying to slot back in to my previous fast pace rhythm and multi-tasking activities. On sharing this with a few breast cancer survivors and oncology nurses, I was relieved to learn that the confusion, memory loss, increased anxiety, nervousness, and depression that I was experiencing were all known side effects of the medications I was taking. I’m sure I was previously advised of these side effects however there were so many medications and so much information provided at the beginning of treatment that it was difficult to remember everything. It was a relief to know that I wasn’t going crazy and I stopped pushing myself so hard.

I felt very fortunate to work at a health service during my breast cancer diagnosis and treatment as I had much support from several nursing colleagues who were willing share their knowledge, provide or obtain information and offer their opinion when requested. Further support came after learning that there were two other staff who had also been diagnosed with breast cancer in 2021. We were able to share information, support and friendship as our journeys were at similar stages. There were also other staff who had experienced breast cancer who reached out to offer support and kindness.

Whilst COVID-19 restrictions had prevented the formal breast cancer support group meetings in the surrounding area, I was very grateful to have access to the supportive group of friends, family and work colleagues at the time. To be honest, I probably wouldn’t have actively sought out a formal breast cancer support group at the beginning of my diagnosis and surgery, however I have since been unexpectedly surprised by the strength, comfort and support I gained from connecting with other breast cancer survivors and those currently undergoing treatment or recently diagnosed with breast cancer. I would certainly now recommend connecting with a breast cancer support group whether that’s face to face, online or informally with people you know or meet along the way.

It’s now 12 months since my surgery and I have just received the all clear from my 12 month mammogram and ultrasound with my MRI scheduled for next month.

Having now learned to prioritise my health, I have recently commenced an extended holiday to focus on restoring my health.

As I think back over the last 12 months, I can recall so many acts of kindness and care provided to me by family, close friends, work colleagues and even from people that I didn’t think I knew that well. I was absolutely blown away by the care and support I received and feel so thankful and blessed.

I will be forever grateful for persistent and caring friends and family who have taught me about how to support and care for others.

I have learned the benefits of receiving support and to never underestimate the impact of sharing even a small gesture or act of kindness to those going through a difficult time.

I hope to pass on to others, some of the care, support, hope, kindness and encouragement that was shown to me. A small effort can make a big difference.