It will be fine

I first found a breast lump in 2010. I was working as a surgical registrar in Luton. My husband had just proposed, and had taken 7 weeks’ holiday to sail the North West Passage in the Arctic - definitely no wifi or 3G there! Although I was working towards becoming a breast surgeon, all common sense went out of the window. I spent the night literally howling on my sofa, alone. It was obviously going to be a cancer, and I’d need a mastectomy, and my hair would fall out, and I wouldn’t be able to wear a wedding dress, and my fiancé would leave me, and I’d be dead in 2 years…. Not melodramatic at all then!

My boss knew I wasn’t right the next day, and asked me what was up. I burst into a flood of tears, and told her everything. She spoke the voice of reason - at my age, it was highly likely to be a cyst, and rang the breast consultant who saw me the next afternoon (there are a few perks of working in the NHS). That night, I confided in a few close friends, who all said it would be fine. In clinic, I was anxious and scared. Because of my age, they only did an ultrasound scan. And what I saw was lots of tiny cysts.

Everything was fine.

I’ve been a consultant oncoplastic breast surgeon at Ipswich since 2013, and pride myself on my relationship with my patients. Since I have been a scared, anxious patient on the other side, I do know what they might be feeling. My waiting room is full of fear, and I’m the woman that nobody really wants to see - just in case I’m the bearer of bad news. I can empathise with them, and acknowledge the unspoken elephant in the room. And for the vast majority of the women I see, the scans are normal and I can send them on their way with a smile and promise to drink G&T when they get home.

I found another lump in September 2014, and my GP was concerned enough to refer me to a colleague in West Suffolk Hospital (I didn’t want to be seen in my own hospital). I’d waited a month or two before getting it checked out, as I was almost certain it was another cyst. The worry is always there, though, at the back of your mind, even if you’ve had normal scans before. But again, everyone told me it would be fine.

I know that people mean well, but this phrase grates with me. I’ve said it to patients before, and have had to eat my words when a scans show something unexpected, which is a horrible conversation to have. I never comment on what a scan might show, even though some patients beg you to placate them. It’s making a promise I can’t keep. I find it hard to accept that friends and family can promise things will be fine - how can they know for certain…?

This time I had the dreaded mammogram. And you know what, it wasn’t so bad - a tight squeeze that lasted for a few seconds, and then it was over. The USS only showed cysts - the same as last time.
Everything was fine.

In March 2015 I’d noticed another lump on the other side. Again, I’d been told it would be fine. This time the ultrasound showed a new cluster of cysts.
Everything was fine.

However, I was starting to feel like I was wasting everyone’s time. I’d been back twice in 6 months, and surely I should just get used to my lumpy bumpy breasts.

As a consultant I tell all my regular cyst attenders to come and see me if they notice a new lump, even if it’s only been a couple of months since the last one. Sometimes that ‘cyst’ is actually a cancer. But how good was I at taking my own advice?

Jump to July 2015. I’d noticed a new lumpy area in the same side as March, and it had been growing for a couple of months. I was sure it was just cysts again - nothing to worry about. I finally mentioned it to my mum, and she said I should get it checked out. Again, everyone said “It’ll be fine”. Like a good patient, I waited to get an emergency appointment with my GP, who didn’t examine me, but faxed a referral to West Suffolk. He took my word as a breast surgeon that I had a lump. Part of me wanted him to examine me just to reassure myself that (a) there was a lump, and (b) I was right to get it checked out.

I saw the same lovely consultant the following day. I had another mammogram - and this time it was painful, as the lump was starting to ache. I was actually quite blasé about having the scans, as it was just going to be another cluster of cysts, wasn’t it? And reassuringly, the mammogram was normal.

Then a locum radiologist did the ultrasound for me. One of the pros / cons of being treated at West Suffolk is that everybody knows who I am. I worked in the breast unit as a registrar at the beginning and end of my training, and my husband is a surgical consultant, ex-Medical Director and ex-interim CEO. It is almost impossible to be anonymous. But this doctor just knew me as ‘Liz’, which was exactly what I needed. Before she put the probe on the lump, she asked me if I wanted to see. I said yes, because everything was going to be fine. We both looked, and suddenly I knew my life would never be the same again….




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