Breast Cancer — Without Breasts?

This wasn’t supposed to happen to me. Truly.

I know lots of women with breast cancer utter those words, as I also did during my first go-round with Stage 1 in 2006.

Following my 2006 diagnosis, my doctors offered this advice:

“Treat this cancer to the max. It’ll be a year of hell, but it’ll buy you 40 more.”

“I can do a year of hell for 40 more,” I said. “I’m in.”

What did “in” mean? It meant a radical double mastectomy, chemotherapy, an oophorectomy (removal of my ovaries and fallopian tubes).

I did it. I did it all. I did it to the max. I was 4 years, 10 months cancer free when it happened.

On January 9, 2011, I had just come in from ice skating out on the lake with Don and Theo. We were cold, but happy, exhilarated from the rush of the skates gliding on the smooth surface, trails of shaved ice left behind in our wake.

I flopped on the couch, turned on the news, and pulled a polar fleece blanket over me up to my chest. That’s when I felt it.

Even though I was wearing a thick sweatshirt, I felt it.

My forearm brushed over something that felt like a large marble.

“What in the heck is that?” I thought to myself.

I reached down into my sweatshirt and there it was — a lump the size of a large, red, round grape just below my left nipple.

Don was sitting in the easy chair next to me.

“Honey?” I said. “Could you come here? Check this out?”

He did. I saw a shadow cross his face.

“Was this here before?”

“No,” he said. “This was definitely not here before.”

I contacted the oncologist on call at William Beaumont. I knew there wasn’t anything he could tell me over the phone. But it was comforting just to talk to someone, let them know what’s going on, ask them to start putting the ball in motion.

The next day, with my sister Lisa and husband Don by my side, I went to see my oncologist. She felt the lump. Could be a necrosis, she said. Could be something to do with your implant. Or scar tissue. Or early stage breast cancer.

She left the room and conferred with her colleagues and the breast cancer surgeon, Dr. Nayana Dehkne. Dr. Dehkne ordered a biopsy, stat. I went straight from my oncologist’s office to the other wing of the hospital, where I was prepped for a biopsy.

Dr. Dehkne ruled out a problem with my implant and scar tissue via ultrasound. That left two options: necrosis (hard lump caused by trauma to an area) — or a return of my breast cancer.

Two days later, the biopsy results confirmed what I already knew in my gut. Breast cancer.

So, how does this happen? How, many of my friends have asked, can you get breast cancer when you no longer have breasts?

Science is not perfect.

When I had my double mastectomy, the doctors told me that it is impossible to get every single cell of breast tissue that exists in my body. They try. They vacuum it out from around my collar bone area, under my arms, scrape the cells off of my chest wall. But even in the best circumstances, they can only get 98 or 99 percent. There are some left behind.

Science is damned good. But it’s not perfect.

So, in that 1 or 2 percent of the cells that remained, the Monster found a foothold. Between my left breast implant and my left nipple — which isn’t EVEN a nipple, but a reconstructed, very well done look-alike — it found a few leftover cells of healthy breast tissue to invade.

That’s how it happened.

That’s how I went from planning a square dance to celebrate five years cancer free to battling cancer again — and this time, a Stage 4.

What’s my prognosis? No one knows for sure. But, at least when I asked THE question — Are we talking weeks? Months? A year? My oncologist said, “No, we are not talking months. I do not have a crystal ball, but I believe you could live for years.”

That will likely mean I will move in and out of remission, and will require chemo when the Ugly Monster rears his hideous head.

But that I will happily do, given the alternative.

Once again, I’ll do whatever it takes. I’ll do treatment — and to the max.

Just let it work.

Dear God, when they scan my body in a few weeks to gauge the impact the chemo is having on the cancer in my body, may it be receding, not static, or, even worse, spreading.

Please let the chemo dissolve cancer cells like the dots on a Pac Man game.

Let me score high. Let me enter my initials as the new Champ.

I’ll gladly do another year of hell to buy myself 40 more.

— Amy Rauch Neilson

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