August, 2024: I’m coming up on the tenth anniversary of when I was diagnosed with breast cancer, and nine years since active treatment (surgery, chemo, radiation) ended. Since then I’ve been taking tamoxifen to suppress estrogen in my body because mine was a hormone-sensitive cancer. 

In the early months and years, I feared that I would spend the rest of my life constantly aware that I was under the shadow of death in the form of recurrence. But that awareness faded sooner than I’d expected. Perhaps humans aren’t equipped to be constantly considering our own mortality. 

Most of the time I didn’t think about cancer anymore. When it came up, I had a rote patter that I would go through: “I had breast cancer x years ago, it’s been x years since active treatment ended, and at the five-year mark it was considered cured.” As my routine checkups dwindled from quarterly to annually, I had fewer reminders. 

Here in Australia I was referred by my GP to a breast specialist, a reassuring older gentleman with decades of experience in treating breast cancer, who is very good at explaining things. Every year about this time I get my imaging done (mammogram and ultrasound), then go see him to discuss the results. Last year he said: “Nothing has changed in the imaging, and that’s exactly what we want to see.” Nothing changed in the treatment, either – I’m still on tamoxifen for another year.

All those routine checkups continued to be routine… until they didn’t.

Last Monday I went to a local imaging clinic to have my annual mammogram and ultrasound, in anticipation of my annual visit to the breast specialist. I was in a good mood, and enjoyed chatting with the two technicians. As often happens with me in Australia, I ended up talking about my life (“Wow! You’ve had an amazing life!” is the frequent response). As often happens in healthcare settings, I also talked about the iniquities and inequities of the US healthcare system. 

As also often happens, I was blind to the nuances of what was going on around me in the present.

When the ultrasound technician finished her examination, she said “Just stay here after you get dressed, you don’t have to go back to the waiting room.” This was not routine, but I took it at face value. With several large paper towels, the used paper gown, and some difficulty, I cleaned all the gel off my boobs, then sat down to wait. Eventually the technician came back, accompanied by a doctor, a reassuring older gentleman with a white mustache. “Jen saw something on the ultrasound. It’s most likely a benign fibroadenoma, but we should do a biopsy to be sure.”

Those are the moments when the floor caves in beneath you. My brain had to switch tracks from “It’s a nice day, I’m going to go get some errands done after this and meet Brendan for lunch” to “Oh-shit-I’m-going-to-die.”

Fortunately, they had an opening that same day to do the biopsy. The needed referral was obtained by phone from the breast specialist, Brendan came to hold my hand, and very shortly I was again naked from the waist up, twisted sideways on the examining table so that my right boob faced the ceiling. This was a different room with a different machine, so the doctor’s assistant/ultrasound tech had to call back the first ultrasound tech to help her locate the questionable area – at six o’clock, near the skin surface just below my right nipple. I guess/hope it’s a good sign that this thing wasn’t so easily found on the ultrasound. It’s not big and clearly defined like the tumor was ten years ago.

The biopsy itself was much easier this time. This doctor also was a good explainer and told me everything that was going to happen step by step. He demonstrated the loud snap the biopsy instrument makes when it takes out a chunk of cells, so I wouldn’t be startled by the noise. He cleaned and numbed a patch of skin, then cut into it with a scalpel so he could easily get the instrument to the site. The assistant meanwhile was holding the ultrasound wand pressed into my breast so the doctor could see what he was aiming at. This also blocked my view of what the doctor was doing (just as well).

As the doctor had explained, it needed multiple passes to ensure that he got at least two coherent samples for testing (“It has to be big enough to fluoresce under the microscope”). In this case he took three. I wasn’t feeling anything (“Usually these things don’t have nerve endings, but occasionally they do”), so I was not bothered.

It was all quickly over. The doctor complimented me on being a great patient. “I’ve had a lot of practice,” I said drily.

The assistant dressed the tiny wound, and the doctor said he would send the samples to the lab, marked “urgent” so results should be available in three working days. It would be up to the breast specialist to inform me of those results. The two doctors have worked together for years and “He’s a humane man” the biopsy doctor told me, implying (though not guaranteeing) that the specialist would not keep me in suspense about the outcome.

The annual checkup I already had scheduled was more than a week away, but I called the specialist’s office and thought that he would call me when he got the results. As of Friday, no call. Which could mean that the lab was delayed and hasn’t got the results to the doctor. Or the doctor has the results but (a) it’s good news, so he’s in less of a hurry to call me or (b) it’s bad news, and he didn’t want to deal with it in the final minutes of a busy workweek. Now I’m left hanging til Monday. At least.

So now… we wait. And I am forcibly reminded that you can never entirely leave the cancer tribe.

Later: I finally got a response from the specialist the following Monday via his secretary, “It’s ok.” Which presumably means no cancer this time around.

Later still: At the scheduled appointment, the doctor reiterated that all was fine, but to keep a closer eye on things he wanted to see me again, with new imaging, in six months. In February 2025 he told me to stop taking tamoxifen – ten years was enough. (Sadly, this did not make as much difference as I’d hoped to menopausal symptoms like hot flashes and interrupted sleep.)

2025: …and we did this all again the following year, when the ultrasound technician saw something suspicious in the other breast. This time Dr S wanted me to have the biopsy done by a guy in the same hospital as himself, not the clinic closer to home that I usually go to for imaging etc. This proved to be a very bad idea. The suspect area was deeper this time, and new guy couldn’t get his biopsy gun working correctly – he kept plunging it painfully deep into my breast, 6 or 8 times before he could get coherent samples. By the next day my (very large) left breast was almost entirely purple from bruising and very sore. Never going to that guy again.

On the upside, the ultrasound tech assisting him was more experienced than the one who had done the first imaging, and even before the biopsy began he told me that the suspicious area was mostly likely an imaging artifact, some benign tissue causing a shadow. Which proved to be the case when the biopsy was analyzed, but I went through a few more agonizing days of waiting and wondering. 

Six months later Dr S was preparing to retire and offloading patients to Dr G. My first visit with her everything was entirely normal, so we’re back to a yearly schedule, and now (August 2026)  I’ve just got through another round of imaging and visit – all is well.