A Second Lump

After He Said Cancer | A Memoir

She motioned to me to join her at the physical exam table. I got up without thinking, just as I had done thousands of times before in my career when another doctor asked me to double-check something on a physical exam.

“Here, put your fingers here,” she said. She was the third specialist that we had seen for male breast cancer. After several medical errors, I wanted a fresh set of eyes on his imaging and her opinion of the best next step.

She directed my fingers to an area a few centimeters away from his left nipple. The moment I pressed my fingertips down on the skin, I could feel it immediately.

It was a small lump.

As I pressed, the lump moved underneath my fingers. Normally, this was a good sign that it wasn’t tethered in place by the small octopus arms of the cancer beginning to spread in all directions. But his other lump had moved freely like this too.

Nausea came over me in a wave, and my legs suddenly felt weak.

In so many ways, it felt just like the one in his right chest that ended up being cancer. The one that required a year of chemotherapy and radiation, followed by two years of immune therapy. The one that nearly took his life when a blood clot formed near his port site and spread to his heart. The one that I secretly hated but was trying to accept for my own healing.

I returned to the chair and sat down before my legs buckled. My peripheral vision was starting to fade.

To my knowledge, no one had examined the breast tissue on the “normal” left side of his chest since he was first diagnosed three years ago. That was the last time that his team of breast cancer doctors had examined him thoroughly. During that visit, they were focused on the lump near his right nipple and the rock-hard lymph nodes in his right armpit.

Had anyone touched his chest since that first physical exam three years ago? Perhaps, the doctor in Boston did.

I tried to think back to that visit, which was a “second opinion” to rethink his care after his cancer team in Seattle began making mistakes. The Boston doctor must have examined his chest, but this was probably focused on the right side where the cancer had been removed. By that time, there was nothing but a long scar where the tumor had been. Even the redness from the radiation was also gone.

Wait. Did he examine him, or was the visit solely for counseling? I struggled to remember. Certainly, most of the visit was spent explaining recommendations that differed from the plan proposed by the Seattle team.

The physician was still examining the left side of his chest when her eyes met mine.

“Did they know about this?” she asked.

“No – no – no,” I sputtered, the lump in my throat growing. “I think this is new.”

“We need to check this out,” she said. “I will order a mammogram, and they will follow it up with either an ultrasound, biopsy, or both – depending on how it looks.” I knew the drill, having ordered tens of thousands of mammograms in my career.

I rose in my chair but quickly sat down again. There was no point in getting up, and I didn’t know if I could rely on my legs to hold me.

Male breast cancer was already rare, but to be diagnosed with a second cancer in the breast tissue on the other side of his chest was unthinkable. But not impossible.

I suddenly remembered reading that men with breast cancer have a higher chance of being diagnosed with a second cancer on the opposite side. When I read this, I assumed that it only applied to men with a genetic mutation predisposing them to breast cancer.

My husband couldn’t get a second breast cancer. Of this, I was sure. He had a normal genetic screen of more than 60 mutations known to increase the chance of developing breast cancer. He had been unlucky once. How could lightning strike him twice?

I looked over at him, lying on the exam table. He was semi-reclined and locked eyes with me. His eyes were wide open, eyebrows slightly raised, lips slightly parted. The strong and confident look that defined my husband had melted for an instant. He understood what this could mean.

The tightness in my chest was returning. The little grief demons had found their way back into my chest and were dancing at the thought of a mental health collapse. God, I hated them.

It felt like we were at the beginning again.

I couldn’t fathom it.

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If you would like to read other posts, here are a few:

1. How It Began. This story is the origin of my Substack and tells the story of the first moment when we learned of my husband’s breast cancer diagnosis. https://www.afterhesaidcancer.com/p/how-it-began

2. Dandelions in the Lawn. https://open.substack.com/pub/tigerinmykitchen/p/dandelions-in-the-lawn?r=1acedj&utm_campaign=post&utm_medium=web&showWelcomeOnShare=true

3. The Day He Proposed. https://www.afterhesaidcancer.com/p/along-the-salish-sea?r=1acedj

4. Surrender. https://www.afterhesaidcancer.com/p/surrender?r=1acedj