29/05/2020

Tom had the day off so he could come with me for my appointment. My mum and a few friends had kindly offered to come with me, but I didn’t want to make too much of a fuss. And I really wanted Tom there.

We walked in again, this time along the north bank of the Thames. It was basically deserted due to lockdown. I don’t think I will ever be able to walk through such empty streets in central London again. The perks of a global pandemic.

We arrived early and had to have our temperatures checked again then answer the long list of questions before being handed a mask and allowed through to the waiting room. At reception, the lady said in no uncertain terms that Tom was not allowed to be there. Even when I told her I had been advised to bring someone with me, she asked him to wait outside. So off he went.

The clinic was running late (much more like the NHS I am used to) so I sat alone in the waiting room for close to an hour before being called through by Hannah. When I stood up alone, she worriedly asked me if I had brought anyone with me. I phoned Tom and he came upstairs and we all went into the consultation room.

This time I was seen by a female consultant breast surgeon, Laura. She was wearing scrubs combined with some very glam shoes, an odd combination but I admired the shoes. She also had a huge engagement ring that kept sparkling as I looked at it. Laura sat at her desk, I sat opposite, Tom next to me and Hannah accross the room from us.

“It’s not good news.”

I admired her directness. Laura explained that the biopsy results had come back as an invasive ductal carcinoma that was stage 2 (over 2cm) grade 2 (on a scale of 1-3, the cells inside were medium aggressive). I tried my best not to cry and tried to keep smiling. I really do hate crying in front of people.

The rest of the appointment was a blur but this is what I can remember:

• we still had to wait for the biopsy to be tested to see which receptors were on the cells (this would determine my treatment plan)
• I would definitely need some form of surgery and chemotherapy and radiotherapy
• the chemotherapy would likely bring on early menopause so I had to think about fertility treatment
• I could be referred to be gene tested for BRCA1/BRCA2 mutations

I needed an MRI scan to check for any other lumps, Hannah had been confident that I would want to get that done as soon as possible so had already booked one for me. The appointment was in 10 minutes over in the imaging department. Walking out of the consultation room to the main hospital, I broke down in tears. I did not want Tom to hug me as I knew this would make me cry even more. I really did not want to cry, but I couldn’t stop.

We were called in for the MRI almost immediately by a bubbly Australian radiographer called Tina. She introduced me to Neil, who went through a questionnaire with me to make sure I was safe to have the MRI – he then put a cannula in my arm so that they could inject the contrast. Contrast is a fluid used to enhance the image made by the MRI. Whilst sobbing I thanked Neil for placing the cannula so painlessly.

In the MRI room I had to lie on my front with my hands above my head. I had to lie still whilst the machine was scanning, which took 15-20 minutes. I wished I had blown my nose before lying down. As I lay there with my nose running, I just kept thinking that this couldn’t really be happening to me. It was a surreal experience in the MRI scanner. The machine is very loud, so I had earplugs and headphones on, as well as wearing my corona facemask and I had a blanket over me to keep me warm – all very claustrophobic. I felt as though I was in some kind of sensory deprivation tank.

After the MRI, we had to wait for the scan to be reported before going back in to speak to Laura and Hannah. This gave me time to call my parents to update them, I also had to update my brother Luke and tell my younger brother Ben the bad news – I had not told him anything this far.

Tom got drinks for us and we sat in the courtyard at St Barts and called our families to update them. It was a really sunny day and there were lots of staff sitting having their lunches outside. I kept thinking what a lovely place it would be to work.

Finally we were called back in to discuss the MRI results. Some good news: it was just the one lump!

We still had to wait for the receptor results before a final treatment plan could be decided but provisionally….

Best case scenario: the tumor is responsive to oestrogen, I could have surgery the following Friday at St Barts where they will also carry out sentinel lymph node biopsies which, if negative, means I only need radiotherapy.

Less good case scenario: if the tumor was not responsive to oestrogen this would mean that I would need to undertake 4-6 months of chemotherapy before having surgery.

We discussed what kind of surgery I would have. The choice was between a lumpectomy (removal of the lump with a safety margin) or a mastectomy (removal of the entire breast). The advantage of the mastectomy is that you reduce the chances of any recurrence. Tom asked what the chances were of recurrence, Laura told us somewhere between 0.5-1% per year of life left. So in 10 years time I would have a 10% of another cancer developing. I was prepared to take my chances and decided that I would go for a lumpectomy.

Laura told us that the cell testing results should hopefully be back by the end of the day and that she would call me as soon as she had the results. She advised going home and having a large glass of wine, which I did.

So now we wait.