When we moved to France in 2003 I visited our local GP for a prescription for hormone replacement therapy (HRT) but was told I had to visit a Gynaecologist for assessment first. I had been taking HRT for years but understood this was the French way so agreed to go. My GP rang his local contact in the next town and made an appointment for me for the next week, apologising for the delay!
The following week I trundled off to meet the consultant and was subjected to a full body examination. I was a bit shocked as this did not involve any respect or dignity towards me as I was ‘laid out’ without even a towel to cover the areas not under examination. Anyway I was given authority to take HRT but told I had to attend the next specialist in this game, a Radiologist for mammograms.
I had entered the UK system of routine screening before we left the UK so was aware of the need to be vigilant and the following week I visited the Radiologist. He was a real character and at each visit referred to me as an Anglo-Saxon.
Every town in France seems to have a Radiologist’s office, either in a house or bigger building and the queues are always enormous. It appears checking out the internal workings of the body either by X- Ray, UltraSound, Scanner, MRI or other means is prolific. Patients keep all their X-rays and other results so large envelopes are also a feature in the waiting rooms.
The mammograms were completed and possible micro-calcifications (calcium like deposits) detected. These I gathered were not too serious but had to be monitored in case they were micro-calcifications which can turn cancerous. Imagine looking at the black sky on a clear night, with lots of stars twinkling, this is what the deposits on the mammogram x-rays look like.
For the next two years I was ‘mammogrammised’ six monthly to see if there was any increase in the twinkly stars and as the rate of increase was slow, this was reduced to annually until 2008 when the Gynaecologist and Radiologist decided I was safe to be ‘put’ into the French two yearly screening programme. As you can imagine my collection of enormous envelopes was becoming quite heavy.
All was well in 2010 and following our move to Normandy my new GP added me to the screening programme in our department.
In May this year I was summoned to the ‘booby bus’ in Domfront and following the mammograms was ushered into a small room where an elderly, probably retired but earning a bit of extra money, doctor proceeded to jiggle my boobs around. At least I assume he was a doctor, nobody introduced us.
A couple of weeks later I got a letter saying I was to have further investigations and to contact my GP. Here we go again I thought and called the GP surgery for an appointment for the following week. Two days later my GP rang and said I must call to see her that evening at 6.45. She told me I had to go to a local Radiologist for a further, close up mammogram and I had an appointment for the end of the week.
After comparing the piles of previous x-rays and this new close up one, This Radiologist decided the increase in twinkly stars warranted a biopsy. So it was back to the GP who rang her local Gynaecologist pal. Apparently in France some Gynaecologists go on to specialize in breast cancer diagnosis, treatment and management. I fleetingly wondered if male breast cancer victims had at last got the chance to visit a gynaecologist!
The following week, my elder daughter, Elizabeth, had literally flown over to France and off we all went to continue this route of investigations. This doctor was an absolute scream. He looked at the X rays, did an ultra sound and then looking very sad explained that the amount of possible micro-calcifications in two areas was not good, and he classed them as Stage 5, which has a 95% chance of being cancerous.
He explained that this type of cancer was not urgent for treatment as it is an ‘in-situ carcinoma’ it lives in the milk ducts of the breast, official title ‘Ductal Carcinoma In Situ’. He told me if one area was cancerous I would have to have a lumpectomy followed by radiotherapy, but if both were cancerous then I would have to have a mastectomy. Radiotherapy would not be required in this case but he would take a lymph node to check there was no spread, although it was highly unlikely.
I told him if it had to be done, then that was life and I had no plans to work as a magazine model. We then had an hysterical, yet tension reducing conversation about me not being able to get a job as a sex worker and went through, for some reason, all the English and French words for a prostitute. He is such a sweet man, he took my hand and told me everything would be alright. As a nurse, it was very odd for me to be on the other side of this conversation. I had often wondered what it was like, and I was surprised how detached, positive and matter of fact I was about the whole issue. I probably sub-consciously decided to deal with the situation IF we had a problem, and there was a 5% chance it would be OK.
He then proceeded to telephone a specialist Radiologist for an appointment for the following week. I was totally calm about all this twinkly star stuff going on. Elizabeth had to return to work so could not stay, but she left me in the capable hands, as always of my dear husband, Don, who is a calm, unflappable soul.
The following week we undertook the first of four two hour round trips. The first was for a ‘feasibility study’. All these appointments were conducted in French, which probably lessened the tension for some strange reason. More x rays were taken by a delightful radiographer, Melanie, who specialises in this procedure. To my amusement the long couch in the room with the hole in it was not a spa style face in the hole massage couch. I had to lay flat, on my stomach with the object of inspection poking through the hole. More x-rays and measurements were taken in this position and finally the Radiologist arrived and said a ‘Mammotome’ was to be undertaken. This is a biopsy of the twinkly stars to see if they are micro-calcifications and have turned cancerous. I was given a prescription to get dressings, local anaesthetic, a twelve foot bandage!!! and surprisingly, ‘arnica’ which I had to take prior to and after the procedure to reduce bruising.
I asked if this was hereditary, thinking of my two daughters and any risks for them, he replied it was not. I also asked why in one boob and not the other and he replied “It is like hand basins, some have calcium deposits, some don’t” Mmmm.. OK ….got that.
The following Wednesday, at the appointed hour I left my poor husband to wander aimlessly around the town for the projected two hours the procedure would take and taking a deep breath entered the room with the boob couch. I lay flat on my stomach in the required position and even more x-rays and measurements were taken and then the couch was raised in the air. I now know how a car must feel when being jacked up for a tyre change. The Radiologist entered the room, smiled at me and sat beneath the couch on the right hand side. I felt the local anaesthetic injections. Not too bad, rather like the injections at the dentist. I felt no discomfort at all during the following invasion of my body except when I saw, a few minutes later, a bloody scalpel (literally) pass before my eyes.
Then I heard a noise, imagine a small drill, or a nail gun…. bang bang, rat a tat tat, bzzz.. etc……. This was obviously the machine withdrawing the samples to be examined. Apparently 4 fragments of 2.5cm were taken from one area and 5 fragments of 3 cm from the other. After this two steel clips were inserted into the areas. These are permanent and for future reference for the suspicious areas. I asked Melanie if these set off airport scanners and she shook her head and laughed saying I was only the second person to ask that, the other being an English woman too. French women ask if they fall out. Still pondering on how and where they could fall out!
I felt absolutely nothing. It took over an hour for this performance, then I was told to lie on my back and hold an ice pack to the wound site for 45 minutes. The bleeding stopped, steri-strips aplenty and a dressing applied then I was compressed into the 12 foot bandage and allowed to leave.
Dearest Don was waiting in the car for me, so relieved it was all over. He whisked me off to the local McDonald’s for a double latte before we drove home, slowly.
Two days later, I had to go back again for a routine check of the wound site and for an ultrasound to check the level of bruising. All was OK and I was reminded I had to do as little as possible for 15 days. No problem for me, that doing nothing business!
So despite feeling sore, as would be expected, the whole procedure was tedious rather than painful.
After ten days I returned for the results. This required another flipping mammogram to be done. Melanie and I are best pals now, obviously, so I told her I was going to do one on her next. Then I saw the doctor for another ultrasound and he said the bruising was minimal. After this he took my hand and told me the results were good and there was no problem, at this time. One of the samples showed I do have micro-calcifications, but they are behaving at the moment, and the other sample showed I had none. Next thing, I have to go back to the Gynaecologist to give him the results and then go through a monitoring procedure, more ghastly mammograms and ultrasounds, in the first instance, in 6 month’s time.
I was one of the lucky 5%, but who knows if this will change in the future. My husband, children, close friends and Facebook and Twitter pals have been so supportive and I am keeping the glass half full and staying positive!!
My experience of a biopsy has been positive this time, but my thoughts are with anyone, and their friends and families, who are going through the trauma of diagnosis or treatment of breast cancer.