The referral was a fortnight later on 27 October at the Borders General Hospital (BGH), where I met my breast cancer consultant, for whom I had prepared. I had googled him, worked out what sort of character he would be, and was ready for him being mildly apoplectic that (I had guessed) there were no notes, no scans, de nada from Homerton Hospital to give BGH's team some clues about what lumps had been where previously. They only had my unreliable word for it about my previous pathology.
I had mammograms with the best mammographer on the planet, and then off to ultrasound for the first encounter with radiology. The initial radiologist had a look for a couple of seconds, took one picture, did the calm flustered thing, and went to get the consultant radiologist, who then set to. The consultant radiologist is awesome. He efficiently took a number of biospies of The Lump, photoed everything else, lead me through a discussion about what he thought were 'troubling, concerning, suspicious' areas and said he would send me off for an MRI to identify what would need biopsies next, instead of biopsying absolutely everything, which would have meant another six or seven biopsies. The radiology team suggested ask them a lot of questions. So I did that and asked about being referred up to Edinburgh as the centre of breast cancer treatment for South East Scotland. I learned all the same consultants from Edinburgh work at BGH. There are fewer patients at BGT needing treatment so there is more time per patient, although of course there are the usual pressures on the service. Edinburgh breast cancer unit, with its much larger usership, has longer waiting times and shorter surgery slots. I would have a shorter wait for surgery and much more of a chance of having a single operation to remove of cancerous tissue, including having a full mastectomy, and combine it with reconstruction than in Edinburgh where most mastectomies and reconstructions have to happen separately.
After radiology, it was back up to mammography to picture the marker the radiologist had put in to show what he had biopsied, and then in to see the consultant breast surgeon who was still frustrated he had no notes from Homerton. He explained everything I had already guessed or discovered about the lump, and did the doomladen positivity thing, explaining they would have a pathology meeting the next day to discuss initial findings and whether I should have an MRI. He also said that once the results were back the following week, there would be a pathology meeting on the Friday to decide about next steps, and I'd be told the initial biopsy results and those next steps by the specialist cancer nurse on the following Monday, in ten days time.
The biopsies were bleeders, as I discovered later that day, feeling a warm oozing spreading out across my knitted top, and I improvised with new just-out-of-the-packet antibacterial dishcloths as excellent bra padding, stopping further staining or snagging on clothing and keeping the risk of infection down. I worked out that I should have sat still more for the first 24 hours, not tried to do light chores. I was in some pain but paracetamol worked and after a couple of days I was fine. The bruising and scabbing was a bit startling for others to see, though.
The next day, I got a late evening call from the nurse specialist, following the initial pathology discussion. Yes, I should have an MRI and it would be in a few days' time.
I took the following week of waiting for the biopsy cultures to grow and deliver, to do some internet searching. I had made sure I got a good look at the ultrasound screen during the biopsies to get an idea of The Lump's shape, so I went through all the pictures on an ultrasound pathology images website, recognising all the lump shapes from my fibroadenomas before and picking out two or three possibles for The Lump, all of which were cancerous. The main aim was to get used to the language being used to describe the lumps, the pathology, the treatment decisions, the look of what MRIs and other scans look like - general background padding onto which I would be able to place the words of my own diagnosis, when I got it.
I also started the phone round, warning close family and friends what was in the offing, basically preparing them to get calls in the following week they might find uncomfortable.
