Tanya's Lump

Tanya’s always been active and healthy. She and her husband Jeff are runners and they eat nutritiously. Tanya also has regular check-ups because she’s concerned about her family history of cancer.

Tanya never misses her mammograms because of this history. Her doctor always makes a big deal about also doing regular breast self-exams, so she makes an effort to do them sort of regularly. She honestly never thinks she’ll find anything.

One night, after her shower, Tanya does her regular self breast exam to check for anything abnormal. Something doesn’t feel quite right. 

She tells herself not to panic, that it’s probably nothing. In the morning, Tanya checks again. She still feels a little pebble-like area. Her plan is to call the doctor, and get it checked out.

Her doctor’s office tells her to come in right away - that they’ll work her in. Dr. Branton goes over her chart. She’s had annual mammograms since she was 40 and all have been normal. The last one, only 10 months ago, showed nothing suspicious.

Dr. Branton does an exam and confirms what Tanya has felt.  As he sends her for a repeat mammogram, he encourages her that she’s acted quickly so whatever it is will be caught early.

The appointment is set for the following day at Salem Hospital’s Center for Outpatient Medicine (COM). Tanya’s called that evening by Admitting to ‘pre-register’. This will speed up her entrance into the hospital in the morning.

When she arrives the next morning, Tanya goes directly to the 2nd floor of the COM and checks in with the person at Radiology Admissions. Tanya changes into a gown and has the mammogram. It confirms there is a suspicious area.

The radiologist recommends a biopsy. Tanya is transferred to a room called the stereotactic biopsy room. This biopsy procedure involves lying in a prone position on a table with an opening that allows the breast to be accessed.

Using a specialized imaging machine, the radiologist can view the lump and insert a needle to withdraw a ‘tissue’ sample to be studied. This is really a simple procedure with only a local anesthetic.

The results from the lab shows it’s malignant…cancer! That evening she shares what’s happened with Jeff. He’s very concerned. He’s scared, but determined to help and support Tanya in whatever she needs.

Tanya and Jeff meet the doctor to discuss treatment options. They are given lots of information so they can make educated decisions. The options that are possible for Tanya include a mastectomy or a lumpectomy, followed by radiation and possibly chemotherapy.

They’re referred to the medical oncologists who consult with them about their treatment options. The discussion helps Tanya make her choices, knowing that the advice she’s been given is from doctors and nurses who’re specially trained in the field of oncology. Tanya decides on surgery.

The surgery performed is a lumpectomy with a sentinel node biopsy. This means that the surgical team removes as much tissue as they can to get the ‘margins’, but no more in order to preserve the breast. A blue dye is injected into the main (“sentinel”) node, while Tanya’s in surgery to see if there is any cancer in that node. Since its negative, there’s no need to remove any more lymph nodes.

There’s a scar, but the breast remains normal-looking. Since this is a day procedure, Tanya goes home later with only tenderness and bruising.

Tanya recovers from the surgery and begins her 3 months of chemotherapy. She receives a peripherally inserted central line catheter (PICC line) in our SHAPES department, located on the 1st floor of the COM, for her weekly chemo.

She also has her lab work done weekly to monitor how she respond s to the chemo. She experiences some nausea as a side effect of the chemo. She finds her sessions with the dietician helpful.

Tanya loses all of her hair. Social Services refer her to former patients who offer support. She also attends the “Look Good, Feel Better” program sponsored by the Regional Cancer Center and the American Cancer Society.

Radiation is the other part of Tanya’s treatment. In the Radiation Oncology Department, the oncologist develops her 6-week treatment plan. The physicist and the dosimetrist assist the oncologist in the highly individualized treatment plan that will be used to deliver the radiation.

Protecting other body areas is very important. A radiation therapist delivers the treatment. A registered nurse (RN) develops Tanya’s care plan to address the side effects. During the treatment, Tanya and Jeff participate in the “I Can Cope” program, an ongoing educational and support class for cancer patients and their families.

When the treatments end, Tanya’s doing well. Her hair grows back. She regains her energy. She continues to have regular visits with her oncologist. It’s now been 2 years and she’s still cancer-free.

She really believes in early detection…getting mammograms regularly, doing self-exams and taking action at the sign of any concern. It’s true that cancer caught early is very often curable.

In the hospital, Tanya has a fairly large file that is handled by the Health Information Management Department.

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