It has been 2 years since my mastectomy and immediate reconstruction with an implant. I am about to go to my annual plastic surgery follow up appointment right after recording this episode.

I always say that the plastic surgeon put me back together after the breast surgeon took me apart to remove the cancer (and the left breast in my case). So you will hear me say that the plastic surgery appointment is easy compared to the medical oncology or breast surgery follow up appointments. The plastic surgeon did her work and I recovered. It is essentially a “well-visit” and she does not have any focus on my risk of recurrence or my overall longevity.

I was completing my appointment check-in on my phone before going to the appointment and it hit me that some of the health history is permanent. Despite the abnormality of the breast that is listed in my health history in my online chart being an event from 2 years ago, I realized I am not ready to archive that content or remove it as a health condition in my chart.

Ultimately, I do want to put 2023 and all associated health problems (i.e. breast cancer diagnosis and mastectomy and the reality of survivorship hitting me hard), I am not ready to do so. Why? There are too many reminders of what it was like back then to even begin to list them right here. What happened then has changed me (sort of) and changed my life (for certain).

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Two things happened on the day I am recording this episode that make me think about how my life is different because of breast cancer. I was doing so well not thinking about breast cancer today that I forgot to implement the usual precautions for avoiding any bug bites on my left arm. I was bitten by an ant on my left hand at the end of my walk today. Tiny ants biting seems like no big deal, but the general strategy for lymphedema prevention is to avoid impairing the integrity of the skin on the side where a lymph node dissection has been done. This includes avoiding bug bites! I know the risk of lymphedema developing in my left arm is actually very low, but I do not want to do anything that would potentially allow for breakdown in the skin on my left arm or hand.

As I was standing at the sink washing my hands after the ant incident, a flood of urine ran out of me. It left urine running down over my ankles, with visible streaks of urine on my pant legs and on the footbed of my sandals. I had no intention to sit on the toilet at this moment. What does this have to do with breast cancer life? Typically, with a pause I am able to get control of my bladder. Today was different. I cannot say for certain that I am having increased urinary urgency or incontinence because of my breast cancer treatment, but the symptoms are much worse than before I started tamoxifen in 2023.

This urine flood reaffirms my recent decision to begin taking low-dose vaginal estrogen. I had discussed this option with my medical oncologist and my gynecologist last year. At the time I did not think I needed the estrogen, but after realizing the urinary side-effects I have are not getting better, I decided to get a prescription for vaginal estrogen. Without a cancer history, I would have not hesitated to add in estrogen as part of my peri-menopause or post-menopausal health care. Breast cancer life changes everything!

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Once I got my diagnosis of invasive ductal carcinoma, I was immensely scared of dying. I was shocked and sad about the diagnosis. I was sure I needed a double mastectomy, because I never wanted to get diagnosed with another breast cancer. My doctors did not recommend a double mastectomy. I only had the left mastectomy. I started tamoxifen a few weeks after surgery.

Now, two years since the diagnosis, I am confident that I will not be diagnosed with a cancer in my remaining (right) breast. There are two strategies in place for me at this time that lower my fear of another breast cancer developing. First, I now have a breast cancer screening plan that was developed with my oncologist, to best screen my dense breast tissue. This involves MRI and contrast-enhanced mammography. Secondly, and equally as important, I am taking tamoxifen. Tamoxifen is prescribed as my anti-estrogen or hormonal therapy, to reduce the risk of that prior breast cancer showing up somewhere else in my body. At the same time, tamoxifen has an effect on the tissue in my right breast, to halt the development of cancer. The way tamoxifen benefits my breast tissue will provide reduced risk of cancer in that breast for several years.

If you’d like to be the first to receive updates and exclusive content from the upcoming Breast Cancer Life newsletter, please email me at connect@breastcancerlife.org. I’d love to have you on the list!

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