Lumpectomy 2022: Another Step In The In-Between

As I headed into my second lumpectomy, I was struck by how different it felt facing this surgery again.  I was less fearful of the actual procedure and more anxious about the possible results.  Instead of surgery to remove diagnosed DCIS, like my 2019 lumpectomy, this surgery was to remove a spindle cell finding.  The pathologists didn’t know if this was cancer or not.  Instead of being curative, this surgery was diagnostic. This was yet another step during the in-between.  Was the lump benign or cancerous?  Only full pathology would tell. 

Surgery Day, 2022

My alarm rang at 5:30, and I blinked out of my sleep.  It was time to get ready for surgery day.  I would have no breakfast or coffee this morning since I had an early check-in for localization.  

The shower was slow and therapeutic as I scrubbed my hair and body. I knew that I wouldn’t get another full shower for a week.  As the water fell over my body, I breathed in the steam and relaxation and tried to release any lingering worries.  Everything had fallen into place without a hitch this time.  My pre-op medical check and covid test were done.  All I needed to do was show up.

I was hungry as I walked around the lake with Dave and the beagles in the morning, but I knew I was facing walking restrictions after my lumpectomy.  So, I relished that time together, capturing mental pictures of the morning sun glistening off the lake.  

We left for the hospital about 15 minutes before I needed to arrive for localizing.  Unlike last time, this surgery would be done at my hometown hospital.  We could avoid the LA traffic, and Dave would be able to go home while I was in surgery.   

A Surprise Double Localization: Wire and Wire-Free

I arrived at the breast center to check in at about 7:45 AM.  Dave settled into a nearby chair, and I began signing forms.  To my delight, this would be the only time I would need to sign paperwork.  My check-in here was for both the localizing and the surgery.

When the nurse navigator called me the day before to review the procedure, I was grateful for her calming demeanor.  She would be with me right up until check-in for surgery and walk me to the OR.  Dave wasn’t allowed in this time around due to Covid protocols.  I was glad I wouldn’t be alone as I transitioned from the breast center to the hospital.

The localization process for my previous lumpectomy was challenging. The radiologist was unclear about which benign fibroadenoma to mark with the wire, and there was a significant delay as we waited for confirmation from my surgeon.  

This time, I confirmed with the women’s center beforehand that the radiologist and my surgeon were clear about where the lump was.  The wire was to be placed at the most recent biopsy clip at the 4 o’clock location. Everyone was clear where they were going!  That was reassuring.

I was surprised to discover that I would have two localizations.  I would have a wire placed as expected, but I would also have a wire-free localization done. The hospital had recently begun training the surgeons on this more modern type of localization, and my surgeon was transitioning to wire-free instead of wire.

There are many types of wire-free localizing devices available, and while I’m pretty familiar with the technology, this was the first time I would have one placed. 

Once the radiologist and I finished talking about why I would have both a wire and a wire-free device placed, I got positioned on the ultrasound table for the localizing process.  I breathed deeply and tried to relax as the numbing began. The burning and stinging weren’t fun, and I gripped the hand of my nurse navigator as the radiologist moved the needle around, ensuring I wouldn’t feel anything beyond the initial sting.

It went quickly.  I was numbed, and before I knew it, the device was placed.  I had no sensations of pressure or pain at all.  Then, she placed the wire.  Both localizations were done so fast that I didn’t have time to reflect on what they were doing.

After the wire was snipped and the area covered, it was time to get a mammogram to verify the placement.  This was the most gentle mammogram I’ve ever had!  I put on the purple imaging gown and gathered my things.  It was time to transition to the OR.

A Quick Transition to the Hospital

The nurse navigator and I walked out of the women’s center and looked for Dave.  I hadn’t realized it, but he had been in the car, searching for me, rather unsuccessfully.  I called him, and he pulled up to be my chauffeur.   We were at the hospital entrance in just a moment, and it was time to kiss him and say, “see you later.”

Since my lumpectomy was going to be an outpatient surgery, he wouldn’t be allowed up on the surgery floor.  I was glad that the nurse navigator and radiology tech planned to walk me to the OR. 

I walked through the hospital doors, remembering the last time I was there as a patient.  I had been in Labor and Delivery, giving birth to my youngest son.  The familiarity of the hospital hallways and the companionship of the nurses gave me peace.  While I wasn’t with my loved ones, I wasn’t alone.  I felt wrapped in grace and love as I walked in faith towards another surgery.

Getting Ready for the Surgery

The nurses opened up the double doors to the outpatient surgery wing.  A pre-surgery nurse immediately greeted me.  I said goodbye to the nurses from the women’s center, and he showed me to my room.

A gown, a cap for my hair, and some cleansing wipes were on my bed. He showed me the restroom and instructed me on how to get prepared.  It was a bit challenging to get myself all cleaned off without help from Dave, but I did it and crawled into the hospital bed.  

The nurse asked me questions about when I last ate and other things I can’t remember.  After he finished his paperwork, ran my urine test to ensure I wasn’t pregnant, and placed my iv, it was time for me to chat with the doctors.  

I talked with my surgeon and ensured he would call Dave after the surgery was done.  He glanced over all my paperwork, looked at the localized area, and exited the room saying, “Let’s rock and roll.”  

That was the last time I remember seeing him.  The anesthesiologist came in and talked with me, verifying the last time I had eaten, and talked a little bit about the process. A surgical nurse came in, and the two of them unlocked my bed.  I remember seeing the anesthesiologist put something in my iv and then them wheeling me out the door of the room. I saw the double doors to the OR, and the next thing I knew, I was awake.

In Recovery

I was disoriented when I woke up because I wasn’t in the same room.  I couldn’t even remember the OR!  The recovery team was there and quick to ask me how I was feeling.  I glanced down and realized the surgery must have happened because I was all wrapped up.  

“How did it go?” was my first question.  The nurse said all had gone well.  I breathed a sigh of relief.

“Can you call my husband?” 

She picked up the phone, called him, told him I was awake, and then I got to talk to him.  I wasn’t ready to go home yet, but it was reassuring to hear his voice.

The recovery area had a few other patients, and I could see the nursing team monitoring us with care. There was a bit of a delay in getting me some IV Tylenol, but the process moved quickly once that arrived.  

I got dressed in my bed, thanking myself for choosing easy-to-put-on clothing.  I had a front-close recovery bra, a loose-fitting button shirt, and an open flowing cardigan.  Nothing was too tight or difficult to put on in the bed.

Once I was all set, they removed my iv, and I got into the comfortable discharge chair.  It wasn’t a standard wheelchair like I’d been expecting.  This one was comfy and padded, like a fancy office chair.

I checked my phone and saw that Dave was right outside.  “Ok, he’s here.” 

After thanking the nursing team, I was wheeled out the doors, down the elevator, and right out to Dave.  It was 2 o’clock, but it didn’t feel like any time had passed.

I got up carefully and settled into the seat.  I pulled my mask off and smiled at Dave.  This part was over, and I would be home in just a few minutes!  

Getting Home

I was pretty happy for the rest of the day.  I wasn’t sure whether it was the relief that surgery was done or the drugs they’d used to put me out during surgery.  But, I was comfortable and happy to be relaxing at home. 

I expected to be dizzy like I had been after my previous surgery.  But I wasn’t.  I was careful every time I got up, but there was never any issue.

I wasn’t in much pain at all, but I decided that I would get ahead of any pain at night by taking my prescription.   I took a single pain pill before bed, anticipating that it would help me sleep and keep any pain from waking me up. 

 Unfortunately, the pill also had side effects of insomnia, anxiety, and agitation.  I laid awake in bed that first night until 2 AM, spinning about what the lump actually was.  What was going on?  Dave was sleeping restfully next to me, and I was still up. When I wasn’t up using the restroom – because I had drank so much water that day- I was thinking about all the worst-case scenarios.

This wasn’t working.  I pulled up my phone and decided to see if I could take anything to help me sleep.  Nothing quite like researching drug interactions at 2 AM…

Thankfully, Benadryl was allowed and wouldn’t have a critical interaction with the pain pill I’d taken four hours before.  Whew.  Perhaps I would get some sleep.

My mind finally quieted, and I slept a bit before the dogs woke us up at their usual time.  

Good thing I had planned recovery time off because I would need naps to make up for that restless night of sleep.  After that night, I decided to go off of that medication and transition to Tylenol.  

Reflections on this Second Lumpectomy:

This surgery felt different, and as I’ve been recovering for the past few weeks, that has been a consistent topic of reflection.  I remember feeling relief after my first lumpectomy because the cancer was out.  This time, I felt more anxiety post-surgery because we needed to wait a week for the pathology.  I had no idea what I was in for after surgery.  I could be done or need much more treatment.  

I felt much less anxiety about the surgery itself.  I had been through a lumpectomy before and knew what to expect.  For me, knowledge and experience lower my anxiety level.  Also, I wasn’t headed to an unknown hospital.  The familiar setting of the hospital was calming.

Everything went so much smoother this time.  There wasn’t any awkward transition time from the localization to the surgery.  Because I had been admitted to the hospital at the breast center, there wasn’t any waiting for me in the admitting department.  The hospital was quiet with the visitor restrictions, which made it peaceful for me as a patient.  

Pathology results: It was benign!

It was a week before my pathology was in, and while I have a post to write about that, I am ecstatic to share that the finding was a benign fibroadenoma.  Why this particular fibroadenoma was so mysterious on the biopsy remains unknown.

My stitches were removed two weeks after surgery, and my surgeon released me from his immediate care. I’ll see him again in about six months.  I will meet with my oncologist soon and discuss the pathology with him.

I’m grateful that these eight weeks of in-between have ended with such a positive result.  I’m still processing the mental and emotional turmoil of this latest challenge.  While I would have preferred to skip surgery, that wasn’t a choice that the biopsy supported.  Happily, for the time being, I’m out of this phase of the in-between.

Important Note: I am not a medical professional. Please take any medical questions you have to your care team. For more information, please see my disclaimer. All information on the page should be considered general advice only.