“My life is otherwise completely back to normal, and I am very grateful, every day, to be a ‘Pink’ survivor.”
Sharon Van Der Nest
On Friday 13 September 2013, I trundled off to the Well Women Clinic in Harare for my annual mammogram and breast scan. Actually, it was almost 14 months since the last visit and I was a bit concerned that my right breast had changed shape slightly over the past few months. There was a puckering of the skin on the right underside of my breast, which I decided was due to a 7kg weight loss program I had been following. Hoping for no delays, I had a lunch date with the girls from work at the Fishmonger Restaurant and was looking forward to a cold gin and tonic!
After completing the breast scan, Dr. Mvere the radiologist expressed concern at two irregular dark ‘masses’, one in each breast, that were not consistent with fibroadenosis [non cancerous breast lumps]. She strongly recommended that I return to the clinic on Monday for a core needle biopsy to ascertain if these 2 masses were malignant, or not.
I left the clinic for lunch in a fairly dazed state and remember what a beautiful day it was…blue skies and sunshine and the possibility of breast cancer prognosis…I had lost my husband to pancreatic cancer in January 2011 and was fearful for my two daughters.
Monday 16 September.
I underwent the core needle biopsy which was a relatively painless procedure and involved removing small samples of breast tissue [3 from each breast] using a hollow ‘core’ needle. At this stage I had not mentioned anything to my daughters for fear of alarming them unnecessarily.
Wednesday 18, September-4pm.
I was in my car parked in town and I called Georgi at the Well Women Clinic to check if the results were back from the Lab. She kept me holding for a minute or so before asking if I was near a landline because Dr. Ingrid Landman wanted to talk to me.
I knew then the results were positive.
Dr. Landman explained the core biopsies from the right breast showed a lobular carcinoma- grade 2 and from the left breast a ductal carcinoma- grade 1. She was, however, so positive and reassuring and reminded me that breast cancer, diagnosed in its early stages, was treatable.
When I told my daughters the diagnosis, they immediately panicked, but I was calm, because I had to be, and I felt ready to deal with whatever came next! What a journey to embark on…
Dr. Landman referred me to Dr. Carol Ann Benn, a specialist breast surgeon who heads up the Netcare Breast Care Centre of Excellence at Milpark Hospital in Johannesburg, and was advised that Dr. Benn would undoubtedly recommend a sentinel lymph node biopsy to ascertain if the cancer had extended into my lymph system, or if it was just contained in the breasts. She also said Dr. Benn would probably perform a bilateral mastectomy and depending on the results of the biopsy, there would perhaps be the possibility of a breast reconstruction, performed immediately after the mastectomy! I hoped this would be the case as I was fearful with thoughts of the disfigurement in losing my breasts..
Saturday 28 September
I flew to Johannesburg 10 days after the diagnosis, with a consult booked with Carol Benn at 6pm that evening! During the week before I left, I felt strangely happy to be alive although anxious for what lay ahead.
Her waiting room at Milpark was very busy but friendly, informal, and comfortable. When she finally called me at 8.45pm, I was surprised to be greeted by a tall, slim, blonde woman dressed in faded jeans and a sweater with her hair casually tied back. She gave me a big hug and a smile, and I was immediately reassured! She was confident, professional, and impressed with the detail of the lab report from Harare.
She explained their medical team approach at the hospital. The method insured all patients that after being diagnosed with breast cancer, they would be presented to a multi-disciplinary team consisting of a cancer surgeon, a radiologist, pathologist, reconstructive surgeon, oncologist, radiation oncologist, psychologist, and nursing sister who would work together on a united decision to find best way forward for the patient! I felt in good, expert hands.
The first step was the sentinel lymph node biopsy which was performed under light general anaesthetic 3 days later. It involved a small cut under both arms, about 2cm in length, with the sentinel lymph node being removed along with 2 to 3 other lymph nodes which were then sent for pathology. A small drain to drain excess fluids was inserted on both sides and stayed in for 3 days.
5 days later the results were ready… The cancer had not spread into the lymph system and depending on the success in the removal of all of the affected breast tissue during the mastectomy, hopefully there would be no need for chemotherapy or radiation.
How lucky was I! God was looking after me!
A skin sparing bilateral mastectomy with prosthetic reconstruction was recommended by the team, and I was booked for surgery 3 days later. I met the handsome Charles Serrurier, the plastic and reconstructive surgeon who was appointed to do the reconstructive surgery.
The nursing staff at Milpark were amazing. They showed kindness and compassion at all times and were efficient and professional and very friendly!
After recovery from the anaesthetic, I awoke with fairly severe pain in my right breast and a feeling of weight on my chest, but was thankfully hooked up to a pethidine drip which was soon very effective! I was bandaged around my chest area but actually felt a sense of relief to still have boobs [albeit not real ones!]
Remarkably I was discharged 36 hours later, with pain relievers and again with 2 drains inserted under my arms and pipes draining into a measured dispenser which I carried around in a wooden box like a handbag!
This was to stay in place for 2 weeks, and in that time I visited the hospital twice to remove the excess accumulated fluid. During this time the bandages were removed to reveal two brand new perky breasts, very swollen of course and without nipples… I initially experienced a strange sense of loss at this discovery but was assured by Charles that a year later, I could come back when everything was healed, and he would construct new nipples from skin off my stomach and the existing flat areola skin that remained. This I duly did a year later. Carol Benn was very confident that there had been a very safe 10mm margin between the tumours and the skin of the breast and hence no need for chemotherapy or radiation! She sent me for a consultation with Devon Moodley, the oncologist who prescribed a 5 to 10 year course of tamoxifen, taken daily, to stop my body producing any more estrogen. 3 years later, I suffer no side effects from this drug, apart from hectic hot flushes. My life is otherwise completely back to normal, and I am very grateful, every day, to be a ‘Pink’ survivor.
