Breast Cancer: ‘The way I see it, my new bra is half full, not half empty’

I was about to leave my doctor’s appointment for an ongoing discussion about my resistance to blood pressure tablets, when I remembered the rash on my breast.

“Could I have some ointment for this,” I said, pulling down my blouse a little. “It itches a bit.” Within minutes, the doctor had me up on the table and after a brief examination she declared I would have to go to the Breast Clinic in the Mater hospital. “I will write to them and they should get back to you in three weeks,” she said, “but if it goes any longer than that, get straight back to me.”

It was a rainy day in late November 2022 and as I walked home all sorts were running through my head. I am 83, and until then I had never encountered another elderly woman being told to present herself at a Breast Clinic. This kind of thing is usually kept under wraps, I suppose. I did a little research and found that according to Breast Cancer Ireland, 36 per cent of women diagnosed with breast cancer are over 70. Apparently, the risk of getting breast cancer increases as you get older.

When I told them (my eight children, their partners and the age-appropriate grandchildren), their responses ranged from concern, to incredulity, to plain disbelief. They had to believe it, however, when a letter arrived telling me to present myself on December 1st at the Mater, when I would have a mammogram and possibly a biopsy. The directions said to enter by the big red door on Eccles Street.

Menopause support must tread a fine line between awareness and stigma

---

Menopause: ‘We need to swing the pendulum to the middle and normalise it’

---

Playwright Marie Jones: ‘My mother told me there was no such thing as menopause in her day’

---

That door was to feature a lot in my life over the next while, but I didn’t know that then.

[ Breast cancer diagnosis: ‘I asked if I should bring someone with me. They said yes – so I knew what was ahead’ ]

My youngest daughter and housemate, Katie, came with me and we waited in the very crowded reception area. I had a mammogram and, after the doctor inspected the results, I was told a biopsy and scan were necessary. The doctor told us that the results were “suspicious and concerning” but she could say no more at that stage. The team would analyse the results and get back to me.

From the age of nine, when I had meningitis, to the present day, I have trusted the medical profession to do the right thing and take care of me.

Not a view shared by all my family. As some of them worried, I remained calm.

Two weeks later I was back at that red door with Katie. The biopsy and scan indicated that atypical cells had been identified in some milk ducts. The registrar explained that it was a form of “non-invasive breast cancer”. There were two masses rather than lumps, both far enough away from each other to be in two different quadrants. Because of this the treatment required was a mastectomy. Standard operating procedure in the case of mastectomy is to remove the breast and take a sample of nodes under the arm to ensure the cancer has not spread.

We went to another room where leaflets were given to us and one of the breast care nurses, Niamh, talked us through it all again. You know what it’s like when a doctor tells you something you weren’t expecting: the mind goes blank.

Niamh explained that what I had was ductal carcinoma in situ (DCIS). This is the earliest stage of breast cancer. It may also be described as precancerous. With DCIS, the cancer cells are formed inside the milk ducts but have not spread outside them. The next step would be another visit to the hospital for a pre-op to ensure I was fit enough for surgery.

The strangest thing happened a few weeks after my diagnosis. I had pain in my left breast which frightened me

Everyone was very concerned. Some members of the family questioned whether I should go ahead with surgery. Cancer cells in old people grow slowly – maybe I would be okay without the mastectomy. I listened to everyone but my mind was made up and I had no fear. Losing my left breast was not a problem. I had got enough use out of it through my long life and it would be no harm. When I passed the pre-op with flying colours, the doubters in my family, more confident that I could survive the operation, became reconciled to the idea.

The most wonderful thing about my experience in the Mater was the treatment I received from the breast care nurses who were at the end of the telephone at any time to provide information, tenderness and compassion. The strangest thing happened a few weeks after my diagnosis. I had pain in my left breast which frightened me. I telephoned Noreen who told me that this happened very often. It could be your body talking to you she said, confirming that something was amiss but bear in mind you had a biopsy a few weeks ago and it might be that too. She calmed me and I was grateful.

I was keen to speak to someone who had been through the procedure, so one daughter put me in touch with a lovely lady in Ballybunion, Co Kerry. Collette had had a mastectomy six months earlier and was happy to talk to me about her experience. We chatted several times both before and after the operation. It was a great help, she described a very positive experience, although I was later to wonder if in the words of the Scottish poet Thomas Campbell, distance had lent enchantment to the view.

[ How to be ‘vigilant but not fearful’ about cancer recurrence ]

Christmas came and went and, near the end of January, 10 weeks after I had first seen my GP, I was called for surgery. It was 5am on a Monday morning as I walked to the Mater with Katie beside me pulling my little suitcase. “Another great adventure,” I said to her as we approached the ward. I was grateful that my glass half full approach to life endured even as I contemplated having only one breast.

At the hospital, a physiotherapist came to instruct me about the exercises I should do immediately after the operation to ensure mobility in my arm. I changed into my gown and two hours later walked to the anaesthetist who chatted away the way they do to keep you calm. “I see you are a writer,” she said, looking at my notes. “Oh yes,” I replied and I was just about to tell her the title of my latest opus (Openhearted, available in all good etc etc) when bang, I was gone.

I woke up with a local anaesthetic drip and a Jackson Pratt drain in my side to remove blood and fluid and help the wound heal. The next 48 hours passed by with visits to the bathroom, which invariably involved me getting tangled in the tubes attached to me. The breast care nurse fitted me with a post surgery bra and told me that I could call in again in a few weeks to collect another. They are available in Marks & Spencer and Penneys, I was informed.

I was discharged from hospital after a two-night stay armed with a large prescription. Two weeks on antibiotics, one week on a stomach tablet, paracetamol and ibuprofen, with a table showing when the medication needed to be taken. The bulb attached to the drain had to be attended to and the discharge measured twice a day, and thank goodness for Katie in that and in many other regards.

I have learned that the chest rash probably had nothing to do with the cancer

I have been known to miss the glass when pouring water from a jug because of impaired sight due to macular degeneration and it would have been an impossibility for me to do it without her help. The Breast Care nurse telephoned every three days to check the amount of fluid discharged until finally it was all gone. This meant another walk to the hospital to have the drain removed and home for a much-wanted shower.

For those first few weeks I rested, did my arm exercises and went out for a short walk each day. I had an upset stomach, due to the medication, but this improved over time.

The much-awaited day came on February 23rd when the surgeon confirmed that all cancerous cells had been removed and, in fact, I had been “on the cusp”. In other words it was caught in time and no further treatment was necessary. “Come back in a year,” he said.

I write this to appeal to other older women and to the kind people who care for and love us: be mindful of breast health in older age. Our chances of breast cancer increase as we get older and yet, for some reason, screening is not automatically available to people over 69.

I am happy to report that I am fit and well two months post-op. The way I see it, my new bra is half-full, not half-empty. I have learned that the chest rash probably had nothing to do with the cancer, although asking my doctor to look at it was the reason the cells were discovered. I am grateful and count myself a very lucky woman.