So by now everyone knows my excisional biopsy was positive for cancer. DCIS with microinvasion, to be precise, with DCIS at every margin.

We all know what comes next. More surgery, punctuated by lymph node localization so they can do a biopsy at the same time.

The second excisional biopsy was a little bit different than the first primarily because of the lymph node biopsy that was done at the same time. The lymph node localization has to be done either the afternoon before a morning surgery, or the morning of an afternoon surgery. My second excisional biopsy was scheduled for afternoon, so I had morning lymph node localization. At least being at the hospital made it easier to remember I was n.p.o.

The visualization you don't get when you transcribe the report: I have never seen a needle that big before. I have also never seen an injectable that green. It didn't help my nerves any that they carry it around in a lead box. You know, when they say "the contrast material was injected," they skip the "with a big-ass needle" part. (Isn't that a term you'd like to see added to the next edition of Current Medical Terminology??) Thanks to a nearby supply of warmed blankets, I was freezing on one side and nice and toasty on the other while I waited for the radiologist. And you know you wait... and wait... why do they give you an appointment? I was, however, rather a captive patient - they'd taken my clothes up in outpatient surgery then wheeled me to Nuclear Medicine in a wheelchair. They must have sensed my plan to stop somewhere for coffee, because I had an escort everywhere I went. Or, maybe they were afraid I'd bolt. Thank God someone invented topical anesthetic: I closed my eyes when the big-ass needle was on approach and I hardly felt a thing. Once again, my overdriven imagination ensured that the real thing was really not that bad.

More warm blankets and more waiting, then they wheeled me up to another room for more waiting and more scans. The technician put an X to mark the lymph node for biopsy, then my escort dragged me back to outpatient surgery to wait some more. I went home later that evening, woke up the next morning and went back to work.

By now, this entire process was taking up a lot more time than I had allocated for it. I wasn't anxious for news from the doctor - I was quite certain we were done with that lump. I mean, I've done the reports. You don't get clear margins, you try again and you get clear margins and you're done. In my mind, the only news I was waiting for was whether or not the lymph node was positive and if I'd need radiation and/or chemotherapy.

So, the biggest shock of my life was when the doctor called and said there were no clear margins. As in none. As in not one. I know I was babbling - I kept saying "None? No clear margins? There were NO clear margins?" How could that be? I just had 1/6 of my breast removed! The lump was gone. How could there be NO clear margins? The second biggest shock was when she recommended a mastectomy.

I felt like I'd gotten on a train that was barreling down a track to somewhere I didn't really want to go but I was stuck on it. I was really trying to make the best of it but this news was a bit hard to take.

I never, ever typed a report and thought I'd be experiencing anything similar. I found I wasn't enjoying it at all. Reading the reports wasn't any fun, either - I couldn't find any mistakes. (Who does that account, anyway? You guys are good!) What isn't in the report is the tears, wondering how to tell husband and children (telling the cats was easy - they were very understanding), and wondering how much worse it's going to be before it gets better, IF it will get better at all.

Two weeks after I celebrated the 24th anniversary of the first time I gave birth and put a child to my breast, I walked into UCLA Medical Center to have a mastectomy.