I Found a Lump

I found a lump under my right nipple.

My first thought was, “Oh, God, no…”

My next thought was, “There is no way in Hell…”

Then they dam broke and the thoughts flooded in:

• “Now you will really be able to relate to you friends’ journeys.”
• “But I already cared deeply about them. I didn’t need to experience it too.”
• “No, this has to be something else, the odds are different for men.”
• “But I have male friends with breast cancer.”
• “Still, the odds are in my favor.”
• “But maybe I was drawn to breast cancer for this very reason.”
• “Shit.”
• “I know exactly what treatment for this looks like.”
• “I’m nowhere near as tough as my friends who have gone through this.”
• “I’m glad I got health insurance last year.”
• “I’m glad I have life insurance. I wish it was worth more.”
• “No one is going to believe me.”
• “Maybe it will go away.”
• “I’m scared.”

This wasn’t discovered with a self-breast exam. I found it because there was a sharp pain above my nipple. It was sensitive to the touch, I could feel it when I stretched, I could feel it when I rolled over on it as I slept. Then I stopped sleeping because it bothered my head more than my chest.

Fear would bully me all night long. After one very restless night I sat down on the couch with Jamie and just blurted out, “I think I have breast cancer.”

She didn’t laugh at me, she just listened. It was what I needed. I decided to give it another week to see if it was something glandular that would simply go away.

It didn’t.

In the midst of this scare I was trying to get my article on Metastatic Breast Cancer finished for the local paper, finishing plans for the American Cancer Society 5k fundraiser that I was helping with, and wrapping up the portraits and stories for the Reveal Mission that would be exhibited at BSU. One afternoon I sat recording a story of one of my friends and I just blurted out that I had found a lump. She responded by asking me why we were working on her story when I should be focused on my health. I promised her I would make steps that day.

I called my wife’s doctor first. I know, that doesn’t make much sense, but when we found a lump in Jamie’s breast years ago when she was breastfeeding he was who we went to. He diagnosed it as a swollen milk gland, patted us on the back for being vigilant, and didn’t even charge us for the office visit. He has been her (thus our) doctor for 25+ years. I figured he knew a lot about breasts.

His office gave me a referal to a specialist and they called me the next day. I was surprised to find out that the first available opening was two months out. Honestly, what is the good of early detection if you can’t get in to see a doctor for 60 days? I’ve seen how fast some tumors grow.

It was at this point I knew I needed advice. I have made myself available to help share the stories of women with breast cancer. These women have become close friends. They have trusted me with their journeys and I knew that I had to, wanted to, needed to reciprocate with my own healthcare journey.

All of them gave me the same, basic advice. “You have to be your own advocate. Do not wait 60 days on this. Get seen now.”

I listened. I called one of the breast cancer centers and tried to set up an appointment. I was informed that I needed a referral. Even though I had avoided him at the beginning, I called my doctor. He saw me that same day.

In retrospect I wish I had called him first. The reality is, he knows me. When he came into the room he asked good questions, he examined me and my nipple, and then we had a good talk.

I told him what I already knew – my nipple is sore, and that is good, because most breast cancer tumors aren’t painful. My nipple still looks the same, it hasn’t changed, is normal color, hasn’t inverted, and isn’t expressing fluid or blood – and all of these things are good. I know the typical breast cancer signs too well.

And then he told me what he knew – that because of the work that I do, because of my friendships, because of what I do know, that he knew I (and thus, he) wouldn’t be satisfied until we had proof this wasn’t a serious issue. He ordered a mammogram and an ultrasound.

Then he looked me in the eyes and said, “Chad, I could send you across the street for emergency tests right now. Yet I know your heart and I don’t think you want to take the place of someone else who may need those emergency scans today.”

That felt right. If he thought I could wait two weeks for the diagnostic scans, I would peacefully wait as well.

He never once made me feel stupid for feeling scared. He didn’t belittle my pain. He didn’t shame me for relating to the stories I have grown so close to. He did, however, offer this statement on my way out of the exam room, “And for goodness sake, you are already empathetic enough with breast cancer survivors. You don’t need to go through the same thing yourself for them to accept you any more!” That made me smile. It didn’t, however, make the pain go away. Though I waited another 12 days for the scans, my symptoms didn’t change.

This health scare has given me a different perspective. Now I truly know what it feels like to find a lump. I have felt the breath of breast cancer raising the hair on the back of my neck. I know what it feels like to wait, in fear. I know what the difference is between a screening mammogram that is done just to make sure there is nothing suspicious in the breast tissue, and a diagnostic mammogram that is done because something has already been found.

I also recognize that my journey is quite different from that of my friends. I don’t think that as a man I would be shamed by a diagnosis of breast cancer as some men have been. This is due to the fact that I’ve been educated in this area and know that it isn’t just a ‘woman’s’ disease. I wouldn’t have the same emotions to deal with if I had surgery and lost breast tissue and a nipple as many of my female friends have. I wouldn’t have to deal with the decisions around reconstruction, modesty or scarring. If anything men’s scars are considered badges of honor.

Even so, I don’t need no stinking badges.

Today was my scheduled appointment for a mammogram and an ultrasound. I have a lifelong friend who is a nurse in the clinic and she made time to sit with me and answer my questions and walk me through what to expect.

She explained that at worst I would know today that if they found something they didn’t like. It was even possible they might be able to fit me in for a biopsy this afternoon if needed.

Before my mammogram they put a Spee-D-Mark sticker on me to help quickly indentify the location of my nipple and the lump in the imagry. 

She introduced me to the technician who would perform my mammogram. I asked her if we could call it a man-o-gram and she was happy to comply. As she was clamping me in I told her that I had always wanted to witness one of these procedures, but I hadn’t expected to be quite this close. I was surprised by how much she manhandled me, but then maybe that is normal when a person doesn’t have a lot of breast tissue. It was awkward fitting into the machine, but I think I was much more focused on getting results than having any concern for how the procedure felt.

She invited me back to her screen to show me the comparisons between my left and right breast images. She showed me the blood vessels, the lymph nodes, and the position of the small bb she had taped to my right nipple before we took the scans. While the tissue under my right nipple is a little different than that on the left, it didn’t look like a drastic difference. It also didn’t show anything that looked like a lump or a mass. She left the room to consult with the radiologist and returned within a few minutes.

My man-o-gram images were clear enough that the radiologist didn’t feel the need to do an ultrasound. They diagnosed me with gynecomastia.

Before you are concerned that they are going to send me back to Jamie’s gynecologist, let me define the condition. Gynecomastia is a painful swelling in breast tissue in men caused from changes in hormones. So no, I don’t have breast cancer, but I guess I am in man-o-pause. It will probably just go away. If it doesn’t, I’ll go back and see my own doctor.

This afternoon I sent a message to the survivor who pressed me to take action when I was interviewing her. When I explained that I am just a hormonal man with sensitive nipples she responded that I should be wary of hot flashes and be grateful for nipple sensitivity. She no longer has hers.

I am grateful to have gotten results back today, and positive ones at that. I know there were others sitting in the waiting room with me today that won’t be feeling the same way tonight.