On October 17th 2023 I went to the hospital for an echography; the radiologist asked me almost immediately if they could perform a biopsy. So they stuck a needle in my breast and took out a few tissue samples. It was painful as hell and I ended up crying, confused, and trembling on the bed. The doctor asked me why I went alone for a check of this entity. Well, I didn’t know better, but there was my first lesson:
if you can, bring someone with you to medical appointments.

The radiologist that saw me on October 17th, booked me a mammography for 3 days later. I had never done this exam before, and it was very painful, especially because my breast was still suffering from the biopsy. But a mammography can highlight things that an echography cannot, so it was necessary. In the meantime, the results of my biopsy came in, and there was no doubt: “it’s cancer, a breast carcinoma, and unfortunately a triple negative one”, said the doctor.

The gynecologist explained the therapy plan and the additional exams that needed to happen as soon as possible. I was not alone, this time around, and I am forever grateful about it: I didn’t understand all of it, to be honest, too caught up in a whirlwind of thoughts, fears, questions. I was sent to the breast clinic, where a breast nurse was ready to talk to me. I just couldn’t stop crying. Everybody kept telling me I was going to lose my hair. It’s the only thing I can still remember very clearly. I was given a folder and a box: everything I needed to know was in there.

On October 23rd 2023 a series of medical exams started for me. The overall goal was to exclude cancer metastases in my body and to understand a bit better the general status of the disease. I started with a bone scan scintigraphy. It went down more or less like this: I was injected a radioactive substance, then sent home for a few hours, where I was allowed to eat and I had to drink a lot of water, the more, the better. For the exam to take place, the bladder needs to be empty (a full bladder can obscure the pelvis and the surrounding pelvic bones), so they asked me to pee right before getting on the table. The exam lasted around 45 minutes, which seemed an eternity as in the middle of it I realized I had to pee again, and I obviously couldn’t. Also, the camera moved very very close to my face without touching it: overall, an horrible experience. A few days later I had the results: the medical report stated that there were “no arguments for bone metastases”.

In the meantime, the multidisciplinary oncology consultation took place at the hospital. Radiologists, oncologists, radiotherapists, gynecologists, they all sat together to discuss, amongst others, also my case.

what was the verdict? what therapy plan they were going to propose to me? It’s all in a letter that I have summarized and translated to English, redacting privacy information and trimming it down to the essential core. Believe it or not: my entire future depended on this plan.

I had a short break of a few days, and the medical checkups resumed on October 27th, when a few things happened. The first of these things was a chest radiology exam, which showed that no pulmonary lesions were present or suspected. Another piece of the puzzle falling into place.

On the same day, I also had an abdomen ultrasound of my liver, gallbladder, and bile duct, which together can paint a pretty accurate status of your hepatic health - or lack thereof.

To close off this day, I also did a magnetic resonance imaging (MRI) exam with a contrast medium. The question to answer here was mainly: is my tumor a solitary lesion? or part of a bigger, scattered group? and how big is it? are my axillary lymph nodes healthy or not? This is the imaging modality for dense breast imaging: it’s also, unfortunately, very expensive.

On this day I met my oncologist for the first time.

I think I spent most of the appointment crying, first, and asking questions, afterwards. They explained - again, and in a greater amount of detail - the therapy plan, the steps still required for the actual plan to start, the side effects, and the overall goal we were trying to achieve: slow down the tumor proliferation, and hopefully kill it all.

You will lose all your hair, and it’s going to happen very, very fast.

Before starting chemotherapy, we needed to make sure my heart was healthy enough to endure it. So I went to the hospital for a full cardiological exam: an electrocardiogram followed by an echography. We didn’t expect anything to show up - I have never suffered from cardiological issues - but basically, like with everything, “you never know”.

At this point of the ordeal we still needed to take care of two things, and both of these had to do with implanting stuff in my body. The first thing we inserted was a little clip in my breast, a tiny titanium marker used to pinpoint the exact position of the tumor. If we were going, hopefully, to kill the whole tumor, the clip was going to guide the surgeon find the correct area for removal later on. Furthermore, the clip was going to be monitored during imaging exams in the course of chemotherapy to understand changes over time.

The very last thing before chemotherapy could start was the insertion of a port-a-cath in my body. A port is an implantable device that allows long-term central venous access, very useful for administering medications like chemotherapy, for drawing blood, or for providing intravenous fluids. With an implanted port, the medicine goes straight to a central vein, bypassing smaller, peripheral veins, and protecting them from damage.

Chemotherapy day (finally) arrived: the sooner I started, the better, obviously. Not sure what happened on the day, but I fainted while getting ready. The pain from the port surgery, the tiredness, the stress of it all, I just went down on my face. My oncologist suspected a pneumothorax (a collection of air outside the lung but within the pleural cavity) so I was sent to radiology for some x-rays.