Things I wish I knew before I found a lump in my breast

When Ann Marie O'Sullivan was diagnosed with stage three breast cancer, she didn't know what to expect. It's left a legacy, she writes, but it's not all of her.

Writer Ann Marie O' Sullivan convinced herself she didn't have cancer. But, she did. 

Being diagnosed with cancer thrust me onto an unfamiliar stage. I was told to play a part I didn’t understand. I thought I knew the gist of how the play might go. But it turned out, I knew nothing.

When I found a lump in my armpit I was sure it wasn’t cancer. It was sore and of all the things I thought I knew about cancer, it was that cancerous lumps were never painful. I told myself it would pass and played with it between my fingers, curious but not alarmed.

This was at the beginning of Covid and visiting my doctor wasn’t an option. The lump got bigger and I decided to check my breasts not because I expected to find anything, but because I thought I should. I found nothing.

All of Cork had concerns to discuss with the GP, but when I did reach her by phone I admitted that I had been poking this new armpit lump and I suggested that I was the cause of its soreness. She told me to stop poking it, it was more than likely swollen lymph nodes and without a lump in my breast it wasn’t concerning but it would be good to keep an eye.

She asked me to wait and see and ring her back in two weeks.

It stayed sore and the discomfort continued to reassure me. 

“Cancer isn’t sore”, I told myself any time my mind wandered.

Like any sensible person, I had Googled it. The first few links all said the same thing, cancerous lumps are hard and painless.

But I, and the internet, were wrong. 

The oncologist later explained, most cancerous lumps are not painful but some patients do experience pain.

During those two weeks, I checked my breasts more regularly and found a tiny nodule in my left breast. The lump in my breast was a strange discovery. It was smaller than a pea and I couldn’t always feel it. Some days, I couldn’t find it.

This was another thing I was sure I knew. I decided I couldn’t always find it because my breast tissue was just changing in density or texture with my cycle. This too was wrong. Changes in breast tissue don’t feel like this solid hard lump I had found. I know this now.

Still, I was worried enough to call her back and make an appointment. On the day I went to her I considered putting one of my daughter’s stickers on it. It was so elusive I worried I wouldn’t be able to show her. She found it and referred me on.

The registrar oncologist took three attempts to find it under my direction. It was miniscule. But it was there. 

Ann Marie O' Sullivan: 'Even before my appointment I set myself up as an armchair oncologist'

The cancer had started in my breast and had spread to my armpit where the cells were dividing further. He drew around it the pea shape with a marker, and around the large lump under my arm before I was given a mammogram and ultrasound where they discovered another lump further back.

Six biopsies were then taken from my breast and armpit while I asked when I would get a phone call. The appointment leaflet had reassuringly said most people only visit once and if needed, they get a phone call when the results are clear. 

I had no reason to think I wasn’t most people. In fact, even before my appointment I set myself up as an armchair oncologist and started researching how at risk I really was.

Being female is a risk. I conceded that I was a female. There is an increased risk for women over 50. I was 37. This was going well. Obesity was a risk factor, I calculated my BMI online and I was within “normal” range. Alcohol consumption increases risk, I rarely drink. I also don’t have any genetic disposition to cancer. These were all ticks in the “unlikely to have cancer” box.

I saw the risk factors as a prescriptive list of who got to play the part of cancer patient and who didn’t. 

Despite the slow dawning of the possibility that I had cancer, I told myself it couldn’t happen to me. 

At times I had myself convinced. But I was wrong.

But still, I asked about this phone call to confirm I was in the clear and when it might come. With droll surprise, I was told that anyone with six biopsies taken would be brought back into the clinic regardless of Covid restrictions. I nodded, feeling like I should know what that meant.

At that moment, I wanted to ask: “Do you already know that I have cancer? Is that why you are so sure I’ll be back here?” But that was too much to produce in the moment. Hospitals move quickly and during the pandemic everyone was trying to get out of the room as quickly as possible.

Later I learned to ask: “What did you mean by that?” and it’s still one of the most useful tools I have. It means I don’t have to decode what I thought they were saying and turn that around into a question. Instead, I can just ask them to be clearer. I learned to always ask because anything that worries me during an appointment will replay endlessly for me at home.

He was right. I was brought back. Once diagnosed, the full house lights came up on all I didn’t know. I was centre stage without a clue.

I thought breast cancer was one thing, and that you had this one thing or you didn’t. But there are huge differences between breast cancers. There are stages to breast cancer from 0-4, breast cancer can metastasize, there are different types of breast cancer and the different types result in a variety of treatment options.

Ann Marie O'Sullivan with her husband Stephen Fewer at home in Cork. 

I had Stage 3 Her2 positive breast cancer treated with neoadjuvant chemotherapy, surgery, and radiotherapy.

Out of all the scene changes I wasn’t expecting, or the dialogue I struggled to understand, the part I never anticipated was that I could feel this well again.

It didn’t seem possible that I could become someone who had cancer and doesn’t think about it every day. Since being diagnosed I’ve heard of women who had cancer 10, 15, 20 years ago and carry on living healthy lives. I didn’t know they existed and I wish I had.

Having seen cancer represented on television, by hearing distant stories of it, I thought I knew what it was and how it ended. It’s not possible or desirable to know everything about breast cancer. People’s experiences of it and their outcomes are hugely varied. There are millions living beyond cancer and I wish I had understood that that was true.

A time came when I was told the treatment was a success. People stopped directing me around the stage and everything grew still again. I remain unsure of what will happen next, but I’ve stepped off the stage and feel like myself again. Cancer was part of me, it’s definitely left a legacy, but it’s not all of me.

For now, I look forward to my next role because I’ve a feeling the best is yet to come.

Find out more

• If you have any concerns regarding a lump in your breast or armpit, or any other changes in your breasts – such as the nipple turning inwards, dimpled skin, an enlarged breast or nipple discharge, always consult your GP.
• Details of the eight signs of breast cancer are available at breastcancerireland.com
• If you would like more information on breast screening, breast cancer, it’s causes and treatments and a guide on how to check your breasts visit www2.hse.ie/breast