I Know The Pain..

I know the pain. Segmental Mastectomy

Sometimes, some maladies leave a profound effect on our minds and heart. That might be an episode in our life or in our loved ones' life.

One of my very dear friends has experienced a pain that can break a person both emotionally and mentally. But rather than succumbing to despair, she bravely fought against her illness and chose to rise above all odds. The way she dealt with the unfortunate disease teaches us how to be optimistic and cheerful in the most gloomy times. That is why I have decided to pen down her story as it's not only inspiring but also gives us awareness about some rare disease conditions.

Shabrin, a charming and soft-spoken girl, was born and raised with the silver spoon in the Land of beaches, Goa. Being the youngest child in the family, she was loved and pampered by all, her life not less than a fairy tale princess! With excellence in academics, she completed her High school and soon her parents found her soulmate, Naahid. He was one of the nicest persons in the world and so without giving another thought she married him at the tender age of nineteen and moved to Visakhapatnam. 

Naahid and his parents warmly welcomed Shabrin into their family. Her caring and generous nature soon won everyone's hearts and she was happily living her marital bliss. Three years later, when she was planning to have a baby, she was diagnosed with PCOS (polycystic ovary syndrome). The reason anticipated by the doctor was quite out of the blue. Accordingly, exposure to heavy pesticides (during a pesticide control performed at her home) and deficiency of Vitamin D led to an adverse effect on her ovarian cycle. It was worrying as it meant a decrease in fertility. However, she kept calm and kept her faith in God. A year and a half later, her faith won and she was blessed with a baby girl, whom they named, Aksha.

Life was beautiful and complete for my friend now. But another challenge was knocking at her door. About two years later, she experienced a striking pain in her lower back, which slowly radiated towards her neck. The condition was diagnosed as Ankylosing Spondylitis. She was subjected to medications and physical therapy. Meanwhile, her husband kept looking for alternate treatments. A family friend in Surat told them about a well-known Acupressure therapy in their city. Without any delay, they headed to Gujarat and Shabrin soon started the therapy sessions under the doctor's guidance. With the grace of God, the treatment worked on her and she had great relief from spondylitis pain.

Her life was back to normal again. Since marriage, owing to various reasons, this couple could hardly go out for a vacation. So this year Naahid planned a romantic trip to the Maldives for their anniversary. She jumped for joy on being told the news and thought to herself that after coming back she will speak to her husband about the second child. But once again destiny had planned something else for her.

A couple of weeks before their vacation, that is in the first week of May 2020, she experienced a small lump and pain in her right breast which increased with each passing day. When Naahid discovered it he rushed her to the doctor. Initially, she was prescribed medication for a month but it did not help. So a Sonomammography (Breast Ultrasound) was performed. The report arrived and the doctor informed them with a stern face that some more tests such as FNAC are to be carried out as there was a lump of about 5cm/2cm in size. Shabrin instantly froze, with all sorts of negative thoughts running across her mind. All the wonderful moments spent with her family flashed in her mind and she wondered what if it turned out to be C..C...Cancer! After coming home, she hugged Naahid and cried her heart out. This time she lost her calm and was too anxious about her loving daughter. She blabbed, "Promise me you will take care of Aksha if anything happens to me. Promise me you will take care of Mom-Dad and most importantly yourself". Naahid, completely understanding his wife's condition, became her strength, and pleaded her not to be so pessimistic and despondent. In the next few weeks, a set of tests were performed and it was learned that the lump was Benign (non-cancerous). This brought some happiness back to the family and they breathed a sigh of relief. The doctor suggested surgery to remove the lump with the condition that it may alter the shape/size of her breast. For a young girl of her age, this was traumatic. It was nothing less than body-shaming herself. So they decided to consult some more doctors before opting for this surgery.

One of the renowned neurosurgeons of the city told them that this lump was formed due to accumulation of abscess (collection of pus). He assured them that he will remove it by sucking abscess material through the needle, without going for a cut. This brought back the lost smile on Shabrin's face and the procedure was scheduled for the same day at noon. The procedure began as explained earlier by inserting the needle at the abscess area. But what went unexplained was that the procedure avoided the use of any anesthesia. This was horrifying and when the doctor sucked the abscess through the needle, she screamed out of pain. Doctor asked her to cooperate and so she mustered all her strength. She bore the pain till four needles but then it became impossible for her and thus on her request, the doctor gave her local anesthesia. A total of about FIFTEEN syringes were used during the procedure. After a couple of hours, she was discharged from the hospital with the assurance that everything will be alright now. But in contrast, on the third day, she felt a lump and pain again. The whole procedure was repeated TWICE in a period of a week, without the use of local anesthesia. Even then, her problem did not resolve. She was extremely distressed and literally begged her husband not to take her to the doctor again.

Being a doting husband, Naahid could understand her situation and feel her pain. So considering all the factors, with his family's consent, he took Shabrin to her parent's home in Goa. Her father scheduled an appointment with a well-known surgeon over there. After consultation and necessary examination, to their shock, the doctor informed them that the lump had increased to the size of about 6.5cm/6cm. Without any further delay, another operation was scheduled, wherein using a surgical scissor the breast was opened by making an incision of about 7inches deep and 1.5inches wide. The abscess material was removed and the wound was left open with only a dressing over the groove that needed to be changed every day. She was sent home and now everyone expected she would be fine soon as the lump has been removed by making a deep cut. But God seemed to be really testing her strength and patience. Her pain and inflammation continued and she had to go for the same operation thrice in just two and a half months. In the end, the groove was almost the size of a fist. But despite all that, there was no sign of recovery. 

The doctor now felt quite apprehensive about her case and he consulted various Specialist doctors across the world. A completely new possibility was discovered, and they said that it might be Tuberculosis of the Breast. This was concluded by the theory of exclusion and by one of her reports that indicated the presence of Granulomatous mastitis. 

Granulomatous mastitis is a rare chronic inflammatory breast condition with unknown cause and there is still no generally accepted optimal treatment for it. This disease can clinically mimic malignancy, which may sometimes be misdiagnosed as carcinoma.

As there is no proven treatment for it yet, she was suggested different treatment options. One of the treatments suggested to her was to go for Tuberculosis medication. However, the doctor cautioned her that these medicines may or may not be effective on you plus the medicines may have severe side effects. Her father disapproved of this option as it was only a trial made on the basis of doubt.

Another treatment suggested to her was Total Mastectomy (whole breast removal). When the doctor told Shabrin about this, her heart sank and she was down in the dumps. She cried, "Is this what I deserve after going through the pain of multiple surgeries?" She cursed herself for not living her life to the fullest in anticipation of the right day. She wished she could go back in time and erase her misfortune. In the end, she surrendered herself to the Almighty and subjected her worries to the will of the Supreme Power. And as it is said, "God’s mill grinds slowly but surely", her prayers were heard this time. 

Shabrin's case was being reviewed by different doctors. An Oncosurgeon, a specialist in Breast Cancer, studied her case. He explained to them that as a sinus tract and two lymph nodes have developed in her breast, surgery is necessary to remove them. However, instead of Total Mastectomy, a Segmental Mastectomy can be performed. In this procedure, the lump and lymph nodes under the arm will be removed, leaving as much normal breast tissue as possible. It is also known as Partial Mastectomy or Breast-Conserving Surgery. As she is under the age of 30, it will be performed in such a way that there will be No Scar, No alteration in Breast Shape and Size. My friend was in tears of joy but at the same time found it difficult to believe. So, the doctor further explained to her that tissues behind your arms will be pushed in a way that it will cover the removed part of your breast. Naahid was still quite apprehensive but she knew that going for this major surgery would be the right decision. She drew herself close to her husband, took his hands in hers, and said, "Honey, I know after so many surgical failures, you are too scared to let me go for it. But understand, this surgery will make me free of these unwanted tissues." Naahid was awestruck looking at the strength and positivity in his wife's eyes. He kissed her gently on the forehead and said, "OK dear, we will go for it. However, remember one thing, I hope and pray that everything will be as explained by the doctor, but God forbid if it doesn't, never body shame or underestimate yourself. My love for you will never change." Shabrin was deeply touched by his words and the respect for her husband in her eyes increased by several folds. 

It's been more than a month now that the Segmental Mastectomy has been performed. Initially, there was a difference in the shape and size of her right breast. But slowly, as committed by the doctor, her bust size is getting to normal. There are no more scars and grooves. However, some after-effects like difficulty in lifting her right arm, fatigue, loss of appetite, etc still persist that accordingly will decrease with time. Her life is slowly getting back to normal. Expecting for her good health and praying she doesn't have to go through the pain of any more surgeries. Also hoping and wishing Aksha could get a sibling soon!

Dear friends, if you or any woman around you experiences any lump or pain in the breast, kindly do not panic, but at the same time, do not even ignore it. It is important that the Right Treatment is perceived at the Right Time. Be aware and regularly examine your breasts either on your own or by an oncologist. Remember, Early Detection is a blessing and a key to living a healthy life!