One common reaction to saying “I have cancer” is that people want to know, though they don’t quite like to ask, how I realized I had it. Here’s how it went:

April 2014: Had my yearly mammogram (“difficult breasts” mean I’ve been having mammograms, and often follow-up ultrasounds, at least yearly since age 35). All clear.

Late Sept/early Oct: (I was on a business trip in Stockholm) I had been having a lot of breast tenderness, which seemed to be getting worse over the last few months (most likely menopause-related). Now I felt a different pain, deep in my right breast, as if I was being stabbed with a pin. It wasn’t constant, but it was persistent.

I don’t do routine breast self-exams precisely because my breast tissue is so dense and lumpy – it’s hard to know which lumps I should worry about. But I have a good general idea of what my breasts feel like and, when I was trying to locate the source of this new pain, I could feel something new in my outer right breast, a lump which felt sharper and more defined than the surrounding breast tissue.

I made an appointment with a gynecologist in my new hometown in the south bay. I believed there to be no history of cancer in my family (later learned I was wrong about that), so I wasn’t particularly worried, but there were other things I wanted to talk about anyway (like my damned periods coming every 16-18 days! With cramps like I had in high school! Menopause sucks).

Oct 20: The gynecologist suggested I schedule…

Oct 24: A mammogram and ultrasound. The mammographer saw some calcifications and denser areas he didn’t like the look of, and scheduled me for…

Oct 30: Core needle biopsies on two areas of my right breast. An in-office procedure, but nasty. I lay down on a table with my right breast dangling through a hole, whose hard plastic edge cut into my ribs. There’s a mammogram machine under there, which squeezes the breast as usual. They take an image, and then you have to stay in exactly that position (the plastic squeeze plate holds your breast) so the doctor can guide the biopsy needle to the correct area. He injects local anesthetic, then goes in with something that makes a noise like a drill but he said was a vacuum. I was turned to face the wall; if I had not met the doctor during my previous visit, I would have had no idea what this person doing this horrible stuff to me even looked like. To distract myself, I contemplated linguistic questions, like the fact that the very kind and competent assistant (Russian ?) spoke perfect English, but used no articles: “I will call doctor now.”

NB: In any medical offices where you’re going to spend significant time, make sure you like the nurses and technicians; you’ll be seeing more of them than the physicians.

The first area hurt when he stuck the biopsy needle into it; perhaps the anesthetic hadn’t fully reached that deep. I was tense and scared when he started the second one, but that time it didn’t hurt. He took more samples from the second area, perhaps because of what he had already seen in the mammogram and ultrasound.

Nov 1: I flew off to the OpenStack Summit in Paris. My breast hurt inside and was bruised outside from the biopsies, a constant reminder that maybe there was something going on that I should be worried about. I became more worried as the week went on. But I had lots of good distractions: I was busy with the conference, colleagues, former colleagues, and friends from across the tech industry, and an old friend who came to visit from her home in Switzerland. And, of course, Paris! Though I didn’t have time for tourist stuff – just lots of walking, talking, good company, food, and wine.

Nov 6: I finally spoke with the gynecologist. (“I was about to call you,” she said.) One of the biopsied areas was clear. The other wasn’t. She said: “It’s very early, very small, we’ll be able to take care of this easily.” [NB: It turned out to be not very small at all.] She gave me the name of a surgeon back in California. I called and scheduled an appointment while I was standing outside a restaurant waiting for colleagues to join me for dinner. I was still in shock, so I told two teammates and one completely extraneous Ericsson colleague what was going on (they were very good about it). Ate a great meal and drank a lot of wine.

The next week, when I was back in the US, I met with the surgeon…

In sum: I have been having mammograms as often as doctors tell me to, but that’s not how this cancer was found. This tumor apparently grew quickly, within six months after a clean mammogram. It announced its presence through pain.

“About 5 percent of all target zone breast pain is cancer. So it’s worth having your doctor check it—if only for the relief of being sure…” – Dr. Susan Love’s Breast Book

…I didn’t read this until later. In fact, the websites I checked say that pain in the breast is “unlikely” to be cancer.

5% is unlikely, true, but if it’s a different kind of pain than you’ve ever felt before, pay attention.

That pain persisted until the tumor was removed – I could feel it, a slight burning sensation, as if something with small, sharp teeth was gnawing away inside.

Next: What Happened After Diagnosis

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my breast cancer story (thus far)