I got a call yesterday from someone wanting to schedule an ultrasound of my breast. I was sure there had to be some kind of misunderstanding, since I already had an ultrasound of my breast last month, but no, there was no misunderstanding. My cancer surgeon, Dr. Arnaout, ordered another ultrasound after seeing the results of the MRI.

I knew this couldn’t be good. I called the Womens Breast Health Centre and left a message on the nurses’ line, asking that someone call me back to explain. Then I called GC and he came over and waited with me for the phone to ring. While we waited, we tried to think of non-fatal explanations for the doctor wanting another ultrasound.

“Maybe,” suggested GC, “the tumor has vanished!”

A couple of hours later Dr. Arnaout herself called.

She told me the tumor is twice as big as they thought. It’s 1.9cm.

But that wasn’t the worst news.

The worst news is that there’s another area of concern on that breast, exactly opposite of where the tumor is. It’s about the same size as the tumor, but it’s not a tumor. I think she described it as a “non-masslike enhancement of suspicious disease.”

Now, anything I can say about that would be speculative because I’m not sure what it is exactly and my efforts to look it up have not yielded anything useful. I do know it’s not a good thing. (I should have grilled the doctor while I had her on the phone, but I didn’t want to take up too much of her valuable time and I figured I could look it up later, and besides, I was in a bit of a state of shock.)

She went on to say that instead of dealing with a 1cm area as we previously thought, it’s a 5cm area. And that means we’re looking at a mastectomy instead of a lumpectomy.

My gut feeling is it also means a greater risk the cancer has spread to other parts of my body, and therefore I’ll have to have chemotherapy as well. But she didn’t say that.

She did say it’s possible the MRI was wrong. Apparently MRIs are greatly influenced by hormonal fluctuations, and I had mine at a particularly hormone-rich point in my cycle. Therefore, the MRI might have seen something that wasn’t there. And that’s why she has ordered the ultrasound – to see if it confirms what the MRI saw.

I asked her about the results of the bone scan and other imaging tests, but she didn’t have those yet.

Meanwhile, the appointment on June 1st has been rescheduled to June 8th.

I got off the phone and looked at GC, who had gathered enough from my end of the conversation to know the news was bad and that we were moving beyond lumpectomy to mastectomy. It was a grim moment, and it demanded a little levity.

“Do you think one-breasted women are hot?” I asked.

“Yeah,” he said, and then he wrapped his arms around me and we both started laughing.

The rest of the day was spent in that weird hyper-emotional space that envelopes you when you’re absorbing horrifying news. I felt the same way the day I found out I had cancer. Terror, in waves. And all kinds of other feelings in the spaces between the waves.

There was a day – a single specific day – on which I got cancer. I don’t know what day it was, except it was probably about four or five years ago because that’s how long it takes breast cancer to grow from a single mutated cell into a discoverable lump.

Four or five years ago I was in the best physical shape of my entire adult life. I was running, lifting weights, doing yoga and aerobics, skating, skiing, eating well, and not smoking. I was lean and healthy. I looked good and I felt good.

I love the irony of having gotten cancer during my two-year healthy-lifestyle phase, because I am by nature a self-indulgent and slothful layabout who would rather eat 2,000 Smarties in the interests of mathematics than eat a single vitamin supplement.

I read that anger is common with cancer. It’s not unusual for people to ask “Why me?” But I haven’t felt any anger and I’m not really surprised it’s me. I’m as good a candidate as anybody, I suppose. Except that none of my blood relatives have ever had any type of cancer, so we’ve always felt protected. A little smug, even. Now I feel kind of apologetic to my relatives, especially my sisters and nieces, for being the weak link that let cancer get its foot in our collective door.

I guess I’m a little surprised that it’s breast cancer, even though one in eight women can expect to get breast cancer at some point in their life now. I’m not sure why it surprises me, but it does. And I’m surprised that it’s my right breast. I never consciously thought about this before, but at some level I thought if I ever got cancer, it would be on my left side. Left lung. Left ovary. Left kidney. Or cancer of something that there was only one of, like my cervix or my brain. I know that doesn’t make sense, but there you go.

I wonder if the day I got cancer was an otherwise good day, or if it was a difficult, stressful day. I wonder what I was doing the exact moment that cell mutated.

I wonder why I got cancer. Was it something I did or didn’t do? Was it something I knew I should or shouldn’t do? Like that time I used the flea pesticide on the dog indoors even though the instructions said to use it outdoors only? (I probably wouldn’t even remember this, except that all the ants in the ant farm died, which gave me pause.) Was it microwaving food in a plastic container? Not taking Vitamin D supplements? Eating a Boston Cream donut? Not eating walnuts?

Or was it something totally off the wall that we don’t yet know causes cancer, but maybe someday we will. Like doing push-ups or touching cats while wearing yellow socks.

Or was it just bad luck? Just a totally random sequence of events at the genetic level, which was totally beyond my control?

I guess I’ll never know. But if I could do it all over again, I’d take my Vitamin D supplements. And I wouldn’t use that pesticide indoors.