On quitting smoking and finding breast lumps

About three years ago, I found something in my right breast. It was a real, honest to goodness lump: about the size and consistency of a halfway melted frozen pea. And it hurt. A lot. Indeed, it was pain that alerted me to its presence. Once I found it -- after the shaky-handed, cold-sweated, stomach-dropping discovery -- I couldn't stop touching it. It was as if I had to keep reminding myself that this was real and that it was probably going to kill me.

I decided to allow myself exactly one day of imagining worst-case scenarios. I envisioned the instructions I'd leave for my funeral, the songs I would ask to be played, the tearful things my friends and family might say in my honor. But after one day, I couldn't stop. It had become an idée fixe. I couldn't just let it go.

The day after I found the lump, I left for a business trip to San Francisco. I remember calling my doctor from the BART somewhere between SFO and Powell Street. Because of my insurance, I'd have to see my primary care physician before being referred to a specialist; I knew that this process wasn't going to be quick. I scheduled a consultation for the week after I returned and tried to put it out of my mind. I need to concentrate on something else.

That's when I decided to quit smoking. On my mental list of things to do before I turned 30, quitting smoking was number one (number two was getting married, which I managed to slip in right under the wire). Over the ten years or so I had been a smoker, I had vacillated between casual smoking-only-while-drinking to heavy pack-a-day smoking. I'm not sure I ever even really liked smoking; the first cigarette of the day (which, for me, usually didn't occur until sometime in the afternoon--I never was a cigarette and coffee girl, except for the semester I spent in Paris, when I might as well have been injecting nicotine intravenously) made my stomach queasy. But it was a habit. It was part of my identity. I was a smoker.

But then, suddenly I wasn't. I don't remember the exact date. I don't remember my last cigarette, mostly because I smoked it without realizing it would be the final hurrah. I just stopped. For that first week in San Francisco, I even had a half-empty pack in my purse. I wasn't ready to throw it out, but I knew I wasn't going to cave in and smoke. Being in Northern California, where smoking is only slightly less reviled than, say, child abuse, it was easy to not smoke. It was banned in bars, where, back in Chicago, I did most of my damage. And then the fierce head cold I got midway through the trip helped me get through the first crucial days (even in my smokiest days, I never would smoke through a cold -- phlegm and tar don't mix, kids).

When I returned, I saw my doctor. She confirmed what I knew: there was something there. I was referred to a specialist, with whom I scheduled an appointment two weeks later. But by the time I saw the breast doctor, I couldn't find the lump anymore. It no longer hurt. I imagined it had, suddenly aware it had been discovered, snuck off to some corner of my anatomy to puss and ooze and infect. The doctor, using an ultrasound, couldn't find it either. She concluded that it had probably been a hormone-related abnormality and that I shouldn't worry too much about it. She also said that breast cancer doesn't usually hurt. So whatever it was, it likely hadn't been malignant.

From the day I found the lump to the day I learned it was nothing to fear, three weeks had passed, and I hadn't smoked once. Now that I knew I wasn't dying, I considered lighting up in celebration. But I didn't. It seemed so incongruous to me that I was voluntarily admitting carcinogens into my body while my body, in its own strange cellular division, could be manufacturing the lethal stuff itself. I just couldn't stomach helping it any more.

So it's been three years since I found that lump and quit smoking. I haven't had a single puff since. I only occasionally get cravings (mostly in the afternoon, mostly in the summer, mostly at backyard barbeques or music festivals when the sun is at the right angle and I have a cold beer in my hand), but I've never given in to them. But once again, my right breast hurts. I realize it could be entirely psychosomatic (in fact, it started aching right after my father first told me about the pernicious mutation in our genetic code last fall). I've been poking around in there ever since (and maybe all that prodding is just adding to the discomfort), but I can't find anything. I had my first mammogram in November, and nothing looked out of order in there. But I can't help but be fearful all over again. Because this time, unlike three years ago, I know what might be causing it.

I keep coming back to those words from the breast doctor – breast cancer doesn’t hurt. But then I remember what my second cousin, currently being treated for breast cancer, told me in November when I asked her how she found the lump. “It hurt,” she said.