Read an Excerpt
Sylvia Bryan had always considered the words early detection to have more to do with others than herself. She'd never had anything that needed early detecting, and if she had any say in the matter--which apparently she did not--she would just as soon jump to the best possible conclusion, and proclaim the lump in her breast to be a swollen gland or a benign cyst. Then she could get back to her work in Nicaragua and stop being so body-conscious.
But Harry had insisted on a complete physical because of her fatigue and weakness, and had sent her home from the mission field to undergo a battery of tests that befitted a woman of her age. She had been insulted by that.
"I hope I don't have to remind you that you're a man of my age," she told him, "so you don't have to go treating me like I'm over-the-hill at fifty-four."
Harry had bristled. "I'm just saying that there are things you're at greater risk for, and I want to rule all of them out. You're not well, Sylvia. Something's wrong."
She'd had to defer to him, because deep down she'd been concerned about her condition, as well. It wasn't like her to be so tired. She had chalked it up to the brutal August heat in Nicaragua, but she'd weathered last summer there without a hitch. For most of her life she'd had an endless supply of energy. Now she had trouble making it to noon without having to lie down. So he'd sent her home to Breezewood, Tennessee, to see an internist at the hospital where he'd practiced as a cardiologist for most of his life. After just a few tests, he'd diagnosed her with a bad case of anemia, which explained her condition. But then he'd gone too far and found a lump in her breast. She'd gone for a mammogram then, certain that the lump was nothing more than a swollen gland.
The radiologist had asked to see her in his office. Jim Montgomery was one of Harry's roommates in medical school, and he came into the room holding her film. He'd always had an annoying way of pleating his brows and looking deeply concerned, whether he really was or not. He wore that expression now as he quietly took his seat behind his desk and clipped the mammogram film onto the light box behind him. Sylvia wasn't in the mood for theatrics. "Okay, Jim. I know you want to be thorough and everything for Harry's sake, but my problem has already been diagnosed. I'm badly anemic, which explains all my fatigue. So you can relax and quit looking for some terminal disease."
Jim turned on the light box and studied the breast on the film. With his pencil, he pointed to a white area. "Sylvia, you have a suspicious mass in your left breast."
Sylvia stiffened. "What does that mean ... 'a suspicious mass'?" "It means that there's a tumor there. It's about three centimeters. Right here in the upper outer aspect of your left breast."
He made an imaginary circle over the film with his pencil. Sylvia got up and moved closer to the film, staring at the offensive blob. She studied it objectively, as if looking at some other woman's X ray. It couldn't be hers. Wouldn't she have known if something that ominous lay hidden in her breast tissue? "Are you sure you didn't get my film mixed up with someone else's?"
"Of course I'm sure." He tipped his head back and studied the mass through the bottom of his glasses. "Sylvia, do you do self breast exams?"
She felt as if she'd been caught neglecting her homework.
"Well, I used to try. But mine are pretty dense, and I always felt lumps that turned out to be nothing. I finally gave it up."
"Not a good idea. Especially with your history."
She knew he was right. Her mother had died of breast cancer when Sylvia was twenty-four. She should have known better than to neglect those self-exams. But she had been so busy for the last couple of years, and hadn't had that much time to think about herself.
"Well, I have tried to have mammograms every year since I turned forty . . ." Her voice trailed off. "Except for the last couple of years when I've been out of the country." "Well, it seems that the last couple of years were what really mattered."
She looked at him, trying to read the frown on his face. "But it's okay, isn't it? You can tell if it looks malignant . . ." He looked down at her chart and made a notation. "You need to get a biopsy tomorrow, if possible."
The fact that he'd averted his eyes alarmed her. "You just evaded my question, Jim. And you know Harry is going to want to know. Does it look malignant to you or not?"
He leaned back in his chair, crossing his hands over his stomach. The frown wrinkling his brow didn't look quite so melodramatic now.
She set her mouth. "Be straight with me, Jim. You see these things all the time. I want the truth."
"All right, Sylvia." He sighed and took off his glasses, rubbed his eyes. "It does have the characteristics of a malignancy."
For a moment she just stood there, wishing she hadn't pressed the issue. Malignancy meant cancer, and cancer meant surgery, and then chemotherapy and radiation and her hair falling out and pain and depression and hospice care and death. Her mouth went dry, and she wished she'd brought her bottled water in from the car. She wondered what time it was.
She had to get to the cleaners before it closed. Her hands felt like ice, so she slid them into the pockets of her blazer to warm them. "Come on, Jim. I don't have cancer. I've been tired, that's all, and they already figured out it's from anemia. There is no possibility that I have breast cancer. None. Zilch."