said was so much more real, and so utterly terrifying, she could hardly think straight.
“What exactly would the procedure be?”
“We'll schedule you for a biopsy. I would prefer to do it under general anesthesia since the mass is so deep in your breast. And after that, you'll have to make the decision.”
“I will?”
“Presumably. You're going to have to make some informed choices. There are a number of options in this area of medicine. You'll have to make some of the decisions, they don't all rest with me here.”
“Why not? You're the doctor.”
“Because there are choices to be made, involving more or less risk, and more or less discomfort. It's your body and your life, in the final analysis, and you must make the decisions too. But with early detections such as these, I almost always suggest a mastectomy. It's a great deal wiser and surer. You can always have reconstructive surgery within a few months to restore the appearance of the breast, if you wish to.”
He made it sound like having a fender put back on a car, and not a breast on her body. And she didn't know it, but his preference for mastectomies as the surer cure was what had earned him his conservative reputation.
“Would you do the biopsy and the mastectomy on the same day?”
“Normally not. But if you prefer it that way, we can. You seem to be a very busy woman, and it would save you time, if you're prepared to entrust me with that decision. We can work that out beforehand, in the event of certain findings. We would have to plan that carefully.” Of course, she thought of Sam, to avoid a lawsuit. And then she thought of something else.
“What if I turn out to be pregnant in the next few weeks?”
“Is that possible?” He seemed surprised, and she felt faintly insulted. Did he think she was too old to have babies, just tumors?
“I've been taking Serophene and trying to get pregnant.”
“Then I would think you'd want to abort, if you were, and proceed with treatment. You can't afford to let something like this go for eight or nine months. Your husband and family need you, Mrs. Parker, more than they need another baby.” It was all so coldblooded and so simple, like the razor-sharp edge of a scalpel. She still couldn't believe what she was hearing. “I'd like to suggest that we schedule your biopsy for a week from next Monday and you come in to see me before that to discuss the options.”
“There don't seem to be very many of those, or am I missing something?”
“I'm afraid not, at this point anyway. First we have to see what you've got there. And then we can decide what to do about it. But you should know that my preference is almost always mastectomy in the case of early cancers. I want to save your life, Mrs. Parker, more than your breast. It's a question of priorities. And if you have a malignancy that deep in your breast, you may be a lot safer, and better off, without the breast now. Later, it may be too late. It's a conservative stance, but it's one that has proven to be reliable over the years. Some of the newer, riskier views can be disastrous. Doing a mastectomy early on could well be a great deal safer. And if indicated after the surgery, I'd want to start an aggressive course of chemotherapy four weeks after the surgery. This may sound frightening to you now, but six or seven months from now, you'll be free of the disease, hopefully forever. Of course, I can't recommend that to you now. We'll have to see what the biopsy tells us.”
“Would I still be able to …” She could hardly bring herself to say it, but she knew she had to. She wanted to know, since he had been so free about suggesting an abortion if she were pregnant, “…would I be able to conceive afterwards?”
He hesitated, but not for long. He had been asked this question before, though usually by younger women. At forty-two, most women were more interested in saving their own lives than in having babies. “It's possible. There's about a fifty percent sterility rate after chemotherapy. But it's a risk we'd have to take, of course. It could do you grave harm not to have it.” Grave harm? What did that mean? That it would kill her not to have chemo? It was a nightmare. “You'll