Lightning by Danielle Steel Page A

Sam's assessment of the situation. He told her that the shadowy area they saw was clearly a tumor deep in her breast in an area, and of a shape that almost always indicated a malignancy. Naturally, they couldn't be sure until they did the biopsy, but in his experience what they were going to find would be a tumor, and not a good one. After that, it would depend on the stage it was in, the degree to which it had infiltrated, whether it was hormone receptor negative or positive, and if there was metastasis. He was cold and matter-of-fact, and he painted anything but a pretty picture.
    “What will all of that mean?”
    “I won't know till we get in there. At best, a lumpectomy. If not, you may want to follow a more extreme course, which would mean a modified radical mastectomy. It's the one sure way of being certain that you've eliminated the disease, depending on the stage of the tumor, of course, and the extent of the involvement.” He showed her a chart that meant absolutely nothing to her, which had letters and numbers on it and covered a variety of contingencies, all of them completely confusing.
    “Is a mastectomy the only way to wipe out the disease?” she said in a strangled voice, realizing that he'd been right. She was completely confused, and felt utterly stupid. She was no longer the trial lawyer, she was merely the woman.
    “Not necessarily,” he answered her, “we may want to add radiation or chemotherapy. Again, this will depend on other factors at the time, and the extent of the involvement.” Radiation or chemotherapy? And a modified radical mastectomy? Why didn't they just kill her? It wasn't that she was so enamored with her breasts, but the idea of being completely disfigured and desperately ill from chemo or radiation made her want to vomit just thinking about it. Where was Sam now with his cheerful prognosis, and warnings about surgeons fearing malpractice? She couldn't even remember it now. What Herman 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