And after that, did you go for three-monthly check-ups or’?

Yes, three-monthly check-ups with the plastic surgeon, with the consultant and with my oncologist. And they gradually reduced then to every six months and I’m now down to every year. And a mammogram, I have a mammogram every year as well;

So you have a mammogram every year. When you go for the check-ups, what do they do during the check-up;

It’s really just, they’re very, very quick, they really just ask me, “How are you feeling? Is everything ok? Have you any worries, any concerns?” and I get, it’s a full examination of both breasts and under my arms as well. And they sometimes do my lymph glands here and my neck and my back;

Well it’s a two-fold thing. As the years go on you put your cancer into the background, you pick up your life and you go on with your life and you mostly forget that you have cancer, until you get that letter through the post that says “Right, you need to”- you know, “it’s time for your check up.” And then you start to get in the butterflies and you think “What if”, you know, “something shows up again?/” But I look at it two ways. I don’t like the idea of having the mammogram because I’ve been there and it’s not particularly pleasant, it’s bearable but it’s not particularly pleasant, although it’s over very quickly. Theres that side of it, the physical side of it. But theres also the side of it that it’s reassuring that somebody’s looking after you, that you’re being checked and if anything was there that it would be picked up at an early stage, you know, and I find that reassuring that somebody is watching me.

I follow, with no surprise, I follow the American protocol on this. And I do it in America because there are more digital mammogram machines there. There are more people reading them and they were the ones that twice picked up the cancer. So I go for an annual mammogram, yes, which is a digital mammogram. And then in addition to that I go six months later for an ultrasound of my breast in the States as well because they have shown that with ultrasound, often ultrasound can pick up things that a mammogram misses. And even if you have breasts that read very well with the mammogram if you, you really shouldn’t have more than one mammogram a year and if you go for an ultrasound half way through that year you’re having another look at what’s going on in that breast and making sure that nothing else has come up or nothing else needs to be looked at. You are not going unchecked for the whole year.

How do you feel when you go back every year for a mammogram? Are you anxious about it or you try not to worry’?

I think everyone is anxious. You know, it always puts you back to a place where you were absolutely vulnerable and you realise all the laws of the world apply to you. Anything could happen to you and actually did. So I think I, you know I feel very vulnerable. It brings back all the memories of gosh, what. I remember when I was sitting here. You’re also sitting in doctor’s offices and you are looking at women and you see the terror on their [laughs] faces and you still relate to where they are at and what they are going through. And I think that’s always a little difficult;

I followed that up with three-monthly visits to the hospital which were reassuring. That mainly depended on whether you saw the consultant, the registrar or a junior doctor who, I know these people have to learn their way, have to see how it works, but I didn’t derive any confidence from a, especially one boy. Unfortunately when you get old you think of them as young boys, who made a lot of fuss about the tattoos I have on my breast, or where I used to have a breast. And he seemed completely fascinated by these. But these had been used for the radiotherapy, for homing in. Now I didn’t gain any confidence from my visit to the hospital that day, because I felt, if he doesn’t know about tattoos, what does he know about the whole situation;

You get an appointment for a check-up after having had cancer and you cling to it as, this week it’s another, you know, three months or whatever. And you go, and there are fifty other people there, and you are called, and if you get someone who says, “Just lie down on the couch.” and they run their fingers over the scar and they say, “How have you been?”, and you say, “Fine.”, and they say, “That’s fine, see you in three months.” That does not give you any, me personally, any confidence. I need, and nothing annoys me more, is the doctor writing their notes while they are speaking to me. If they can’t spare me the time to look at me when they’re speaking to me, I just feel I’m on some sort of conveyor belt and I don’t derive any confidence from them;

If I have someone who is perhaps a registrar, or up further anyway, who takes the time to feel round my lymph or under my arms and round my neck and my tummy. Now, it may be, someone pointed out to me one time, listening to your baby with the thing, doesn’t actually tell you anything but it makes the mother feel more confident. And maybe that is the situation with feeling and doing that sort of thing, maybe it’s exactly the same. But for me, it gives me more confidence that they have looked and felt and spoken to you and perhaps asked you a couple of questions. And it only takes a few minutes more, just a few minutes more to do that. I feel better after it anyway;

I think I had to go back in 3 months. Every 3 months to the hospital for a year, then every 6 months. But I can’t remember when I next had a mammogram. I think it may have been, probably a while. I don’t think they did mammograms straight away. It may have been a year, I don’t know, I really can’t remember that, but I had to go back you know, regularly;

And how was it, having a mammogram, having had surgery;

Well it was, as I say, it was more uncomfortable. It’s still much more uncomfortable than before I had surgery because of the scar tissue. But its bearable;

So you have the mammogram on both your breasts and do they give you the results there and then or;

No that’s the other worry and anxiety and I find the system wrong and the system bad, and it seems to be from consultant to consultant, it depends what your consultant requires. Some of the ladies I’m in contact with, their consultant would send them for the mammogram first and then he has the results and then when you go in and see him he has the results in front of you. My consultant works differently in that she orders the mammogram and then you get a letter to go and see her and the onus is on you to go and chase up your mammogram to actually go and look for your results. And three weeks, four weeks could elapse before you know your results. And you know if you’re an anxious sort of person, that would be a very anxious time to wait, you know. I don’t think it should be left up to you. I think, you either phone for your results on the day, or the day afterwards, or at least speak to your consultant a week afterwards, you know, to be reassured.

I’m still seeing the consultant every six months and I still pay to go and see the Consultant privately mainly because, as good as they were in the NHS, when it came to follow-up I never saw the same person twice and I wanted somebody who had seen me through this and who knew me as a person. Who knew, and I mean, he knows what I do for a living, he knows me when I walk through the door, he knows how I work and what sort of personality I am.

So I suppose it’s been three and half years. I had my last mammogram January, now that would be three months ago, touch wood I’m still clear. I do get, I am a very grounded person and I’m an intelligent, educated adult, as is everybody else, and I’m a very grounded person and I’m very logical and I still get worried whenever I’m coming up to a mammogram. So it’s happening to me, it’s happening to everybody. And you always think “This is the one, they’re going to find it” and I’m no different and I cannot believe that I’m any different from anybody else. And I still go private for my mammograms because I cannot bear to wait the length of time that it takes the NHS to come back, two to three weeks to tell you you’re clear. And I just can’t, I can’t hack that;

So I pay for a mammogram every year and I go and I get the results within ten minutes of that mammogram being taken. So if it’s good I’ll know straight away and if it’s bad I’ll know straight away. And I won’t waste any time, and I won’t waste time at home worrying about it, because I worried enough that last month going up to it, I don’t want to worry about it afterwards as well;

I think with time it gets worse. The further away you are from the original occurrence, for me, the worse it’s got. So I’m now three and a half years away and it, having the mammogram this time was more worrying than having it twelve months after the operation. Because I knew that twelve months after the operation, with chemotherapy and radiotherapy it was highly unlikely that I would develop another tumour in that time. Now however were getting further away from the treatment so were getting further away from the original primary cancer. And I know that if it’s going to happen it’s going to happen, sometime. Maybe never, but the further away I get the more I worry about it. It’s not, it doesn’t take over my life but it does worry me;

I think the first couple of years, the first one that I had found some areas of micro-calcification and I did a bit of a wobbly then when I got that result [laughing] but spoke to my breast surgeon and asked him to take it to the MDT, the multi-disciplinary team meeting where they could discuss the x-rays and everything. And I went to see him and he more or less said not to be a silly girl[laughing]. But, you know, you expect or you hope that you’ll just go for that and be told it’s normal, exactly as you do for screening. You don’t actually go for screening ever expecting that theres anything wrong. You go to be told “everythings fine,” you know. But the year after that I was a bit nervous but now I don’t worry too much about them. I more or less think it’s just a routine and, you know;

I had regular follow ups, first of all six monthly I think and then it went to annually. Last year, after nearly six years, they signed me off from the breast clinic, except for regular mammograms; were back to every two years now, and they were annual during the five years after the operation.

So you go every two years now;

Now, yes, yes;

And before going now, would you still feel a bit anxious;

Not particularly, I don’t think. Been there, done that, you know [Laughs]. Lightening doesn’t strike twice, I keep telling myself;

Initially I went for three monthly check ups. Then it went down to yearly check ups and now I get yearly check ups. Now that’s with, that’s two check ups a year and I mean, and in the health service, I mean I feel very privileged that’s happening. I mean, almost five years from my surgery I would see my Oncologist for a check up and then I would see my Consultant and then I would have a yearly mammogram. You know, with all the demand within the health service and all the newly diagnosed patients, I feel you know, so privileged that I am able to have access to this information and be reassured that my cancer is not there any more;