A surgeon who thought her breast lump was harmless on what cancer taught her

Sharmin Akter, an associate professor of plastic surgery at the National Institute of Traumatology and Orthopaedic Rehabilitation (NITOR) in Dhaka, has written about her own breast cancer for Prothom Alo's series on cancer survivors. The disease she had operated on many times turned up one day in her own report.

She had had a small lump in her breast since 2019. An ultrasound-guided FNAC came back as fibrocystic disease, so she was not greatly worried. In March 2020, at a conference in Australia, part of the lump felt harder than before. She planned surgery on her return, but COVID-19 pushed it back.

After seeing three patients with advanced breast cancer in a single week during the pandemic, she had a core biopsy. One section showed abnormal changes, and ultrasound, mammography and MRI deepened the suspicion. Surgery confirmed breast cancer; her tumour was ER/PR positive and HER2 negative. After about seven months of chemotherapy and radiotherapy she was declared cancer-free.

Looking back, she writes that had the patient been anyone else, she would not have relied on FNAC alone but asked for a core biopsy. Now, when a lump looks suspicious, she does not hesitate to order ultrasound, mammography or even MRI; she no longer waits on a persistent or unusual lump on the assumption that it is fibrocystic; and she does not decide on surgery without a core biopsy.

Cancer treatment, she says, is never one doctor's decision; a multidisciplinary tumour board is essential. Before treatment begins she talks the whole course through with the patient and family, teaches long-term arm care after surgery in the armpit, and raises fertility with younger patients before anything starts.

Coming round after her operation, unable to make herself heard, taught her how much it matters to a patient that someone is listening. A patient fighting cancer needs accurate information, respect, courage, a skilled medical team and a dependable carer, she writes. She has joined Chattogram Call, an effort to build a non-profit cancer centre in Chattogram.

The experiences and views in the piece are the writer's own.

Photo: Jason Meredith / Wikimedia Commons (CC BY 2.0)

Source: Prothom Alo