Diagnosis: June 2007
She needed things to be in their place. She needed symmetry, exactitude, order. But as she waited in the radiologist's office for the bad news he'd prepared her for—"I don't really have any doubt," he'd said a few moments earlier—nothing was as it should be, or as it seemed.
She'd thought the faint pain in her shoulder was a pulled muscle; it wasn't. She'd thought she and her husband, Ken, would have a relaxing weekend at their New Jersey beach house, but they didn't—not once she stepped from the shower on Saturday afternoon and saw the pitting on her right breast, the two-inch circle of skin that was dimpled like an orange rind. She'd thought the pitting would go away on its own, like a head cold or indigestion. It hadn't. Her breast had grown swollen in the days after she and Ken returned home to New York. Her nipple had begun to retract as if something were behind it, pulling a string. And so here she was.
The doctor returned, confirmed the diagnosis, and made her a cup of tea.
The tumor extended outward from Valerie's breast, into her armpit and upper back. "It wasn't round, the way you picture a tumor—it was like this," she says, splaying her fingers like tentacles. The radiologist recommended the "brilliant oncologist" whose office was nearby. A week later, Valerie shook Oratz's hand. She learned that the dimpling and pitting was called peau d'orange, "skin of an orange," and that it occurred when lymphatic fluid couldn't drain because it was blocked by a tumor—which, in her case, was also tugging at the ducts behind her areola, drawing her nipple inward. She learned that there were four stages of breast cancer, and that hers—which was large, caught late, and growing fast—was stage IIIC, a hair's breadth from the worst-case scenario.
She had always been vigilant about annual mammograms, but had delayed her scheduled appointment upon taking a new job—she had just become the CEO of an international furniture design company, a position that required frequent travel. She had an enviable life: lunch with friends, rooftop parties in Manhattan, weekends with her extended family at the house down the shore—a house so beautifully appointed, it had been featured in a design magazine. A minister's daughter and a devout Christian, she'd been married to Ken, a vice president at an engineering corporation, for 11 years; they collected antique ice cream scoops, invited their niece and nephews to stay with them in the city, and, with their light hair and wide smiles, looked a little bit alike.
"I don't dwell on things," Valerie says. "I'm not a dweller." And in fact, she remained even-keeled as Oratz explained that because the tumor was too big to excise, she was prescribing 22 weeks of chemotherapy to shrink it to operable size. The chemo drugs were so toxic they would have singed and collapsed the veins in Valerie's arm, so getting them into her bloodstream required a port—a small plastic disk inserted just beneath the skin of her chest and connected to one of the body's largest veins, the superior vena cava, via catheter. After her port was implanted, she was taken directly to the chemo chair—because by then, she says Oratz told her, "a week could make a difference."