These are the ways I know the cancer has come again. First, like Bridget Jones adding up alcohol units, there’s a running total clicking through my head of how long each child is spending in front of various screens. I’m tired again. So when we come in from school, and my four-year-old heads straight for the remote control, I just say, “Yes, Jetix, fine.” Then, sitting very still with tea in the kitchen, my brain is on a loop, making mad calculations: “OK, children can have two hours’ TV/computer time a day before their minds frazzle, so if he watches two Power Rangers now, then I ask him to stop, that’ll be OK, even if the big ones are watching America’s Next Top Model later on, and he’s in the room, because that’s only another half-hour and one of the other children’s only been on MSN since 4.30pm, and she goes to sleep around 10pm ... “

Then, I’m cruising my cupboard for colour. “I know there’s a red tweed skirt in here,” I mutter, shuffling past the long black, the short black, the manifestations of charcoal. Imperceptibly, as the chemotherapy, surgery and radiotherapy receded and Herceptin became the once-every-three-weeks staple, I slipped once more into the easy uniform, black-on-black. But it’s back. I know this before I hear it from the consultant, I know it before I even make the appointment. I know it by the way I think I can ward off illness with colour. What did I do with that skirt?

The weight drops. For more than a year, I’ve been struggling to lose that steroid-induced stone and suddenly I’m eating poppy-seed pastries with abandon but losing a pound a day. This is the real indictment of the times I have grown up in, more even than the rampaging cancer all around us. Cancer is running at one in three in the UK, one in four dying of it, but what really marks me as early 21st-century woman is this: I’m welcoming the weight loss.

Last of all, the medical proof. There is always a residual fear of seeming paranoid. But a pain under my arm doesn’t go away, so I phone Peter Ostler the oncologist, and mention it, by the by. “Yes,” he says, “go see Muhamed [al-Dubaisi, the cancer surgeon].” I don’t tell the family this is anything other than routine, and Mr Dubaisi, who looks grim when I come in, soon lightens considerably and says: “There is nothing there.”

The following week, there is more good news. Thirteen months after first taking my blood, the genetics screening team at Northwick Park Hospital tell me they can’t find any mutation. The quiet geneticist is wry about the delay, says if they could send the samples across the Atlantic to America they’d have the results in a fortnight, but their samples have to go across London to St George’s hospital, and “St George’s have a backlog”. I phone my parents to spread these good results for my gene pool, only my mother says another first cousin has breast cancer, from which my grandmother also died. I don’t trust the genetic screen.

When the red blotches appear on the mastectomy scar I just note them, curse my dry skin, and double the doses of aqueous cream. The red patches are precise in shape and they don’t itch. They also don’t go away, no matter how much cream I use. I run over the symptoms Mr Dubaisi mentioned: look out for backache, dyspepsia and “anything that doesn’t go away”.

I register my husband Anthony watching me check the marks in the mirror, but not saying anything. Fear of red marks. At the next Herceptin treatment, at home on the Jewish festival of Purim, our son dressed in a sky-blue version of Thunderbird One for the day, I say to the nurse: “Look, can I show you something, without worrying all this lot?” I lift my shirt. “Yes,” she says, “I would get that checked.” I can’t tell from her blank voice if this is caution or serious. So I say, when it comes back, what does it look like? “Usually,” she says, “usually it’s a red rash.”

Fear. I practically have my shirt up almost before I’m sitting opposite Mr Dubaisi. “I’m used to this,” I gabble, apologetically, for thrusting my chest at him. He smiles, but his face has become still. He gestures to the couch, calls in the nurse and draws the curtain round.

“When did this come?” he says. “You were here just two weeks ago.” He is prodding the three spots insistently, then springing his finger away again, as though to test if the red stays.

Back at his desk, he has his palms together supporting his chin, in classic contemplative pose. “What are you thinking?” I say finally. “I’m thinking when to do the biopsy,” he says. “Is Friday a religious day for you? What do you do on Friday?”

We do it that same night. I phone home, rearrange my teenagers, Anthony comes to the Garden clinic round the corner from where we live and Mr Dubaisi says he’s giving me extra anaesthetic, “so you have no pain at all”. Why isn’t Dr Kaplan doing the biopsy? I ask. First time round, Glenda Kaplan was in charge of biopsies; variations are making me anxious. I’ve been telling myself how I’ll know my way round this time. Like how I’d be excellent at divorce a second time, having made every possible mistake first time. Although, I have to add, I never did get the wedding dress right, even the second time.

Mr Dubaisi looks at me quizzically. Why not Glenda? I ask again. “Because,” Mr Dubaisi says, “it’s not in the breast. This is a surgeon’s job, this biopsy, it’s an excision of the skin.” Oh, right, I say, of course, I don’t have a breast there any more. Then, because this is the second time round, I persevere, heeding the mental voice saying, ‘Ask, if you don’t understand’. “So is it skin cancer?” I say. “No,” he answers. “We don’t know for sure until we do the tests, but I believe I know what this is. It is a recurrence of the same breast cancer you had before, and it is in the chest wall.”

Mr Dubaisi is the most cautious of speakers. For him to say anything definite, like, “I believe I know what this is,” before he has the test results in front of him, is as good as a hundred test results. So, when he says that, then I too know what it is.

Equally, four days later, when he says, “I am confident it has not spread”, and he says this before the scans and MRIs and blood tests, so sure am I of this man and his reluctance to say a word too early, that I go home and tell the children: “It has not spread, Mr Dubaisi says so. And Mr Dubaisi is a man who would not say it is raining, even if rain was pouring against the windows, unless he himself was outside feeling rain, and testing it with his surgeon’s hands.”

Mr Dubaisi believes this is a “local recurrence” as the parlance has it - not great, but not a killer, not in the organs - which he will remove, cutting again the area he has cut before. Though he is sure, and that’s good enough for me, we do the week of tests. The CT scan is first, in a mobile unit that drives around the country and has landed at Bupa Bushey in time for me.

They shoot iodine round your veins, which then shows up on the x-ray. Only the iodine bursts through my veins, an explosion that gets everybody running, while at the same time saying, “This is absolutely fine, no problem, you’ll have a whopping bruise, though.” Actually, apart from a few seconds, they’re right, it doesn’t hurt, just looks bad; my left arm instantly growing huge mounds, like Popeye muscles.

The doctor has another stab. I say, “Can you please call my husband in?” The blonde one, the English nurse, nods, and says yes. A minute later, I can see they are all still in the mobile unit with me: the English doctor, the English nurse, and the black-haired nurse from Australia. “If you are all in here, who is calling Anthony?” I say. They mutter, “we usually keep people out of the scanning area.” “You’re nowhere near scanning yet,” I say, “You’re just trying to put the needle in. I would like Anthony please.”

I have to ask three more times. Later, Anthony tells me that the nurse said: “Can you come and calm your wife down please; she’s getting a bit heated and emotional.”

They never do get that needle in, but next day, in London’s Wimpole Street, at the London Imaging Centre, I meet “it”. The doctor who can both do his medical stuff and has the bedside manner to go with it.

Ian Renfrew is called by the radiologist to look at my arm; she doesn’t want to try injecting a bruised limb. Dr Renfrew strides in, checked shirt under forest-green jumper with pink edging, and mutters, “Shocking.” “Really?” I say. “Really? Is it shocking? Because whenever they can’t get needles in, they say that it’s my veins which are no good.”

“Where is Bushey, anyhow?” Dr Renfrew asks me. “I was at medical school with a guy from Bushey, never knew where it was, but he ended up as a jingle on the radio: I’m Ba-aa-a-a-ry from Bushey ... “ Needle is in, bone and CT scan completed.

That night, it’s children’s author Anthony Horowitz’s latest book launch, at the residence of the ambassador from Peru, a bemused-looking man with a very courteous manner.

Some of us are talking, about tonsil operations and burglaries and bad stuff that has been happening. Maybe because I’m tired, when somebody says, “Anyhow, you’re looking really well, Dina, that’s great”, I actually tell them. I say, “Oh, in fact, it’s come back, my tumour. They’re operating on Tuesday. Turns out it’s not such a brave new Herceptin world, after all.”

The group I’m standing in goes awkward. Faces register concern, but spiked with discomfort, and bodies shift. And I realise that what I’ve said is the literal truth. It’s not such a brave new world, and cancer’s not just a sickness - it remains a taboo.

• Take Off Your Party Dress, Dina Rabinovitch’s book on living with breast cancer, will be published spring 2007.

• 18 March 2021: this article has been edited to remove some personal information.