What I’m writing about today is very personal, yet I feel I have to share it because it could save someone’s life. Follow up with your yearly mammograms, even if your breast care office tells you, “if you don’t hear from us, you have nothing to worry about”. You should be worrying–the life you save could be your own.
I went for a routine (well, I had a little problem that went away, so I thought I was OK) mammogram in January. Since I never heard back from the office, I figured I was fine. However, last time I was at my primary care physician’s office, I asked her about it. She looked through my enormous file–at first she couldn’t find it. Finally, she did. ”I signed off on this, you are fine,” she said. Then she stopped. ”No,” she continued, “you have to follow up. You need another mammogram.” OK, I thought, they messed something up, no biggie. I scheduled the follow up for two weeks later.
At the followup appointment, the rad tech explained there was a questionable spot that needed magnification. ”Ok,” I thought, “No biggie. Magnify away.” She clamped me down, the machine whirred around, and voila, we were done. Or so I thought. Next thing I know, there are two doctors in my face explaining that I had ‘microcalcifications’ that were questionable and I needed a biopsy. This was a bit worrisome–I just came in for a followup exam, not a biopsy! The doctor explain microcalcifications can sometimes be breast cancer and walked me down the path of ‘what if.’ The rad tech then showed me the room where I would have my stereotactic biopsy the following Thursday. I was a bit alarmed that they had taken the liberty to make the appointment for me without asking my schedule or availability. When I tried to complain, I was told, “No, you don’t understand. You need a BIOPSY.” Cue music reverberations. Biopsy, biopsy, biopsy, biopsy.
Wait, did the doctor say breast cancer? You’ve got to be freaking kidding me. After all I went through last year, now you are going to tell me I have to have a biopsy? I didn’t like the kind the doctor explained to me, and told him I wanted a surgical biopsy. I had melanoma when I was 17 and knew I would have to go back if the stereotactic method didn’t get clear margins. ”No,” he chided me, “I don’t think it is warranted in this case.”
Whatever. I went the following Thursday for the stereotactic biopsy. Let me say now, if you have neck problems (I have three bulging disks, severe spinal stenosis, and other various neck issues that cause me pain), don’t do the stereotactic unless you have no other choice. Your breast will be claimed into a mammo machine after it is dripped through a hole in a table, your arms will be in the ‘swimming’ position, and you will be facing the wall, and will not be able to move for the entire procedure (mine was at least 17 hours. OK, it only felt that way, it was probably 45 minutes). I didn’t even get to meet the doctor doing the procedure, just got to hear her yell at me to not move, “We’re working with millimeters here!” They took about eight samples, steristripped me up, and sent me on my way. ”We will have results tomorrow by 3 pm.”
When I hadn’t heard anything by 4 pm, I was worried. I called the number the rad tech gave me. The person who answered the call stuttered when I asked for the results. ”Uh… you have to call your doctor for those. I’m faxing it to her RIGHT NOW, so call her RIGHT NOW.” I knew that didn’t sound good, but also knew I was supposed to get the results from Dr. Millimeters. ”I am supposed to get the results from Dr. Millimeters–can I talk to her?” “Uh… sure, call her RIGHT NOW.” Great.
I called Dr. Millimeters. ”Well, she says, hmmm, you have atypical ductal hyperplasia cells that are detached… you need a excisional biopsy, a lumpectomy…” “Who do I get that from?” I question. ”WTFH???” I think to myself, “a lumpectomy?” ”Oh, well go to a breast surgeon for that” Dr. Millimeters says, dismissively. ”A breast surgeon? I don’t have one–who do I see???” “What do you mean you don’t have one?” “Why would I have one if I haven’t had a problem?” “Oh, we have one here…Dr. Scream. Go see him. Thank you, have a nice day.”
WHAT??? Dear G-d, what now? My DH talks to some of his doctor friends and is told NOT to go to Dr. Scream. Go to Dr. Good. Dr. Good is an excellent surgeon. Great, now I have to shop surgeons. Just get these freaking atypical cells out of my left one! It is my fav! I fed my baby with that–it was his fav, too! I’ve grown attached to it!
After consultation with friends who are surgeons, I decide to go see Dr. Kitty. Dr. Kitty works out of the Wilmot Cancer Center–it is a world class center, and they have a breast center specifically for these types of situations. Fine. I make the appointment and hold my breath.
Last Thursday, I saw Dr. Kitty. I brought my friend J with me–and TG I did, we did nothing but laugh at a place that is so scary. In fact, we laughed the whole four hours (!) we were there! We laughed with the tech who took my BP, with the nurse who took notes for me, with the social worker who talked about her services with me, and with Dr. Kitty. However, what Dr. Kitty had to tell me wasn’t so funny.
“You have atypical ductal and lobular hyperplasia. The problem is that sometimes these atypical cells are just the tip of the iceberg. We have to biopsy the area to be sure we get it all and to make sure you don’t have breast cancer.” There, she said it. Breast cancer. But how? I do my monthly exams, I eat healthily (most of the time), ok, I don’t exercise like I should, but it’s been cold out. How could she be saying these words? Turns out, these microcalcifications are too small to feel with monthly exams and sometimes are breast cancer. This is exactly why women need to have mammograms every year.
“I’m going to Israel in May,” I tell her, “Will I be recovered from surgery by then?” “You are not going to Israel if you have breast cancer, ” she starts, “Treatment…” “I already bought my tickets!” I tell her. The nurse interrupts the doctor, “We work around schedules like this all the time…” “Good,” I tell them both, “Because I’m going to Israel in May, breast cancer or no breast cancer!” ”Let’s see what happens…” she tells me. ”HA!” I think, “I’m going to Israel in May!”
She gives me the options for treatment and gives me a second to decide. Mastectomy (extreme, and not my choice), lumpectomy, or another stereotactic procedure. I choose lumpectomy. Not too cold, not too hot. Hopefully it will be just right. She asks when I’d like to schedule it. ”Tomorrow?” “Probably the week after next.” She disappears for a while and comes back with information and the winning date for me. ”April 5th, a Tuesday. How does that sound?” ”Perfect,” I lie. No day sounds good for a lumpectomy. She also offers me tamoxifen, a chemo drug that folks with my symptoms take for five years. It destroys fertility (while on it), so that would probably be the end of my desire to be like Sara Emainu and have a kid at my advanced age. However, it would decrease my risks of breast cancer by 50%. I tell her I have to think about it.
What’s been going through my mind, however, is the thought of ‘what if.’ Not “what if I have breast cancer,” because that possibility is already on the table. My ‘what if’ has to do with the fact that *I* had to act as my own advocate–what if I hadn’t followed up with my primary care physician and found that I had had a bad mammo from the git? What if I hadn’t called the office and gotten the results of the stereotactic biopsy? What if I wasn’t diligent with my monthly exams and hadn’t checked it out when I had a problem? So many women have issues that are scary, so they ignore the scary issues. Ignoring a mammogram could be a death sentence for some women!
So there is my latest update. April 5 I will NOT be at the Four Seasons. I will be at the Wilmot Cancer Center at Strong Memorial Hospital. Hopefully the biopsy will show nothing. But, if it does turn out to be cancer, thank G-d I followed up and it is early. Please G-d, if it is anything, early detection can ‘cure’ 97% of all breast cancers. Yes, I will need treatment, but breast cancer does not have to be the death sentence it was for our grandmothers’ generation. So please, please, don’t ignore symptoms. Follow up, have them checked, and don’t be afraid. The life you save could be your own.