Stay Calm & Get Your Mammogram!

Ladies. This is very personal for me, so please listen. This is an important post to draw your attention to getting your annual mammogram. It has been a harrowing past two months leading up to getting my own results - please don't wait as long as I did.  

August 30th began like any other day, ahead of me was a full check-list of things that I needed to get done, not the least of which was my routine appointment for my mammogram.  Even though I hadn't kept up with my mammograms on an annual basis and had in fact gone three years without one, I wasn't the slightest bit worried or nervous about what the results would be. It was just one of those bothersome procedures that I needed to have done and then wouldn't think about again for another twelve months. I was certainly wrong about that.

The first mammogram itself was uneventful, albeit uncomfortable as mammograms always are. I can't really say that it hurts, necessarily, but still, having "the ladies" smashed as flat as a pancake in a modern-day life-size vice isn't on my top ten list of favorite things to do. 

The following week a letter arrived in the mail indicating "abnormal tissue" that needed to "re-evaluated with an ultra sound." At this point I wasn't really alarmed because I have had issues in the past with breast density and numerous cysts that always have to be confirmed via an ultra sound. One year I even had to have a cyst drained (yes, it involved a very large needle and it was exactly as you're probably imagining). So I scheduled my ultrasound for September 11th and tried to not feel superstitious about the actual date.  I proceeded to have the ultrasound, which was completely painless, and of course the technician doing the procedure gave nothing away with her facial expression. I knew not to ask what she thought about what she saw because they aren't allowed to comment. They are sworn to secrecy - it's the ultrasound technician code.

And so then I waited for the result, assuming they would say it was just a cyst as they always had done in the past. But after arriving home from work on September 17th and reading the letter that had arrived that day, I felt like someone had punched me in the stomach ... hard. The phrase "it is recommended that you contact your primary physician to schedule a surgical biopsy as soon as possible" was all that registered, the rest of the letter quite frankly was a blur.

So the next morning, I arrived at my doctor's office, and camped out in the waiting room. I explained to the receptionist that I needed to urgently talk to the doctor about my ultrasound results. In a most uninterested tone she stated matter-of-factly "he won't be able to see you today - you'll need to schedule an appointment." "No, you don't I understand," I replied with as much calm as I could muster, "I received this letter yesterday from the Breast Care Center and it seems awfully important." I turned it over to her and as she read it, her eyes widened. "Have a seat," she said. "I'm sure he'll want to talk to you about this."  After about an hour of sitting in the waiting room chatting with a woman who had only learned the week before that she had stage-4 lung cancer, I was finally called back. My doctor talked with me in the hallway and I wasn't sure if that meant I had nothing to worry about or if it was so urgent he couldn't waste time setting me up in an exam room. "You need to have ultrasound-guided core biopsies done and you definitely want to get this taken care of as soon as possible," he explained. "Wait a minute," I said, "biopsies - as in plural?" "Yes, you have abnormal tissue in both breasts that couldn't be diagnosed with the mammogram or ultrasound." I felt my mouth go completely dry and I swallowed hard. "So just how worried should I be about this?" "Well," he said, "Nine times out of ten these things turn out to be nothing. But you don't want to be the tenth person who does nothing about it assuming that it will be nothing." Okay then. He passed me along to his nurse who immediately called and made an appointment for me, in two days. They weren't messing around.

The morning of September 20th, as I ate breakfast and got dressed, I tried to treat it just as another ordinary day. But it wasn't. Don't get me wrong, I believe with absolute conviction in the body-mind connection and the power of positive thinking - but shaking that feeling of dread that kept creeping over me was challenging to say the least. Fortunately I had a few left over Xanax from a previous procedure, and I gladly swallowed one of the little "happy pills" an hour before my biopsies would begin. And boy was I glad I did. My doctor didn't explain exactly what a Core Biopsy was and for some strange reason I didn't research it either - which is quite out of character for me because anyone who knows me knows that I research everything. I won't even buy a TV without researching all the different brands, so why I was okay with having someone extract tissue from "my girls" without knowing absolutely everything about the procedure, to this day totally baffles me. If you or someone you know is needing to have it done and you don't know the details of the procedure - this is what you can expect:

Core Biopsy - Ultrasound Guided
When a nodule is seen on mammogram, and the same nodule can be seen on ultrasound, or when a nodule is only found on ultrasound, an ultrasound guided CORE biopsy is frequently indicated. The physician scans the breast with the hand held ultrasound transducer while the biopsy is being performed. This means that there is direct visualization on the ultrasound screen of the needle as it is inserted into the breast abnormality to confirm that the needle is being inserted into the correct spot.

The patient is positioned on her back on the table, and the nodule or other abnormality is found on ultrasound. A mark is made on the skin with a pen to indicate the spot for insertion of the needle; the skin is cleansed with sterile antiseptic solution, and the area is numbed with local anesthetic. A small nick is made in the skin.

A special needle is used to biopsy the area. A loud click is heard each time the biopsy is performed, which is anywhere from 2-5 times. There should be no pain. Small cores of tissue are removed from the abnormal area and sent to a pathologist for analysis.

At the conclusion of the biopsy, an inert titanium clip is inserted into the breast to mark the site of the biopsy, in the event of the need for subsequent surgery. 2 mammographic views are performed after the biopsy to confirm that the clip is present in the breast.
 
Did the procedure hurt? I can't say that it did, not really - when you're injected with the numbing agent, that part stings a bit, but nothing a few deep breaths can't handle. After that, the area is completely numb during the procedure so there is no pain involved. But I do have to say, the loud clicking sound that the device makes every time they remove a tissue sample is definitely unnerving. At the conclusion of my procedure, they did insert titanium clips on both sides - and finished with a mammogram to confirm the clips were in place. In spite of my Xanex-induced haze, I was so curious, I just had to see. The technician was kind of enough to let me step around and look at her monitor - and sure enough there they were. I had been micro-chipped like the beloved family pet.

I was only a little sore for about two days afterward and other than the titanium chips on the inside (which I don't even know are there by the way), I was only left with two small little marks as reminders on the outside. And so then the waiting began again.The two weeks that it took to get the results from my doctor felt like two decades. Finally on October 3rd I got the wonderful news that both biopsies were benign.  I know that I am very, very blessed and very, very fortunate. Many woman are not so lucky and get the news that all of us dread to hear. So for me, relief doesn’t even begin to describe how it felt to hear my news. And trust me, the irony of getting my results in early October, as women everywhere began to celebrate Breast Cancer Awareness Month, wasn’t lost on me. My friends, I had waited three years in between mammograms – much too long. So ladies, I implore you – if you’re at the age where you should be having them done each year, please, please don’t wait. Don't put it off. Please schedule your mammogram appointment TODAY.  Breast cancer is curable if caught EARLY!