Running Through Cancer - Mammogram, Biopsy, Diagnosis
Life can take some really interesting twists and turns, let me tell you. This week, I was fairly blindsided by a diagnosis of ductal carcinoma (aka breast cancer).
A few months back, at a regular exam, my gynecologist noticed a small lump in my right breast. I took note of it and started being more mindful of it: did it change during my cycle, was it getting bigger, did it hurt, etc.
This may seem like a lackadaisacal reaction to something that many women would immediately take action against. But I have no history of breast cancer anywhere in my family, and I've done everything right in terms of having a low risk of this disease. I've breastfed three babies for two years each, I exercise regularly, I eat mostly healthy food, I'm not overweight (140 lbs at 5'9"), I don't smoke and never have, I don't take birth control or hormone therapy medications, nor do I have any hormone related issues. So I figured I'd watch and wait.
A week ago, I noticed a change in the contour of that breast. It's been 9 months since that first exam. This was just a small dimpling of the flesh, but enough for me to take immediate action. Off to the Breast Clinic at Kaiser Permanente Hospital I went.
My first ever mammogram would be the one that indicated a need for more tests. I've recently turned 44, so I'm right in the ball park of timing to start considering mammography. At Kaiser, it's a bit of an interesting 'spa meets cattle call' sort of set up. You check in, scoot around into a women's only waiting room, swap your clothes from the waist up for a chic beige hospital gown with inadequately placed tie closures, and wait with all the other women trying awkwardly to be modest yet pleasant and unworried.
For anyone who hasn't had a mammogram before, I'll hit the highlights. An energetic woman named Diane greeted me and set about very efficiently adjusting a tall white machine in the corner. When she was ready, she had me slip one shoulder out of my drafty hospital gown and step up to a little platform. Like "belly up to the bar," but boob style. So you stick as much of the boob in question onto a little shelf and your diagnostic helper gently lifts your boob flesh a bit further and lowers a transparent tray down onto the top of it. Using a foot pedal, she applies slight compression and steps behind a wall into her radiation free zone to take the image. This process is repeated from multiple angles and with each breast.
The images were read immediately and within 15 minutes they were telling me they'd found enough evidence of a problem that they wanted to do a biopsy. Right then.
But I'm not one to take advice from doctors lightly or blindly. So I stalled a bit and told them I'd be back in the morning. I needed to get home to discuss this with The Husband and gather information from my friend Dr. Google so I'd have some background information. Mostly, I just needed to slow the process down and get a grip on my emotions.
I spent the evening trying to make things as normal as possible. Dinner with the family, homework assistance for the kids, early bedtime as usual. We opted not to tell the kids anything yet, since we really didn't have any information. In the back of my mind, my sub-conscious was screaming at me that this was going to be a positive diagnosis. But until you have the information, definitively, it's hard to know what to do.
Off to the hospital in the morning. I was greeted with the news that they actually wanted to biopsy two sites. There was some micro-calcium in the area that was in a suspicious looking line. On the x-ray, it looked like a constellation of small stars lined up like the handle of the Little Dipper. While these calcium deposits aren't unusual, certain patterns of calcium arise suspicion. So first they opted for one site, the calcium site, to use stereotactic (x-ray) guided biopsy. Using several x-rays in slices, they would be able to guide their system to grab a small plug of the site in hopes of collecting some of the calcium for testing.
I lay on my stomach with my questionable boob through a hole in the table. They covered me with a thin blanket to ward off the chill and used small cushions to prop me up comfortably. It was important that I be absolutely still during the x-rays, to the extent that I even had to hold my breath for each film. Once they had five x-ray shots done to their satisfaction, they injected local anesthetic into the breast (by the way, if you ever have to endure this experience, this really didn't hurt - just a small pinch). Now fully numb and unable to even see what they were up to, they set about lining up the machine as indicated by the x-ray and took one punch at it. It felt just like that, like someone bumped me hard. They plopped the little plug of flesh into a mini-machine that took one more x-ray to make sure it contained the calcium, and they were done.
After staunching the flow of blood apparently streaming freely from me, they sat me up and we changed rooms for biopsy is #2. This second biopsy site would be the actual lump, and would be directed through ultrasound. Lying on my side, they injected a little more local anesthetic for good measure, and set up the ultrasound. Just like when you have an ultrasound to peek at a baby in utero, you see the little blob up on the screen, in real time.
My view of what they were doing obscured by a sheet, it was a bit freakish to watch on screen as the needle slid painlessly through flesh and lined up with the lump. A brief punch and a plug was done. They pulled the needle out and plopped the little plug into a tray. All I felt was a little tug each time they grabbed the plug, and another each time they pulled out to expel it. Eight more of these and they were done!
Between the anesthetic, the chill of being essentially topless for an hour, and the trauma of the very idea of the situation, I was ready to fall apart at this point. I remained pleasant and casual, bantering with all the helpful nurses and technicians, and sauntered out of the radiology department. At that point, I began shivering uncontrollably. Maybe it was the adrenaline burning off, but it seemed like an autonomic response to a situation I knew would end poorly. I could not quite get myself to relax enough to stop shivering.
Thankfully, just down the hall I found The Husband camped out, trying to work on his computer. I set my purse down and dropped onto the seat next to him in tears. "I think I'm screwed," was all I could manage to say. We hugged and he did his best to keep me optimistic and holding together. We went home to wait.
By the morning after the biopsy, I had myself back in control and my attitude sufficiently adjusted. This is just another challenge. Life's details can be messy and up to now I've had it pretty damn good. I had a meeting for a new marketing contract that I was very excited about, so I set aside my worries and headed to the meeting. Things went great and the distraction was complete and restorative. My gratitude toward life in general was back in place and I was optimistic for the immediate future.
When I hopped into the car to return home, I got the call. The doctor who performed my biopsies was a very efficient, pleasant asian woman appropriately named Dr. Dang, was on the line. I was surprised that there was truly not an ounce of dread or anxiety as I took the call.
She informed me I have a 1.2cm lump of invasive carcinoma. She was able to buffer that punch to the gut first by telling me this is statistically the most common type of breast cancer. Second, this size growth is considered small. The final silver lining was that the micro-calcium deposits (which I feared were the fingers reaching out from the lump), are benign.
So I have just that one lump to fight, and I'll be damned if a 1.2cm cancer bean is going to take me out.
Next up: I meet with a surgeon to hear what they propose to do about this little cancer bean.
A few months back, at a regular exam, my gynecologist noticed a small lump in my right breast. I took note of it and started being more mindful of it: did it change during my cycle, was it getting bigger, did it hurt, etc.
This may seem like a lackadaisacal reaction to something that many women would immediately take action against. But I have no history of breast cancer anywhere in my family, and I've done everything right in terms of having a low risk of this disease. I've breastfed three babies for two years each, I exercise regularly, I eat mostly healthy food, I'm not overweight (140 lbs at 5'9"), I don't smoke and never have, I don't take birth control or hormone therapy medications, nor do I have any hormone related issues. So I figured I'd watch and wait.
A week ago, I noticed a change in the contour of that breast. It's been 9 months since that first exam. This was just a small dimpling of the flesh, but enough for me to take immediate action. Off to the Breast Clinic at Kaiser Permanente Hospital I went.
My first ever mammogram would be the one that indicated a need for more tests. I've recently turned 44, so I'm right in the ball park of timing to start considering mammography. At Kaiser, it's a bit of an interesting 'spa meets cattle call' sort of set up. You check in, scoot around into a women's only waiting room, swap your clothes from the waist up for a chic beige hospital gown with inadequately placed tie closures, and wait with all the other women trying awkwardly to be modest yet pleasant and unworried.
For anyone who hasn't had a mammogram before, I'll hit the highlights. An energetic woman named Diane greeted me and set about very efficiently adjusting a tall white machine in the corner. When she was ready, she had me slip one shoulder out of my drafty hospital gown and step up to a little platform. Like "belly up to the bar," but boob style. So you stick as much of the boob in question onto a little shelf and your diagnostic helper gently lifts your boob flesh a bit further and lowers a transparent tray down onto the top of it. Using a foot pedal, she applies slight compression and steps behind a wall into her radiation free zone to take the image. This process is repeated from multiple angles and with each breast.
The images were read immediately and within 15 minutes they were telling me they'd found enough evidence of a problem that they wanted to do a biopsy. Right then.
But I'm not one to take advice from doctors lightly or blindly. So I stalled a bit and told them I'd be back in the morning. I needed to get home to discuss this with The Husband and gather information from my friend Dr. Google so I'd have some background information. Mostly, I just needed to slow the process down and get a grip on my emotions.
I spent the evening trying to make things as normal as possible. Dinner with the family, homework assistance for the kids, early bedtime as usual. We opted not to tell the kids anything yet, since we really didn't have any information. In the back of my mind, my sub-conscious was screaming at me that this was going to be a positive diagnosis. But until you have the information, definitively, it's hard to know what to do.
Off to the hospital in the morning. I was greeted with the news that they actually wanted to biopsy two sites. There was some micro-calcium in the area that was in a suspicious looking line. On the x-ray, it looked like a constellation of small stars lined up like the handle of the Little Dipper. While these calcium deposits aren't unusual, certain patterns of calcium arise suspicion. So first they opted for one site, the calcium site, to use stereotactic (x-ray) guided biopsy. Using several x-rays in slices, they would be able to guide their system to grab a small plug of the site in hopes of collecting some of the calcium for testing.
I lay on my stomach with my questionable boob through a hole in the table. They covered me with a thin blanket to ward off the chill and used small cushions to prop me up comfortably. It was important that I be absolutely still during the x-rays, to the extent that I even had to hold my breath for each film. Once they had five x-ray shots done to their satisfaction, they injected local anesthetic into the breast (by the way, if you ever have to endure this experience, this really didn't hurt - just a small pinch). Now fully numb and unable to even see what they were up to, they set about lining up the machine as indicated by the x-ray and took one punch at it. It felt just like that, like someone bumped me hard. They plopped the little plug of flesh into a mini-machine that took one more x-ray to make sure it contained the calcium, and they were done.
After staunching the flow of blood apparently streaming freely from me, they sat me up and we changed rooms for biopsy is #2. This second biopsy site would be the actual lump, and would be directed through ultrasound. Lying on my side, they injected a little more local anesthetic for good measure, and set up the ultrasound. Just like when you have an ultrasound to peek at a baby in utero, you see the little blob up on the screen, in real time.
My view of what they were doing obscured by a sheet, it was a bit freakish to watch on screen as the needle slid painlessly through flesh and lined up with the lump. A brief punch and a plug was done. They pulled the needle out and plopped the little plug into a tray. All I felt was a little tug each time they grabbed the plug, and another each time they pulled out to expel it. Eight more of these and they were done!
Between the anesthetic, the chill of being essentially topless for an hour, and the trauma of the very idea of the situation, I was ready to fall apart at this point. I remained pleasant and casual, bantering with all the helpful nurses and technicians, and sauntered out of the radiology department. At that point, I began shivering uncontrollably. Maybe it was the adrenaline burning off, but it seemed like an autonomic response to a situation I knew would end poorly. I could not quite get myself to relax enough to stop shivering.
Thankfully, just down the hall I found The Husband camped out, trying to work on his computer. I set my purse down and dropped onto the seat next to him in tears. "I think I'm screwed," was all I could manage to say. We hugged and he did his best to keep me optimistic and holding together. We went home to wait.
By the morning after the biopsy, I had myself back in control and my attitude sufficiently adjusted. This is just another challenge. Life's details can be messy and up to now I've had it pretty damn good. I had a meeting for a new marketing contract that I was very excited about, so I set aside my worries and headed to the meeting. Things went great and the distraction was complete and restorative. My gratitude toward life in general was back in place and I was optimistic for the immediate future.
When I hopped into the car to return home, I got the call. The doctor who performed my biopsies was a very efficient, pleasant asian woman appropriately named Dr. Dang, was on the line. I was surprised that there was truly not an ounce of dread or anxiety as I took the call.
She informed me I have a 1.2cm lump of invasive carcinoma. She was able to buffer that punch to the gut first by telling me this is statistically the most common type of breast cancer. Second, this size growth is considered small. The final silver lining was that the micro-calcium deposits (which I feared were the fingers reaching out from the lump), are benign.
So I have just that one lump to fight, and I'll be damned if a 1.2cm cancer bean is going to take me out.
Next up: I meet with a surgeon to hear what they propose to do about this little cancer bean.
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| 1 week before diagnosis, at the Lost Trail Half Marathon |
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