Better Safe Than Sorry

On Tuesday, March 9, I took the day off to take the girls to the dentist. Later in the day, I went to a routine mammogram. With homework, violin lessons, work, my classes for my graduate program, it’s hard to fit these medical appointments in our busy schedule. I decided it had to be done. While making my mammogram appointment, I realized I forgot to go in 2009. My very first mammogram was on January 5, 2008.  The appointments were fairly routine: Josie had no cavities, Ava had two small ones and my mammogram went off without a hitch.

I got a call the next day. They needed me to return to get a better picture of my left breast. I was greatly annoyed. Why can’t these technicians do an accurate job? They obviously missed  a position or didn’t calibrate it correctly or something. I can’t take another day off do this! I am a teacher. When I am absent from my job, I have to make several phone calls, complete paperwork and make lesson plans.

March 19th: I go in immediately after work. I am told during my exam that there are two slightly suspicious calcium deposits in my left breast. They want a better look. By end of evening, I learn that cancers begin this way, although 80% of the time, it’s benign.  Of course, I believe, mine is benign. Such needless drama, really.

The technician takes a look at the screen when we are through. Silence. “The doctor would like to discuss these results with you.” After I’m dressed, she takes me to another room. It’s dark and cold. I wait for a very long time. This can’t be good. Finally, a tall, handsome man with kind eyes enters the room and sits. He tells me that he thought long and hard about recommending a biopsy, but he wouldn’t be able to sleep at night if he let it go. There is a suspicious abnormality in two places. This news sounds like it is addressed to someone else. Biopsy? Doesn’t cancer naturally follow?  He mentions needles, possible surgery, but start with a needle. OK, I nod. I will do it. No problem, better safe than sorry.

As I leave, I feel a slight pit in my stomach. This will take more time out of my schedule. This will cause my parents worry.

April 5: I take a half day to go get a stereotactic mammogram and (hopefully) stereotactic biopsy. This is when a long needle is pushed into your breast and the mass is retrieved. “The mammo is weird, you lay on a table on your stomach. There is a cutout for your breasts. It’s creepy,” a friend tells me.  “But it’s easy. The needle is huge,” (she spaces her hands about a foot apart, I feel faint), “just ice it for a couple hours after wards.”

Instructions for the stereotactic mammogram: No perfumes, no jewelry, no deodorant. This should only take 20 minutes, the technician informs me.

The mammogram is painful. I lay on my tummy on a hard table. As promised, there is an oval cutout for my chest. Medal paddles squeeze my breast from different angles.  The female technician squeezes my breast so tight with the medal paddles I literally cannot breathe. “Hold still!” I am told over and over again, position after different position.

One hour later, a discouraged technician apologizes. She’s sorry, but she just can’t get it to work. I will need a surgical biopsy.

Report: “Multiple positions were attempted and either the breast thickness is insufficient for the stereotactic device or the target cannot be positioned within the biopsy device.”

I call Willey in tears. I can’t believe this. It’s escalating – this situation – I can’t believe I actually have to have surgery!

My OB/GYN calls me and recommends a surgeon. My friends and co-workers suggest names. Recommended doctors either don’t do surgical biopsies anymore or no longer do them unless you are diagnosed with cancer. I go to my OB/GYN’s surgeon.

He is a tall, serious man with glasses who tells me step by step what will occur, what to expect. He does not crack a smile, not even once. His demeanor is 100% clinical. I believe he is completely competent, even if lacking in warmth. He tells me “due to the size” of my breast (read: small), the biopsy may leave my breast disfigured.  Yes, he used that word. Disfigured. He will try to make only one incision, but the two masses are on opposite sides. He may have to make two incisions. One of the deposits is located so far it’s next to my chest wall. I chose to go alone to this meeting. It might have been better if Willey had come along. Before surgery, I will need to get a wire localization done. This is because the deposits are so small, the surgeon needs a guide to find them. Another mammogram is required. They will locate the deposits, insert a needles and two wires for each “mass” and then I will make my way to the hospital for the surgery. I start to feel squeamish.

I have always been small chested. It bothered me for a very long time. Our society equates beauty with bosoms. Plastic surgery is a popular option, even for people who can’t afford it. I felt inferior in this department through those tough teenage years and into my young adulthood. But after breastfeeding two children, I have had a new found respect for my body. It works. It’s strong. Two beautiful lives emerged from it and my (small) chest somehow found a way to feed those two babies. I have, late in life, come to appreciate my body, flaws and all. And now, it was going to be disfigured. I cried in my car on the way home and washed my face before picking the girls up from school.

I call my sister and express my frustration and my fears about the “disfigurement.” Better to be safe than sorry, Caroline. You can always  look at fixing things later with cosmetic surgery. She is right, of course. I hate it when my baby sister is right.

Next post: Staging and Aging

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