Anatomy of a Breast Cancer Scare

Before I got my actual breast cancer diagnosis, I went through three breast cancer scares.  I know the ends and outs of a breast health center like nobody's bizness.  I may be in my early 30s, but I am old, y'all.  

Before I start going into detail about what it's like to have your breasts examined, I really emphasize getting to know your breasts.  (Hey now.)  You should know how they feel and how they look.  Young women, in case nobody has told you this, your breasts are dense.  The density of your young breasts is what makes them high and proud.  When you get older, your breasts lose density and then gravity starts its cruel game against you (that's what bras are for.... in good times, and bad times....).  I'm going to write this for the young ladies and their dense bewbs.

You're doing your monthly breast exam and you feel something new and suspicious.  I want to emphasize that it's okay if you wait a month or two to see if the lump goes away, especially if the lump moves around and it doesn't hurt if you press on it.  Sometimes lumps will just show up and they do go away.  I definitely do not want anyone to freak out and run to the doctor for every lump you feel.  You will drive yourself insane.

Symptoms to look for, per the American Cancer Society:

• swelling of all or part of the breast
• skin irritation or dimpling
• breast pain
• nipple pain or the nipple turning inward
• redness, scaliness, or thickening of the nipple or breast skin
• a nipple discharge other than breast milk
• a lump in the underarm area

If the lump isn't going away or if your gut is saying "DANGER DANGER THIS AIN'T RIGHT," then the next thing you do is see your gynecologist or PCP.  Despite having dense boobs, they always want to get a mammogram of your dense girls.  Mammograms are not scary.  Please please please do not put off getting a mammogram because you think they are painful or going to hurt.  It does not hurt.  Scratch that - I did have a mammogram that hurt LIKE HELL but that was because the technician sucked.  She did not treat my boob with the TLC it deserved.  I've had a lot of mammograms, and she was the only one I encountered who sucked at it.

When you have a mammogram, it's just you and a radiation tech alone in a cold room with a very large machine.  He/she will start positioning your breast(s) in the machine in ways that are awkward and very uncomfortable.  It does not hurt, though, even when your boob is getting squished.  They take the pictures super quick and it really is over before you know it.  

Next, they typically recommend that you get an ultrasound.  I always got my mammogram and ultrasound done on the same day.  If you have ever had a baby, it is just like that.  A technician rubs goo all over your breast(s) and will never ever tell you what they see as they are taking pictures.  You can ask them questions about what's going on but they will not tell you if they think you have cancer or not.  It's probably about 15 to 20 minutes, and then you are done.  Simple.

Last and certainly not least before a diagnosis: a biopsy.  Depending on what the doctors see, you will either have a ultrasound guided biopsy or a stereotactic biopsy.  I have had the pleasure (?) of having had both types of biopsies.  If I'm not mistaken, I had a stereotactic biopsy done because the suspicious activity in my boobs were calcifications, not a lump.  An ultrasound guided biopsy is so much more pleasant than a stereotactic biopsy.   Here is a diagram from the Mayo Clinic, illustrating what a stereotactic biopsy was for me:

Yep, nothing sexy or easy about that procedure.  I hope to never have that done again.  Don't let the woman's expression fool you.  My expression was probably one of pain, discomfort and counting down the minutes/seconds until the torture would stop.

As for an ultrasound-guided biopsy, it consists of (you guessed it) an ultrasound and a very large needle.  They numb your breast first, which stings like a bitch for a few moments or so, before inserting the needle.  My recommendation: do NOT look at the needle.  Nothing good will come out that; just go to your happy place and stay there until it is over.  They will use an ultrasound to guide (get it?) where the needle should go.  It's painful and uncomfortable during the duration but it does not last too long.  

There you go.  If you are still reading this, then I want to emphasize that not all hospitals follow the same protocol.  Your doctor might see the mammogram and go, "Looks good.  Come back if you're having any problems."  I always went through the ringer because of my family history.  If you are to go through all this testings, then you should have an idea of what to expect.  Nobody wants to get these tests done but it is a necessary evil.  The important thing is to stay on top of your health and if you truly believe something is wrong, get it checked out.  If you do not believe a doctor is listening to you or taking your concerns seriously, then find another doctor.  

I'm going to step off my cancer soap box right now.