Reason #2354 you shouldn’t work out. I was at the gym in early November working with my trainer as I had for the last nine months. I was done. Didn’t want to be there. So I rushed through the last reps of the last set of shoulder presses. Immediately after I knew I had made a mistake. I couldn’t fully straighten my arm. Long story short- I went to urgent care who told me I likely tore something, so I followed up with my primary care physician. While there we chatted about the fact that I hadn’t gotten my routine bloodwork yet or gotten my mammogram that was now a few months past due. The next day I showed up bright and early at the lab for my bloodwork and then I called and scheduled my mammogram for the next week.
On November 11, I showed up to St. Vincent Breast Center. I’ve always gotten my mammograms here because I’ve heard it’s smart to always go to the same place so they can easily compare for any changes. It was a chilly day but the environment is always so warm and cozy there. On this day they gave me a long pink flannel gown to wear. While waiting I sent a text to my friends that all I was missing was a glass of wine. I got changed, went with the kind lady, did the poses, had the discomfort, and left. Everything seemed perfectly normal.
One week later I received a call from the imagining navigator stating they needed more images for my mammogram. (A little side note: navigators are amazing people that work throughout this whole system who hold your hand, listen to you cry, and answer all of your questions.) I listened to what she said: basically I had an area of asymmetry and calcifications that were causing them some concern. I needed to come back in for a diagnostic mammogram and an ultrasound. Like any good patient I immediately turned to Dr. Google and looked up what this meant. As I would learn and regret many times over this journey- Google is not your friend. Google is not there to help you or give you more information. Google is only there to scare the pants off you.
The following day, I called back with my new arsenal of questions and the imagining navigator very carefully answered all of my questions. The day of the diagnostic mammogram arrived. I believe it was December 1. The imager came and got me and did a very thorough exam. When the mammogram portion was complete, she pulled the images up and showed me the images of the concerning areas. I saw the little white specks and the slightly denser area. She drew me a picture of non-concerning calcifications which are round and dispersed. Then she showed me mine- which were grouped together and irregularly shaped. We then moved on to the ultrasound, where she couldn’t find any particular mass… I guess this is fairly common for changes in density.
The most reassuring part of a diagnostic mammogram is that you don’t leave without more information. The imager consulted with the radiologist before I left and it was determined that I did in fact need a biopsy. I could definitely feel the change in the air when she returned. I asked her how worried I should be about all of this. She looked me straight in the eyes and said, “Honey- you need to just give it to God. All you can do is pray.” Now- I consider myself to be a fairly devoted Christian and pray regularly each day, but NOONE wants to be told to pray as answer to that question. Now, don’t get me wrong, she was incredibly kind and stopped by to see me at a later appointment. I appreciated her candor. I would rather be prepared to some extent than caught off guard. I left that appointment with a biopsy appointment nearly 2 weeks out, a hot pink folder with my instructions and went home and started… Googling.
The next day I called the imaging navigator back with a notepad full of questions. If there’s one thing us lawyers are really good at, it’s beating a subject to death. I was ready. She carefully answered all of my questions and then even went to go talk to the radiologist. It was then I learned they were “very concerned” and gave me a BIRADS score of 4C. (Educational side note: Mammograms are numbered 0-6. 0 means needs more info. 3 means follow up in 6 months or so. 4 is split into A,B, and C. 5 means they are 95% confident you have cancer and 6 means you have confirmed cancer.) So a 4C is not so great. I cried. She listened and told me I would be fine.
The next two weeks were a lot of Googling and watching YouTube videos. The more I watched, the more I convinced myself that even if I did have breast cancer, it was likely the “easiest kind”, DCIS, and could be treated with a quick surgery and maybe a hormone blocker for a while.
Finally the day of the biopsy arrived- December 16. I was scheduled for a stereotactic biopsy which is basically a biopsy that takes place during a mammogram. It is 100% as fun as it sounds. The machine is also ridiculous and clearly designed by a man. You climb up on a table with a hole in it. You lie there with your backside up in the air as a mammogram takes place under the table. They then insert the collection needle and take a number of samples. I was a little shell shocked through the whole process but was quite happy I had worn my ultra high waisted jeans for extra coverage. Being the thorough person I was, I asked the radiologist who performed the biopsy what she thought it was, and how worried I need to be. She was very compassionate and told me it could be nothing, but it probably wasn’t. In the end, they gave me a Band-Aid and little ice packs and I was on my way. Biopsy results would take three business days. This was a Thursday. Great.
Fortunately that weekend was full of ICC concerts and Kimberly’s 16th birthday so I was as busy as possible which was a nice distraction. Monday came along and I called to check- only once, which I felt showed great restraint. That afternoon, the imagining navigator called me back. Before she could even start, I asked her if I needed a notepad, or would this be quick. She told me to get a notepad.
She then told me that my biopsy results came back and that I had invasive ductal carcinoma. This was the first in what would turn out to be a series of bad news. I wasn’t counting on the invasive part. If I was going to have cancer, I had told myself it would be the “good” kind. It would be ductal carcinoma in situ, meaning it hadn’t invaded the cells nearby. This was already turning out to be more than I was ready for. The cancer was grade 3 meaning the cells were highly distorted, but they didn’t have the receptor testing done yet. I didn’t cry during this conversation…but I did go to my friends and do a little crying.
The navigators called me back in a bit. I was in my friend’s office and she googled the recommendations as they read them to me. We picked one- Dr. Spivy- and I had an appointment for the next day. This was just a taste of how fast all of this was about to happen. I was worried I would have a hard time remembering all the details now that I’m 8 weeks in. That’s clearly not the case. Next up will be the number of appointments that come when you’re first diagnosed. Hint- it’s a LOT.
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