It amazes me how quickly time passes now. For half of this year, I was telling people that I am 42, but I had been 43 for months. Oh my! Don’t get me wrong, I am not hooked on age and to be honest, I am grateful for every single birthday I get to celebrate. This nonchalant attitude toward age is something I inherited from my mom who boldly declares her age much to the chagrin of family members (mainly because their ages could then be extrapolated from hers). The accouterments that accompany more and more years on the planet include getting screening tests for cancer. As women, the recommendation is, unless you have a strong genetic history of early breast cancer or have a suspicious lesion discovered on a breast exam, that we get a mammogram at 40 and beyond.
So, I turned 40 and was feeling great. After all, I was in better shape at 40 than I had been in my thirties and late twenties. Before I knew it, I was 41 and had not yet gotten my first mammogram. Shame on me, especially since I am a physician and I know better. I went in to get the test done on a fall day, and at first, I was a bit trepidatious. I had heard the stories of the annual “boob squeeze” and in my mind thought the test itself would be very uncomfortable. As you know, whenever you feel the worst, the actual situation is far better than initially anticipated. I left the exam room and walked to the waiting area, where I waited while the radiologist looked at the images and determined whether they were adequate.
The technologist came into the waiting room and told me that more images were needed. So more boob squeezing ensued. Then back to the waiting room. When the technologist came back and said that there would need to be an ultrasound done because there is an irregularity noted in my left breast, I was not sure what to think. My friends that had their mammograms never recounted having to have an ultrasound also. I began to wonder if this was residual tissue from a lesion that was removed from my left breast when I was 19 years old.
I don’t remember where I got the shower hang with the instructions for doing a proper breast self-exam, but I had it in my bathroom. At 18 years old, I was religiously examining my breasts after the random appearance of my menstrual cycle which was highly irregular with as much as 70-80 days apart. On one such occasion, I felt a lump about the size of a ping pong ball. I would move it around and wonder why I would have this at such a young age. The discovered lump was resected about a year after its discovery. At the time, I knew it had to come out, but the sense of urgency to do so was not present. When it finally did get resected, the pathology was a “fibroadenoma.” This incident occurred before Medical School, and the word, “fibroadenoma” was very foreign to me. The word that meant more to me on the pathology report was the word, “benign.”
Mammography images take one and take two in addition to ultrasound were complete. Then I asked to come to a conference room to talk with the radiologist on duty. She was pleasant and empathetic. Her words were initially lost on me as I contemplated the worst case scenario. “Some lesions are surrounding the initial operative site from many years ago are suspicious,” she said calmly. There were no previous mammograms to compare to so the assumption was that these were new and therefore warranted investigation. She told me that she wanted to get me in within two weeks to do a biopsy. Okay. Need more data. I tried not to panic. I have had young friends get diagnosed with breast cancer and watched their journeys. Would this also be my path?
Two weeks passed painfully slowly, and I returned to the Women’s Health Center to get my left breast biopsied. The same female physician that had calmly chatted with me weeks before about the need for the procedure sat down with me and gently reassured me that everything would be a lot clearer with more information. Then, my skin was cleaned and prepped, local anesthetic applied as she and I chatted about our families and favorite things to do in the summer. Somehow, small talk made the moment less tense and much more palatable. Samples were acquired, she disappeared to chat with the pathologist, then returned perhaps smiling under her mask to tell me that she got all the samples needed. We exchanged pleasantries, and I left to wait for the final pathology report to return.
This situation opened up conversations with people I never even knew battled with breast cancer or had scares. The ubiquitous nature of this disease is remarkable. It was incredible how many people I know who are personally affected by it or have a close friend or family member that is affected. Within my own family, my younger cousin battled with breast cancer and is now thriving. During the time that I waited for biopsy result, my thoughts ran amok from how would I cover my Emergency Department shifts if I needed to chemotherapy to this is just a remnant of my previous lesion.
So the week went by slowly, in my perspective, but it did nevertheless, and then the results returned. It was a tense moment like the whole week of waiting had been when the outcome arrived. My husband opened it because I was nervous to do so. He opened it and laid the printed sheet of paper on the kitchen table. Right there in big bold letters was the word “BENIGN.” A sigh of relief. A burden lifted. The word that spelled relief when I was 19 was again doing so at 41. This situation was a scare for sure.
There are several lessons I learned from this experience:
- It is crucial to get screened on time.
- Doing regular breast exams is vital at any age.
- If the result returns “malignant,” there is a considerable tribe of women to offer support, empathy, and encouragement along the journey.
So have you done your breast exam recently? If you are 40 and above, have you gotten your mammogram yet this year? If not, are you planning on it?
About the author:
Dr. Charmaine Gregory is an emergency medicine physician and Clinical Faculty at St. Joseph Mercy Ann Arbor in Michigan. She has been honored as a nominee for the Golden Apple teaching award by the resident doctors she teaches several years in a row. Outside of medicine, her passion to pursue wellness and work life balance. She is also certified to teach live group fitness classes in MMA (Mixed Martial Arts) and offers group fitness instruction to colleagues at national meetings. She is one of the coauthors of “The Chronicles of Women in White Coats.”