PinkState: When 0 > 1

FILE - This undated fluorescence-colored microscope image made available by the National Institutes of Health in September 2016 shows a culture of human breast cancer cells. For the first time, one of the new immunotherapy drugs has shown promise against breast cancer in a large study that combined it with chemotherapy to treat an aggressive form of the disease. Results were discussed Saturday, Oct. 20, 2018 at a European Society for Medical Oncology conference in Munich and published by the New England Journal of Medicine. (Ewa Krawczyk/National Cancer Institute via AP)

 

Last week, I shared my personal experience in honor of Breast Cancer Awareness Month. The aim is to remind people of the importance of keeping up with their recommended screenings — not just for breast cancer, but for all screenable cancers.  According to the National Cancer Institute:

  • Approximately 39.5% of men and women will be diagnosed with cancer at some point during their lifetimes (based on 2015–2017 data).

That’s 4 in 10 people. That means that nearly everyone will be touched by cancer at some point — either facing it themselves or having a loved one go through it. After my own experience seven years ago, I’ve often told people, “If you’re going to get cancer, do it like I did.” I don’t say that to be flippant — my point is that because mine was caught early, it didn’t require extensive treatment and I was able to beat it relatively easily.

Ironically, there was an issue with my most recent mammogram (which I underwent the day of my previous post.) My doc called me the next day to alert me they saw a “focal asymmetry” in the left breast — which could have been nothing, but a diagnostic mammogram (and possibly an ultrasound) were needed as follow-up. I had those this past Tuesday. Turns out, it isn’t nothing — but it still could be nothing particularly ominous. I’ll be undergoing a biopsy this coming Friday to find out for sure.

Hopefully, this won’t be Round Two for me, but if it is, I know the drill. In the meantime, I’ll be continuing this series with a look back at my own experience and what I wrote about it at the time:

Last week, I did my best to gently nudge my female friends to stop procrastinating and make those mammogram appointments they’ve been putting off. As I explained previously, turned out mine was a wake up call I hadn’t really expected. It revealed some calcifications in my right breast, which often signify nothing but sometimes can spell trouble. These are itty-bitty things that one would never feel or be aware of in the slightest absent the wonders of modern day technology.

In order to rule out their being something more than nothing, I underwent a “stereotactic” biopsy this past Thursday. If you’re like me, you probably don’t know what “stereotactic” means, so I’m including the handy dandy Merriam Webster medical definition here for you:

“involving, being, utilizing, or used in a surgical technique for precisely directing the tip of a delicate instrument (as a needle) or beam of radiation in three planes using coordinates provided by medical imaging (as computed tomography) in order to reach a specific locus in the body (as a tumor in the brain or breast)”

Basically, they use a modified mammogram technique to visualize the area of concern and then use that to guide this hollow (“core”) needle to it in order to extract several strips of tissue for further examination. Sounds easy enough, but it does have its tricks: For starters, they have you lay down on a special surgical table, face first. It has an opening toward the top for your breast to – theoretically – hang through, and a pillow above that on which you rest your head, facing one side or the other. Then they elevate the table and the nurses and technicians get you all positioned just so and take several different films in order to pinpoint the calcifications – it’s pretty much like getting a horizontal mammogram. The mammography unit then holds you firmly in place so the radiologist can perform the biopsy. The table they have you on is padded – somewhat like an ironing board – so it isn’t terribly uncomfortable. What is uncomfortable is that you have to lie very still while all this is going on, which means you can’t move your head or neck at all – for as much as 30-45 minutes.

I, of course, further complicated things by managing to have calcifications in the upper outer portion of my less-than-ample boob – which made actually getting the things visualized and me positioned properly for the procedure rather awkwardly difficult. Finally, the fine folks who were working with me quite apologetically asked me to get down off the table so they could remove the padding from it in hopes that this would then allow the target area to hang through adequately enough. Thankfully, it did. (Never thought I’d consider the fact that gravity has very little effect on my breasts a bad thing, but in this case, it was – who knew?!)

At long last, we had visualized calcifications and properly-positioned Susie. Next came the requisite prepping of the biopsy site with antiseptic swabbing and then local anesthetic. (Yes, this involved a needle – no it wasn’t all that bad – pretty much just a pinprick.). Then the radiologist went to work and extracted several tissue samples from the afflicted area. They had to run them to the next room real quick to examine them under a microscope and verify they’d gotten the calcifications, which – yay! – they had. (Yes, I actually said, “Yay!” when this was confirmed.) The biopsy itself only took maybe 5-7 minutes. At that point, they freed me up and it was merely a matter of applying pressure to the incision site and then, after I rolled over (much to the joy of my stiff neck), applying Dermabond surgical glue to the incision – which was about a quarter-of-an-inch – and then a dressing over that, which the nurse did quickly and efficiently.

I cannot stress enough how absolutely professional, kind, caring and warm the staff was throughout this experience. Everyone I dealt with at the breast care center was great, and in particular, Lisa, the nurse who explained the procedure before, who bandaged me up after, and who stood by my side and talked to me and reassured me during the procedure, occasionally reaching over to pat my head or rub my shoulder, was phenomenal. Also, Dr. G, who performed the biopsy, actually was kind enough to massage my neck while we were in a holding pattern at one point during the process. Moreover, they do their best at this facility to make it feel not-so-clinical. There are numerous feminine touches throughout the offices and exam rooms, lots of pink and positive messages. And during the procedure itself, the lights were dimmed and there was soft music piped in – it almost made it seem spa-like.

Almost. Point being that as much as I wasn’t there for a facial and a Swedish massage, what might otherwise have been an uncomfortable and slightly scary experience really wasn’t all that bad.

Afterwards, I sat with Lisa in her office while she went over my discharge instructions: that jittery feeling I had was residual from the epinephrine which is included with the lidocaine they use for the local anesthetic and would go away once I went home and rested/napped for four hours; bandage was to stay on for 24 hours; no lifting more than 10 lbs, and no torquing-type motion with my arms for a few days (there went my grand plans of vacuuming and lawn mowing this weekend!) My Mom was kind enough to be my driver that day, so she took me home and I did as I was ordered. Okay, I did respond to the dozen e-mails that had invaded my work e-mail Inbox that morning, but after that, I rested. And have done a fairly decent job of taking it easy since. The incision is small and healing fine, there’s only minimal bruising, and I’m only mildly sore.

They told me I’d either hear back regarding the pathology results on Friday or, more likely, Monday. When Friday came and went without any word, I pretty much put it out of my mind for the weekend. I wasn’t overly concerned. I remained optimistic that the news would be good – the calcifications would be benign – and we’d all go on our merry way.

To my surprise, the radiologist called me on Saturday. She had the results and said she didn’t want me to have to wait out the weekend. Unfortunately, she wasn’t able to be the bearer of good news – though, it wasn’t terrible news either. I have “carcinoma in situ” – which is an early form of cancer that is defined by the absence of invasion of tumor cells into the surrounding tissue. They classify it as “Stage 0”. Which is, of course, better (greater!) than Stage 1 or 2, and way better than Stage 3 or 4. Basically, Stage 0 means there’s no tumor, no lymph node involvement and no distant metastasis. I just had some nasty little cells hanging out in there that would very likely turn into something worse if left untreated.

So…my next step is to have an MRI of both breasts. This will thoroughly scan for any other nasties. If none are found, then no further treatment will be necessary at this time. If some are, I may have to undergo another biopsy, or, depending on the extent, a lumpectomy and radiation. Obviously, I’m partial to the first option. The good thing about the MRI is that even though it will require me to lay still on my stomach once again for around 45 minutes, per Dr. G, they shouldn’t have to remove any padding to scan me. Sure would be nice if they had it set up like one of those massage tables so I wouldn’t have to keep my head turned to one side the whole time, though!

Dr. G was very apologetic for calling to give me the news she did. Though as my friend Cari described it – it’s the “best bad news” I could have hoped to get. Dr. G did say that it was really fortunate that I got my mammogram when I did – it basically enabled them to catch this at its earliest stages. So I’m looking at this yet again as my opportunity — and responsibility — to nudge others to not put off those mammograms any longer. And that goes for men and prostate exams, and for everyone and colonoscopies, etc. — get tested and scanned when it’s recommended. Don’t be a procrastinator when it comes to your health. Hopefully, all will be well, but if not, think of how much better it is to catch these things and squash them when they’re zeroes.