Yes. The results are in. But before I share the news, let me tell you a bit about my breasts.
I go to a women’s breast center for my annual mammogram. It’s a cozy, boutique-y place with Zen decor and ambient lighting and a receptionist who calls you “Sweetie” in her Southern drawl. The place is so soothing, so womb-like, that it seems inconceivable that cancer would be allowed in the door.
Two years ago I had two breast tumors excised. They were benign, which was good. But the pathology report revealed Atypical Lobular Hyperplasia (ALH), which is not so good.
If you ask your doctor questions about ALH, or if you surf the internet looking for information — and I strongly recommend that you don’t — you will just become more confused and white-knuckle-y. Some people call ALH pre-cancer. My doctor calls ALH “the stage before pre-cancer,” which I like better, so I’m going with that.
ALH is the breast version of a funky pap smear. There are clusters of cells in the lobules that are overgrown and are referred to, ominously, as “marker lesions.” Having ALH doubles your risk for invasive breast cancer. Breast surgeons and oncologists will tell you that taking Tamoxifen will lower your risk by 85%. However, Tamoxifen also plunges you into menopause AND increases your odds of stroke and blood clots.
This is a problem if, like me, you also have an elevated risk of strokes and blood clots. When I was pregnant, I had a bizarre autoimmune condition — antiphospholipid antibody syndrome — that put me at risk for clots and strokes. My blood tests are back to normal now, but no one really understands autoimmune conditions and there’s always the chance that those wacky antiphospholipids could come back.
I opted not to go on Tamoxifen. But I worried all year that a massive, spiky malignancy would appear on this year’s mammogram.
So as I sat on the examining table in my fluffy white robe (one of the benefits of going to a women’s center), I imagined the radiologist giving me a grim look and squeezing my hand.
Everything felt like an omen. I was reading Nora Ephron’s I Remember Nothing on my iPad, which suddenly meant I had cancer because she had, in fact, just died of cancer. The itching on the side of my breast was not dry skin, but inflammatory breast cancer. The stress that had hammered me in my nine post-divorce years had surely caught up with me and had set up something like a meth lab in my mammaries.
A nurse breezed in, all perky and freckle-faced, and explained that I would get my mammogram, then meet with the doctor, then have my ultrasound.
As an extra precaution, I get a breast ultrasound in addition to a mammogram. I do this because I have ALH and also because I have “dense breasts,” a term that is pejorative only when uttered by mammographers. Dense breasts are great for filling out t-shirts…
…but lousy when it comes to breast exams (everything feels like a bunch of grapes) and mammograms (the dense tissue can obscure signs of cancer).
The nurse ushered me into the mammographer’s room, where I faced the dreaded mammography machine. The technician was aloof and matter-of-fact, but who wouldn’t be? Being a mammographer is probably worse than being a dentist. Women look at you like you’re the Grim Reaper and you spend your day subjecting them to searing agony as you smash their poor, helpless breasts between two slabs. I held my breath and grimaced, and finally, it was done.
I went back to the examining room and waited. And waited. The doctor came in. She’s thirty, if a day, and beach-girly. She smiled as she told me the screens “looked good, but the radiologist still has to look at them.”
We dissected the ALH situation, and she agreed with my decision not to take Tamoxifen. She told me about a new study that showed a 50% decrease in breast cancer in ALH women who follow a surprisingly natural protocol:
– 5000 units of vitamin D3 daily
– 3 cups of green tea (loose leaf, not in tea bags) daily
– aerobic exercise four times a week
How could I say no to this? (Note: I am not a doctor and this is not intended to be medical advice. Please check with your physician before trying this regimen). It’s cheap, it’s holistic, and it will get me into shape.
Next, I went to the ultrasound room. The radiologist told me my mammogram screens looked good and proceeded to squeeze hot goop on my chest as he moved the ultrasound thingy over my breasts. The radiologist was white-haired and wizened, which made me happy, not just because he was older than I am, but because he had to have done about a zillion ultrasounds. He pointed out cysts and fatty tissue on the monitor. A few times he squinted and paused, then asked the assistant to magnify and light up a certain area that puzzled him. Then he assured me the spots were just cysts and I unclenched my jaws.
Finally, he turned towards me and uttered the words every woman wants to hear:
“Everything looks normal.”
I got dressed and practically skipped out to the receptionist’s desk. My insurance covered the mammogram, but not the ultrasound, so I handed the receptionist my credit card. I felt a tidal wave of gratitude wash over me, not just for the normal results but also because I have a job with health benefits and I could afford the $280 out-of-pocket for the ultrasound. I asked if the center provided services for low-income women and she said no, but they would like to. I wished I was rich. I wished that rich people would stop buying dressage ponies and set up foundations to ensure that every woman has access to breast screenings.
Later in the day, I sat at my desk at work, closed my eyes, and felt warm green tea wander down my throat. In the tumult and bizarreness that has been my life the past nine years, how wonderful it was to hear the words:
Everything looks normal.
Elizabeth Aquino says
Whew. And thanks for the education. But mainly, whew.
I will confess that when you said mammogram, I skipped to the end to find the results before reading the whole piece. As someone who only ever had one mammogram (yes, it was cancer, so they were both removed and that ended my mammograms!) I have to agree that yes, everyone should have access to great healthcare, and yes, it’s a terrifying experience. I’m very glad you’re not going through that, and that you are blissfully normal.
Thanks, PollyAnna — and I’m so glad you’re okay now.
I’m glad you are okay. Just fyi, there is at least one new alternative to tamoxifen that seems kinder and gentler, from what I’ve read. (Of course, I can’t remember the name.)
But as someone who had a biopsy, dense breasts are apparently the number one predictor of breast cancer and I think it’s obscene this information is not more widely known. You actually can ONLY tell if you have dense breasts from a mammogram, because it indicates how much of your tissue is glandular. You should have been rated in one of four quadrants, and the more glandular tissue, the greater your risk. (I’m in the third quadrant.) It outranks a family history of breast cancer in terms of predictiveness, but no doctors seem to use this information and most patients don’t know about it.
Ick. That’s scary.
Christina Simon says
Glad it went well and “normal” never sounded so good! I’m in the same situation…my mom died of breast cancer so mammograms are always a stressful, panicky time for me. I LOVE the word “normal”
Cuckoo Momma says
Thank God. So happy for you.
Gotta post my updates about my own “annuals” (short version: everything’s stable, see ya next year)… Congrats on your normalcy!
Once again, we were separated at birth! I just had my first “abnormal” mammogram–I suppose I should count myself lucky, as my mother had breast cancer pre-menopause and I, well, I’m well past that…. I had to do the repeat mammo & ultrasound–all to say that the area of concern is “probably benign”–come back in 6 months. Yow. What a deal. I used to have breast-cancer phobia and am the exact person they were talking about when they said that breast self-exam caused more anxiety than identified malignancies. I used to have heart palpitations just at the thought of the monthly exam. I’m glad to turn it over now, to skip out of the hospital with a “probably benign” diagnosis and another 6 months of carefree breasts!
Yay for the next six months! May the rest all be benign.