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.
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.