Wednesday, January 20, 2016

My Mammogram Surprise!

Jan. 7, 2016 The Chatterbox 

"Prepare the umbrella before it rains
Life is full of surprises!"
Author unknown

In addition to protection from the rain, there are many other kinds of umbrellas. And as I count my blessings going into this New Year, I would like to share with you an umbrella procedure that may have saved my life. It was a mammogram that launched me on an unexpected medical journey for the last fourteen months.

Sentinel Columnist Betty Kaiser
On November 5, 2014, I blithely zipped into our local mammography lab for my annual mammogram. I was feeling fine and never dreamed that anything was wrong. I have had one of these every year since I turned 40 with nary a problem. The machinery for this procedure is state-of-the-art and only momentarily uncomfortable. I chat with the technician, get smashed, dressed and leave.

At home I waited for the report that says: “Everything is normal. See you next year.” It didn’t happen. Instead, I received a report that said a small mass had been detected and additional evaluation was recommended. That included diagnostic mammography, spot compression films and ultrasonography.

I was shocked. Blindsided. I couldn’t believe it. One minute I was fine. The next minute I wasn’t. What had gone wrong? I’d like to tell you that my Pollyanna side was preaching “Don’t worry, you’re okay,” but it wasn’t. Deep down, I just knew that a little cell had gone haywire and I was in for a hard ride.

My husband and I were leaving town the following week and I didn’t want to go without knowing more about this small mass. Was it malignant or benign? I needed to know ASAP. As each appointment was piled on, my heart would pound and I felt light-headed. I was overwhelmed by endless information and procedures. This was really happening-to me-and it was scary.

More mammograms and ultrasounds were performed and each time I could tell by the quiet in the room that something wasn’t right. After I got dressed, the radiologist put two sets of images up to compare. The previous mammograms were clear. This time there was a small glowing spot in the tissue. Cancer? A biopsy was the next step to answer that question. Another umbrella.

I was given a tour of the room and the machine that would do the recommended stereo-tactical biopsy. Then, the machine had a time-out (break down) and the procedure was cancelled. Next I was informed that the radiologists had “a difference of opinion.” They were now recommending an ultrasound guided biopsy and the insertion of a clip in my tissue—right after another couple of mammograms.

 “Cancer” and how to treat it became the word of the day. By then my vocabulary had expanded. Pathology reports used words and phrases like “a DCIS Solid with comedo necrosis (plugged by cancer cells); intermediate grade with estrogen receptor possibility." I added more vocabulary (and tension) after I saw the surgeon! He was another umbrella.

Finally, after all the bad news, there was good news. Definitive surgical management was recommended but only a partial mastectomy. Among other things, the mass was “in situ” (confined to the breast duct) and hadn’t spread itself around. That was good. But unfortunately, even with the clip in place the small mass wasn’t easily found. Later a metal hook had to be attached to mark the spot for the surgeon to find. Ouch!

As word of my diagnosis got around, friends, neighbors and perfect strangers started calling me with their stories. That was both helpful and overwhelming. But by the time I got to the hospital I had an idea of what was going to happen from the female perspective. One of my friends told me about the search for the Sentinel Node in Nuclear Medicine in such detail that I wasn't terrified and actually knew what was going on when I got there.

Prior to that I had (again!) been squished by mammography, injected with anesthetic, squirted, the mass located and the previously mentioned guide injected for the surgeon. I will tell you that it was the most painful part of the process. Tears ran down my cheeks as a sweet nurse rubbed my back. Covered with marks and bandages I was wheeled into surgery and came home that night.

In my case, follow up treatment was a little dicey. Tissue samples revealed that although the cancer was contained, its nuclear grade was Intermediate/High. That made a recurrence more likely. A decision was made to treat it with an anti-estrogen drug and a medication to strengthen my bones.

I am happy to report that as of Dec. 18, 2015 my one-year diagnostic mammogram was clear. I’m on a five-year treatment plan like many other breast cancer survivors. The medication is tolerable but not pleasant. However, I have one year down with only four more years to go. Another umbrella. I’m a grateful woman.

Now here’s the bottom line and the reason why age appropriate women must get a mammogram every year—a mass the size of mine cannot be seen or felt. It can only be detected by mammography. And the mass is always cancer at 70 years old! Think about that. If I had waited another year or two the mass would have grown and spread. Timing is everything.

My advice to you is simple: if you are a 40, 60 or 70+  year old female, make an appointment for a mammogram! Stop procrastinating. Get your mammogram scheduled and done. Do it this year and every year. I don’t care what the so-called experts say you’re never too old for this procedure. I’m a good example that it's worth your time.

Have a happy, healthy New Year!

Betty Kaiser’s Chatterbox is about people, places, family, and other matters of the heart.