Thursday, July 21, 2011

Adventures in Breast Health Part 3: Results and Risk Management

Well, Campers... are ya ready for the big reveal? Wanna know what the biopsy results were? The breast specialist's office called me when they got them the day before my follow-up appointment to let me know...  Just as expected, the tests came back negative. Normal. Nothing to worry about... at least for now. Here's what the report said:
Breast (Left, 10 o'clock, 5 cm from nipple), core needle biopsy:
- nonprolferative fibrocystic changes.
- no atypia or malignancy detected.

COMMENT: The fibrocystic changes include stromal fibrosis, adenosis, and slight duct epithelial hyperplasia.
What does all that mean? Basically, that I have lumpy boobs (which we already knew), but nothing cancerous. At least for now.

So on to the follow-up with the fabulous ARNP (Advanced Registered Nurse Practitioner) that is my breast specialist from the breast surgery medical group I was referred to last year. She is awesome. She checked the biopsy site and said it looked like it was healing fine, no edema (swelling), no bruising. She did a breast exam, and pointed out a lumpy cyst or two for me to feel... they were familiar (I've felt them there before), but I'll keep an eye on 'em. Then we talked about my future adventures in breast health. Let me tell ya... sounds like it's gonna keep on being interesting. I'll explain...

I am now officially in the "high risk" group. Last year, I was rated at 18.7%. This year, based on a whole bunch of factors, I am now rated at 21.4%. Or maybe it was 18.4% last year and 21.7% this year... can't remember. Regardless, 20% is the magic number. If you cross that line, you are considered at high risk for developing breast cancer at some point in your lifetime. Well heck... I was damn close to 20% last year, so it's not that big of a difference. BUT... now that I am officially high risk, it makes me a candidate for breast MRI.

Oh boy. Yep. Back on THAT rollercoaster after all! But at least now it is actually warranted. And here's why, as my breast specialist so eloquently put it: "At this point, mammograms are pretty much useless for you. You're too dense." Well, it ain't the first time someone has called me dense! I CAN be a little slow on the uptake at times. But what she meant was that my breast tissue is so dense that a cancerous tumor could easily be hidden on a mammogram. A mammo is still good for showing calcifications, but all those lumpy, dense fibroids hanging out in my funbags would help hide any pesky tumors that might decide to camp out there. An MRI will smoke 'em out. And that's a good thing.

Unfortunately, it's also possible that the MRIs could lead to more biopsies because more suspicious (but benign) areas may show up on the images. But that's okay... I feel the same way as the 2-year survivor PA who performed my biopsy does: If you see ANYTHING remotely suspicious, stick a needle in it and let's find out for sure! I'd much rather sit through a few needle sticks every year than miss a cancer in the early stages and have to endure THAT kind of treatment. (Seriously... I cannot stress enough how painless the biopsy was.) Not sure yet how often they'll want to do the MRIs. Could be every six months, or once a year, or every other year. Depends on what they find after the one I'm supposed to get six months from now.

So I'll be scheduling a breast MRI in December if I've met my deductible by then, or January if I haven't so that the out of pocket cost can go toward next year's. Yeah... chalk up another penalty courtesy of my boobs: I get to pay for an expensive MRI or two every year. Even with my insurance plan's discounted rate, it's gonna be pricey. I'll have to squeeze our tight budget just a little more. And just like with the small band/big cup syndrome, I'm left wondering what women who have the same breast issues as mine but smaller budgets do. What do they have to give up to get the screening they need? How will I afford regular MRIs myself if I ever lose my insurance or they opt not to cover them? Would I have to risk developing an undetected cancer because I can't pay for an MRI that would catch it? Probably. Fingers crossed I'll never have to make that choice. My heart goes out to the women who do.

I am also now required to have a manual breast exam twice a year. (By a professional. Sorry... I'm not looking for volunteers!) I already get one at my annual "well-woman" visit. I can't remember if my GP does one at my annual physical, which coincidentally and conveniently usually falls about 6 moths after my well-woman exam. If not, I'll just call for an appointment with the specialist. What the heck... it will get me closer to meeting my deductible, right?

So all is well for now, and my current adventures in breast health are complete for the moment. Who knows what kind of circus will crop up when I get the MRI at the end of this year. But I'll definitely share the fun with y'all! Hopefully, it will help put you at ease if you find yourself in a similar situation.

This has been a public service post. And now, back to our (ir)regular programming.

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