Continuing Adventures in Breast Health

Last year was the first year in several that when I had my annual mammogram, the radiologist didn't request an additional sonogram while I was there. Nevertheless, my breast specialist wanted me to go ahead and get the MRI six months later just to keep an eye on things (because I'm officially a high-risk candidate to develop breast cancer, donchyaknow).

I had the MRI done in February, which was a couple months late thanks the delayed arrival of "Aunt Flo" during that period of time (no pun intended). That was all clear too, although I can't begin to tell you how much I enjoyed the round and round with my former employer's crappy insurance company trying to get the claim submitted properly. (Side note: thanks to the recent change in my employment status and Mr. Remarkable Monkey's as well, we are now once again covered by a decent BCBS plan through his employer. Thank heavens!)

So last week, I went for my annual mammogram. I wondered if my luck would hold or if I would need a sonogram as well. The tech said no... the Rx was written for just a normal screening mammogram, so they wouldn't be doing any additional imaging. This was the first time in several years that the Rx was for a "screening" mammogram and not a "diagnostic" mammogram. I believe when it's written as diagnostic, they can go ahead and do any additional imaging if needed right then, such as sonograms. "Screening" vs. "diagnostic" can also make a big difference to some insurance companies when it comes to covering it 100% as an annual mammo. I learned that the hard way.

Well yay for me then, right? I figured maybe they're now familiar enough with all my usual lumps and dense tissue that they don't need all the extra imaging they've done for the past several years. I bounced out of the breast center confident that the results would be nothing other than "Yep... all good," and maybe I could even skip the MRI this December.

Fast forward to this afternoon, when the breast center called. "The radiologist saw a suspicious asymmetry in your right breast. We need to do more imaging." Oh joy. So basically, I have to go back in for them to squash my right boob some more to investigate said asymmetry. "We may also need to do a sonogram. Your breast tissue is very dense."

Ya don't say! Duuuuuh! This has been a known fact for years. Now, if the Rx had just been written as a diagnostic mammogram to start with, they could have done all this while I was there last week. Maybe they didn't because my current plan doesn't cover diagnostic? I thought BCBS covered it as annual either way, but maybe they don't? Who knows. All I know is now I have go to another appointment at the breast center. **siiiigh***

It's not so bad. As I've said before, the place has been remodeled and it's gorgeous! It looks like a high-end boutique hotel lobby. Check out these pictures....

I think this is actually the lobby of the NICU unit, but the breast center's lobby looks pretty much like this too.

This is one corner of the large inner waiting area... the one where you get to hang out with the other ladies in your lovely pink hospital gown top while waiting for them to call you back for the actual boob squashing.

A view of the other side of the large inner waiting area. There's also an INNER inner area with changing rooms and lockers, and a bathroom, and a small alcove with a sink, water cooler, and teas... and sometimes crackers.

Yes! It was this issue!
I am not making this up!

Pretty, isn't it? But ya know what those photos don't show? The old, beat up magazines available to help you kill time while you're waiting. They're not all old... some are from the past year or two. But get this: when I was there last week, I enjoyed flipping through an issue of Vanity Fair.... FROM SEPTEMBER OF 1997! I kid you not... Renee Zellweger was on the cover, with an article about how she's Hollywood's next big thing since she had recently appeared in "Jerry Maguire". (Yeah...THAT prediction was dead on... Not.) Seriously?? You spend a lot of time and money creating this beautiful, lush space for the patients, but you can't spring a few extra bucks for some magazines that aren't 15 years old? Really???

I found it hilarious. But maybe that's just me. I'm actually sort of looking forward to my additional appointment next week, despite the inconvenience of having to make a second trip... I think I saw a 1999 issue of People somewhere in the stacks of magazines. I need to catch up some celebrity gossip.

Adventures in Breast Health Part 1: The Smash n' Grab

When I started this blog, I didn't intend to ever post any really personal information. I'm making an exception for a topic that's very important and close to my heart: breast health and breast cancer.

I'm making this exception in part because maybe it will encourage women to get their breasts examined regularly by a healthcare professional. (Sorry... your husband, boyfriend/girlfriend or that random dude you picked up at happy hour doesn't count, ladies!) And also because relating my experiences might make it less scary for someone else who may end up traveling the same path someday. So I decided to post about my latest adventures in the world of mammograms, sonograms, and other testing. Bear with me, because this first installment will be a little long, but there's some good info here

Let me start with a little background history.... I've never had a great relationship with my "girls". Most of the women on my mom's side of the family were/are short with with big boobs, and I inherited that trait. I blossomed fairly early in that department, but not unusually so. Then in the 8th grade, there were accusations from a snotty cheerleader that I "stuffed". I quickly put an end to the rumor by flashing that bitch in the hall one day. (Boy did THAT shut her up for good!) I still didn't think I was really all that overly endowed until the 9th grade, when a male pal signed my yearbook "To the girl with big tits... love, B-- (I'll withhold the guy's name in case he ever stumbles across this blog). What?? Big tits? Who, ME??? Jeez! They were just a C-cup at that point, but I guess a C-cup on a 5'2" skinny little frame look pretty big. I was never self-conscious about 'em until then.

Enter high school, and I filled out even more, ending up sporting a D-cup by graduation. Yep... STACKED at a tender young age, surrounded by wolves. At least back then they were perky! In the years since, I've added just a few extra pounds and my cup size has increased. I'm currently spilling out of a 34DDD, and gravity is doing me no favors... I require bras and bathing suits with STRUCTURE... like steel girders and winches and iron bars. It's extremely difficult it is to find 34DDD bras in stock in most stores. (Victoria's Secret... HA! Their secret is that they don't make bras for real curves.) And who wants to mail order a bra that they can't try on first? I'll give you one guess how fun bathing suit shopping is for me. It's not the few extra pounds and the touch of cellulite that make it so miserable... it's searching (usually unsuccessfully) for a suit that covers AND supports my boobs without hanging off the rest of me like a set of old curtains. Same goes for shirts and dresses to a lesser degree. They're usually either too tight across the bust or too loose everywhere else. So my "funbags" are something I have a grudging tolerance of, and not much more.

Now, add fibrocystic lumps to the mix and hilarity ensues. I had never heard of fibrocystic breasts until I found my first lump at age 25 or 26. My gyno (love her!) ordered a mammogram to confirm that it was just fibroids (it was), and I've had regular screenings since then. All results were normal until about four or five years ago. In addition to changes in my breast tissue, my mom was diagnosed with breast cancer in 2006. Never had a family history until then. Mom was the first. (Way to blaze a trail, Ma!) Suddenly, the imaging centers were wanting to investigate mammogram findings with sonograms, and then a couple years ago, they wanted to follow the sonogram with an MRI.

Honey... you just haven't LIVED until you're lying face down on an MRI table with your boobs hanging down through the specially designed cutouts, IV drip in your arm, MRI machine banging around ya. But all results came back clean, and it was back to just the regular mammo/sono combo, but every three to six months. After about a year and a half, they cleared me to go back to just once a year. Until a year later (last year), when they wanted to do another MRI. At that point I questioned it, only because it seemed like it was turning into a big ol' merry-go-round. So I called my gyno (who has been in charge of my breast health since that first mammogram) and asked if she thought that an MRI was really the way go. That's when she decided to send me to a breast specialist.

Ooooh! Breast Specialist! Never knew there WAS such a thing! So I went to see one of the breast specialists my gyno recommended. The good news... she agreed that an MRI wouldn't really tell them what they needed to know. The not-so-good news... she said a fine needle aspiration biopsy was what needed to be done. Yikes!! The word biopsy was pretty scary to me! Made me a little nervous. But actually, the procedure is pretty quick and simple, and really not terribly painful. They just use a needle, guided by sonogram to the cysts to be investigated, and they suck out the fluid and test it. It was actually kinda cool to watch the cysts collapse on the sonogram screen. (By the way, they were investigating "complicated cysts" as opposed to "simple cysts". Complicated cysts have debris floating around in 'em. Also kinda cool to watch on the sonogram screen... like little tiny snow globes.) All tests came back normal... "See ya next year for your mammogram. We'll do a sonogram if needed".

Cut to this year. I had my annual mammogram last week. Of course they also did a sonogram (knew THAT was coming). The physician's assistant then came in and told me that the radiologist was recommending a vacuum assisted biopsy. A few days later, my breast specialist concurred. This is different than the fine needle aspiration biopsy... a bit more invasive and intensive, but still a pretty simple outpatient procedure. I found some videos that show how the procedure is done, and I'll link them. (Click the pretty colored text areas to view them.)

Am I worried? Not at all, surprisingly. My gyno just did a manual breast exam at my well-woman visit last month, and remarked that my boobs felt less lumpy. And the area they want to check out only showed up on the sonogram, not the mammogram. So it's likely that it's just a clump of fibroids (damn things). I don't expect the procedure to be very painful, though I'm sure it won't be very comfortable or fun and there will certainly be some soreness afterward. And if they DO find anything, they'll be catching it early when it's most easily treatable. Seriously... if they're gonna find something, hell yeah I want them find it as early as possible!

Even if I get the unlikey diagnosis of cancer, I'm not afraid. I personally know 3 or 4 women who have successfully fought breast cancer, including my mom. She's now a 5-year survivor! (Yay Mom!) Plus, I would probably finally get the breast reduction surgery I always wanted but never wanted to actually go through. (Now THAT'S a gruesome surgery!) Might was well do it if they're gonna be cutting bits away anyway, right? But I seriously doubt the results of my upcoming biopsy will be positive for cancer. I just don't think it's in the cards. Not yet, anyway.

So, ladies, do yourselves a favor and be sure to get your regularly scheduled "Smash n' Grab". Depsite what anyone might tell you, mammograms really aren't all that painful and they can save your life. Also, if you have chronic breast issues like fibrocystic tissue, ask if your doctor can refer you to a breast specialist. I feel SO much more at ease with a specialist checking everything out. If that's not an option, just be sure that you have a good rapport and clear communication with your doctor, AND GET REGULAR SCREENINGS!

Stay tuned... I'll post about the biopsy in Part 2 at a later date. The fun is just gettin' started!