Choose Your Own Adventure
10 Ways to Reclaim Your Summer

I might choose to have my breasts removed

I may have to decide soon whether or not to keep my breasts.

There has been a history of breast cancer in my family since I was 15. My paternal grandmother had a malignant lump in her breast. She went into surgery not knowing if she would have both breasts when she came out. She did not. She had told her doctor that if he found anything, to cut the whole thing off, so he did. This was before the law required insurance companies to pay for reconstructive surgery after a mastectomy, so my grandma wears a prosthesis. She had radiation treatment after her mastectomy and has been cancer-free for two decades. A few years ago, one my mom's sisters had a malignant lump removed from one of her breasts. She had radiation treatment afterward and is cancer-free but, man, she was a wreck during her treatment. One more little bit of reproductive cancer history: Another of my mom's sisters had ovarian cancer when she was 18.

A few years ago, I posted a question for the ladies, asking if they would opt for a lumpectomy or if they would ask the doctor to take it all. I said that if I had a malignant lump, I would have a double mastectomy. Even more drastic than that, if I tested positive for the BRCA1/BRCA2 genes, I would have a double mastectomy. My breasts are not so important to me that I would risk my life to save them. I would rather have peace of mind than breasts and if I only had a lumpectomy, I would be worried for the rest of my life about a recurrence of breast cancer.

Last year, I talked to my OBGYN about having a mammogram and a test for the BRCA1/BRCA2 gene. My history was not quite impressive enough (no first-degree relatives) for my HMO medical group to approve the test. I appealed with the insurance company and was denied coverage for both tests since I am only 35. My mom, who did have a first-degree relative with breast cancer, was planning to ask her doctor about the test, but she was killed in a car accident before that could happen. If my mom had tested positive for the gene, my insurance company would have covered the cost of the test for me.

Recently, the nurse at my doctor's office was filling out an order for a chest X-ray (needed for clearance for something else I will post about in a few weeks) and I saw a check box on the form for a baseline mammogram for women aged 35+, so I asked if she could add that to the order. She asked my age, and my history, and checked the box. It was as easy as that.

Last week, I had a baseline mammogram. It wasn't pleasant, but it didn't hurt like everyone said it would. The tech told me that, with a baseline mammogram, it is not uncommon to be called back to take more pictures, so I didn't panic when I received a call a few days ago that they needed to take more picture of my right breast.

Those pictures hurt more than the first ones did. My right breast is still aching.

The tech showed me the film in question. There are half a dozen tiny little flecks of calcification in one spot. I asked if this could result from breastfeeding and she said yes and that the calcifications would have a distinct shape in that case.

The doctor reviewed the new films while I waited. That was not the case. The flecks are very close to the skin so the tech took more pictures to confirm whether they were in the skin or in the breast tissue. Unfortunately, they were not in the skin, because that would rule out malignancy immediately. Also unfortunate is the fact that they are so close to the skin, which means that I need to have a surgical biopsy, under anesthesia, instead of a quick one in the office. I didn't ask why that is the case because I was too busy freaking out a little bit.

I am not freaked out by the possibility of breast cancer, because I have a plan for that. My little freak out was composed of three parts. Part one: Shock because I thought I was called back for routine pictures, so I hadn't considered the possibility that there was something there. Part 2: A biopsy under anesthesia (and the possibility of additional, more invasive surgery) may mess up plans I have in October (related to the chest X-ray). Part 3: My mom is dead and I can't talk to her about this.

The doctor explained all my options to me, but his recommendation is for surgical biopsy now, so that is what I will do. He said the calcifications are likely benign. Next week, my primary doctor will have the results and will take the next step with the insurance company. Soon, I will have the biopsy, which will remove all of the flecks. Then, I may decide to have my breasts removed.

Comments

Ewokmama

Oh jesus. I just don't even know what to say about that. It really, really sucks! I am sending good vibes your way and hoping you get the best prognosis possible!!!

Robin

I'm so sorry you don't have your Mom there with you to help you through this. I don't have any advice - it's such a personal decision. Just take good care of yourself.

laura

I'm sorry, too, that you don't have your mom there. This is hard. I hope the outcome is benign. You have an army of supporters.

Cindy

Sorry to read about this. My father's mother died of breast cancer that was caught very late, and after a double mastectomy, and I don't know my mother so I don't know her or her family's history and I think about it often... I had one of my ovaries removed a few years ago and it did a number on me mentally so I don't know if I could go through having my breasts removed, I am actually pretty attached to them, but I completely understand why someone would choose to have it done.

sending positive thoughts to you and hoping results come back benign. Support will be there no matter what and with whatever you decide. Please let me know if there is anything at all I can do.

Peeved Michelle

I don't have an emotional attachment to my body parts. I've lost one already -- my useless gallbladder -- and I feel that same way about all my body parts as I did about my gallbladder; my parts are here to serve me and, once they stop doing that, I'll be glad to be rid of them.

What I do have emotions about is my own mortality and how the loss of certain body parts might make my life more difficult. Obviously, the thought of cancer is scary. If the flecks are cancer, they'll be removed with the biopsy and my breast tissue will be removed in a subsequent surgery to prevent a recurrence, and fake breasts will be installed in yet another surgery. All of those surgeries and any additional treatment required all going to add stress, complexity, and difficulty to my life. At this stage, the possibility of death from breast cancer isn't more than the possibility of accidental death, so mortality isn't my worry now, added stress to my life is. As you know, 2010 has already been a bitch of a year for me.

I'd have the same feelings about losing a limb. My legs aren't meaningful to me other than the fact that they help me get around without the aid of other devices. Losing them would be devastating to my way of life. That is what I would mourn, not my legs.

I also don't have any special feelings about my specifically female body parts. I like being a woman but my gender is determined by my genetics and my brain, not by the presence of absence of a uterus or breasts or ovaries.

Still, I don't relish the thought of going under general anesthesia to have my breast cut open to see what's up with these fucking flecks.

KtP

Laura said it well, so I just say "ditto" to that and I'm hear if you need.

Usedtobeme

I'm sorry you're going through this Michelle, and I'm sorry you have to do it without your mom.

Karla

Michelle, I'm so sorry you have to go through this without your mom. I'll be thinking "benign, benign, benign" on your behalf. I know she hasn't had to deal with breast cancer herself, but my mom was a nurse for many years so if you want to talk to her and ask her any questions, I can give you her number. Or if you're in Camarillo and just need a hug, she gives good ones. I curse those stupid ambiguous flecks and their stupid ambiguity! Hopefully you will soon have a definititive answer and can proceed from there. Waiting and not knowing is SO frustrating. Let me know if I can do anything.

Rachel

Wow, that's scary. But at least you have a happy bunch of Internet friends who care about you and want to support you (and I suspect some real-life friends who feel the same way!). Here's hoping that this whole thing will come to an end with the biopsy results and that the calcifications are not only benign, but not cancer-related at all. My mom often gets recalled for breast testing because she has very dense tissue and each time it's scary and then turns out to be nothing. Here's to "nothing". Keep us in the loop.

Leah

Motherfucker, I agree you need no more bullshit this year, or for the next five years.  My sister Lorrie had to do the same procedure you are doing, while it hurt she came up clean it did hurt.  I hope this isn't inappropriate but I envy your flair for writing, so articulate, entertaining and smart as a whip. I picked a good leader :)

Hoping for you the best possible outcome and that you get to keep your boobs even if you can live without them.

xoxoxoxo

Sandy

Do you have a date set for the biopsy yet?

Peeved Michelle

I have an appointment for a consultation with the surgeon on the 23rd. No date for the biopsy yet. This is the sucky part about having an HMO -- the waiting for referrals.

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