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.