A Timely Biopsy: Changing the Rules Mid-Game

What happens when you have an abnormal mammogram—just before the mammogram guidelines are rewritten?

Nancy Berk

November 20, 2009
I had my first abnormal mammogram on November 13th, six months after I turned 50 and one week before the recommendations of the U.S. Preventive Services Task Force made my situation the topic of choice for media outlets everywhere. There’s been no riding the road of denial this week. Had these recommendations been implemented a year or two ago, I would be in a very different place. I can’t say it would be a better one. That’s because I am in the low-risk group.

Today I will have a stereotactic biopsy. A “new cluster of calcifications in the right breast” prompted this recommendation. After a decade of routine mammograms, the news was jarring. I didn’t hear the radiologist’s description of this procedure because I was too busy trying to think of who could drive me to chemotherapy. I reviewed my own epidemiological hypotheses no matter how probable or ridiculous (the bacon bits I put on my salad in the ‘70s, all that diet soda, excessive worrying, toxic people, nail polish, and wine). 

These fleeting moments of anxiety paled in comparison to the anxiety the new recommendations unleashed. I’m a humorist and a psychologist. While nothing about this is funny, the irony is that I once was the clinical psychologist for a cancer institute. (My dissertation was on anticipatory nausea and vomiting in chemotherapy.) I’ve been a researcher and I respect data but I don’t want anyone to die over it.   Channel surfing the morning shows shifted my initial fear about having cancer to fear of others not being able to detect it.

I know that I am incredibly fortunate. This is a blip on the screen compared to what many women face. And the mammograms I had in my 40s serve as important comparison data in understanding my case. My brilliant and kind breast surgeon is optimistic about today’s outcome. Statistically speaking, it will be benign. “Worst Case Scenerio”: Ductal carcinoma in situ (DCIS). “Worst Worst Case Scenerio: Invasive DCIS." PS: It’s not fair to tack on another category after “worst.” All of my boxes were checked until he found a lump in my other breast.   I’ll get an additional sonogram before the biopsy. Statistically speaking, in this economy shouldn’t I have found a two-for-one shoe sale before a two-for-one breast abnormality?
The Task Force identifies “psychological harm” as one of the results of breast cancer screening.   Ignorance is bliss but not for long if you have a bad malignancy. When all is said and done, I doubt this experience will have harmed me any more than a routine colonoscopy. Positive or negative, I’ll be relieved that I have answers—early answers and my own data that just might save my life.
I’ll let you know…
This is the first entry in a blog that will document the pre- and post-biopsy experiences of a “low risk” woman.


First Published Fri, 2009-11-20 11:33

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