Missed the mark

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The bruise from the biopsy looks bad...but it didn't hurt! 

The surgeon I selected to do my lumpectomy has her patients undergo a breast MRI. She uses the detailed imaging of the breast tissue to assist with her surgery planning. While a breast MRI is a valuable tool in certain situations, it's not a standard part of every breast cancer diagnosis. In fact, I know several women who have had breast cancer recently and who never had an MRI.  

In my case, I’m especially grateful that the MRI was done. My original mammogram came back as abnormal in both breasts. As a result, I had a follow-up ultrasound and bi-lateral biopsies. The original biopsies came back positive for cancer in the right breast and negative (or benign) in the left breast. That felt like a small win at the time...at least I didn't have cancer in BOTH breasts!  

On June 5th I went in for my MRI and an ultrasound of my right axillary area to assess the lymph nodes and look for any potential spreading of the cancer. The ultrasound looked good—yay! And the MRI went as smoothly as an MRI can...if you’ve never had a breast MRI, it’s a bit of a trip!  You climb up onto a table, lie face down, and position your breasts in the openings on the table. There was no graceful way to get into position, but the two young technologists were super helpful...even loaning me a hair tie to keep my hair off of my face during the 20-minute procedure.  

Once in the correct position on the table, they placed a ball into my hand and instructed me to squeeze the ball if I needed to communicate with them during the imaging. Then they slid me into the tube-shaped MRI machine and exited the room.  

The radiologist performed the test while looking through a window in an adjacent room. He occasionally gave me positive affirmations via an intercom, “looking good;” “just ten more minutes;” “great job holding still.” 

I kept my eyes squeezed shut the entire time. I’m not sure why, but I was very intentional about not opening them until the procedure was over. I did my best to lie as still as possible and ignore the very loud thumping, banging and humming noises emitted by the machine.  

The procedure itself was not difficult, but much like every other step in this journey, waiting for the results was downright torture. My MRI was on a Thursday. I was grateful to have a multi-day river trip planned for the weekend which served as the perfect distraction.  Still no test results on Monday though. Then Tuesday came and went without a call or email. The imaging was done by a provider I hadn’t been to yet, so by Wednesday I managed to log in to the new patient portal and I found the results on my own.  

Good news...bad news. The good news was that there were no suspicious lymph nodes, and the chest wall looked good. The bad news...the MRI showed that the marker from the original biopsy on the left breast was near the area of concern, but it was unlikely that the mass was actually sampled. The radiologist recommended repeating the pathology on the original sample and if it came back again as benign, he suggested a mammogram guided biopsy rather than another ultrasound biopsy.  

His assessment of the mass in the left breast was a BI-RAD Category 5. BI-RAD stands for Breast Imaging Reporting and Data System, which is a standardized system used by radiologists to report and interpret breast imaging results. Category 5 means the growth is highly likely to be malignant, meaning it is probably cancer.   

Finding out you have cancer once is bad...finding out you might have cancer twice really sucks! I sat with the news that day and processed it for myself before reaching out to my Cancer Care Coordinator the following day to discuss the results and find out what the next steps would be.  

In visiting with other women who have had breast cancer, they said the one certainty in the process is that there would be lots of pivots, turns, and unexpected shifts/changes in diagnosis, treatment and next steps. I'd definitely just hit my first road bump in the cancer journey. 

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