One of the yearly joys for most women, me included, is the annual mammogram. My mother had breast cancer requiring a radical mastectomy with axillary node dissection at age 40, premenopausal, which means her own daughters are at a higher risk of breast cancer, and I don't take this lightly, so every winter off I go to submit to a boob squashing, with a light dose of radiation. All for a good cause, and that noble feeling you get afterwards, right?
Last year, my mammogram showed something suspicious on the left, and I wound up needing a biopsy. This was a benign lesion, thankfully. When I returned this year they kept calling me back for more views, and finally when I was done the radiologist sat me down and explained that I have "very dense" breasts, and though there was nothing suspicious on my mammogram it was recommended that I have breast MRI to get a better look. He said that mammography alone was not the best way to evaluate someone like me, with a family history, a history of a biopsy myself, and dense breasts. These three factors, combined with my age at onset of menarche (12), put me in a high-risk category for breast cancer in my lifetime.
When did I get dense breasts? This was news to me. The mammograms I've been getting for the past 15 or more years have not demonstrated dense breasts, to my knowledge, since I've never had to have ultrasound, and that is what they use on dense breasts, as I know from 10 years working for a mammographer and typing all of his reports. These days it is required that the patient be informed if they have dense breasts, and I had not heard this before. Can breasts become dense as we age? I suppose they can, since that's certainly my category now.
I was told this was not an "open MRI," so I asked for a Xanax or something like that to take in case of claustrophobia. I had an MRI over 20 years ago, and when I was asked if I was claustrophobic I proudly assured them I wasn't. Well, after being laid on a table and slid back about 12' into a pitch dark and narrow drawer, I discovered that indeed I WAS claustrophobic. That was a challenge to endure, and I didn't want to go through that again. However, my breast MRI was on a modern machine and if that isn't considered "open" I'm not sure what open means. I could see the opening in front of me, and it was open behind my shoulders, it was well lit, with a large aperture and a fan blowing, and there was no need for any anti-anxiety medication whatsoever, thankfully.
The MRI went smoothly, and was not a difficult experience at all. The bonus is that there is no radiation, and in the future I will have MRI studies annually and I (think) I get to skip the squishing procedure of standard mammography.
As I had been warned, the MRI prompted the recommendation for breast biopsies. I was prepared for this, and was not too concerned. After all, they can now see literally everything in my breasts and since it was the first look, many structures could appear suspicious. I had an area on the right and an area on the left, one 8 mm and the other 5 mm in size. This time I DID opt to take the Xanax, since I had been through a breast biopsy before, which was somewhat traumatic due to the awkward location and the need to be clamped into the vise of the mammogram machine while the biopsy was performed. It was on the left medial breast, very close to the chest wall, meaning they had to clamp me down very tightly, drawing the skin of the chest in and making it difficult to breathe, but the machine had to hold me there for a few minutes while the biopsy itself was completed. They had to try it a few times, then re-try it, get the biopsy, then take a few more views to be sure it was in the right location. Ugh. I fell apart a bit after that one!
This time I would not be in The Vise but it would be done under MRI guidance, which I knew was no big deal, and it wasn't. I still elected to take the sedative, since I could not help but have a lot of anxiety, being in the same situation as my last breast biopsy - I knew it wouldn't be the same but I seemed unable to convince my reptilian brain of that. In fact, my blood pressure was through the roof when I got in there, which is not normal for me, and I had to lie down for about 10 minutes in a dark and quiet room before it went back down to normal. Yikes.
They were able to get the right breast biposied without difficulty for them or for me, and they told me the one on the left was not very accessible for an MRI-guided biopsy, since it was located near the previous biopsy, close to the chest and on the medial breast (near the cleavage), not a good position for the doctor to access while I'm lying face down. That would have to be done with mammographic guidance (here we go again!!) but he told me that he'd prefer to wait and see the results of the biopsy on the right, and make a decision after that, which suited me. Apparently the two lesions were similar and if the right side was benign, the left would likely be as well.
Long story short (well, short story that I manage to make long) is that the biopsy was benign, and I return in 6 months for repeat MRI to see if there is any change in the lesion on the left. Cancer does not stay the same, so if it looks identical then they'll know it is benign, and can simply look for changes, since they'll know from now on what I'm supposed to look like in there.
It seems like a lot of hassle, expense and aggravation for nothing, but I really can't say that I'm sorry I did it. I could have refused and simply had yearly mammograms, since the MRI was not being done to evaluate any particular lesion, but just to get a better look. However, I thought it was more responsible to go ahead and be sure things are okay, despite the unnecessary stress. Even when you are relatively certain the biopsy will be benign, there is a voice in the back of your mind that worries about other outcomes.
Also, breast biopsies are painful afterwards, and I had to wear an ice pack in my bra the rest of the day and most of the next. Add to that, our dear young dog, Busa, a Great Dane and German shepherd mix, is so tall that he greets me by goosing me in the right side of my boob when he sees me - right in the ole biopsy site! Thanks, buddy. Your heart is in the right place....
