July 16, 2018

Life Lately- Getting REALLY personal.

I wasn't sure if I was going to write about this here but my Mom suggested that I do since it would be an opportunity to bring awareness for breast cancer screening which in turn could drastically impact anyone affected by this disease.  For starters, I am healthy and GOOD and do not have breast cancer, thank God.  However, several weeks ago, I discovered a lump in my left breast while I was in the shower.  I was not diligent about doing monthly self exams (I am now!) but when you're breast feeding, you're very aware of your breasts because they're constantly filling up with milk...I was checking during my shower to see which breast I would nurse Griffin from next and found a lump that felt like a frozen pea.  In my 20's, I had a benign mass surgically removed from my left breast and I was hoping and praying that this was the same thing. I started to slowly panic and wonder, what if it wasn't the same? The next day, I saw my physician who promptly ordered a mammogram and ultrasound for what she described as a "palpable mass".  Unlike my experience in my 20's, there was no talk of "oh, I'm sure it's nothing- you're so young".



The next week I had the ultrasound and mammogram.  The mammogram did not show the mass but the ultrasound did. During the ultrasound, I was told by the tech that the radiologist would come in and chat with me only if further action needed to be taken based on what they found.  My heart sank when when the tech told me that she needed to call the radiologist to come in and speak with me.  When she came in, she very matter of factly told me I would need to get a core needle biopsy done to rule out cancer.  I was so grateful my Mom was with me because the moment the radiologist said biopsy, I fell apart and did not focus on anything else she was saying about the findings.  My Mom was taking copious notes on the size, appearance, what to expect from the procedure and I was sobbing in the chair.  Before the radiologist walked out, she gave me a hug and told me it would be ok.  It did not feel ok.  When you're having diagnostic tests done on a breast mass, you're given what is called a Birads score which is basically a scale from 0-6 on the likelihood that the mass is malignant. 0 is the least likely, 5 is 95% chance of malignancy and 6 is a cancer diagnosis.  My mass was considered a category 4 which is considered suspicious with a 20-30% chance of malignancy.

Because I'm nursing, everything was much more complicated with this situation.  I consulted my OB who suggested I meet with a breast surgeon for a second opinion before the biopsy since breast feeding poses a higher risk for infection and developing a fistula.  I also needed guidance on how to navigate this procedure while still being able to feed Griffin. I met with a wonderful surgeon who suggested an MRI to rule out cancer without having to do the biopsy.  The only potential downside of the MRI was that the results could possibly be inconclusive since breast tissue is so dense with breast feeding.  I completed the MRI and alas, it was inconclusive which meant I would have to get the core needle biopsy. Waiting to get this test done was brutal and my anxiety at that point was through the roof.  My mind would go to worst case scenarios- especially during the night feedings with Griffin.  It was dark and quiet and I would just ruminate on the possible outcomes of the test.  I couldn't focus on anything and while this all panned out over the course of several weeks, I muddled through life in a total fog.  The weird thing was, through all of the unknown and decision making with the tests, I still had to be Mom.  My kids got colds, went to camp, did their normal day to day... life rolled on despite this going on in the background.  I didn't talk about it with anyone besides my best friends and family and constantly resisted the urge to scream: "I HAVE A BABY AND A TODDLER AND A HUSBAND AND THIS IS NOT OK".  It was all very weird to be honest.

On June 28th,  I went in for the procedure. The staff couldn't have been nicer despite me being a total basket case.  In a core needle biopsy, they use a local anesthetic to numb the skin, use an ultrasound to locate the mass, make a small incision in the skin and insert a "core needle" (basically a small straw) into the mass.  They then use a device similar to a small gun (inserted into the core needle) and snap 4-6 samples of the core of the mass.  They place a small titanium marker into the mass in the event it needs to be surgically removed.  If it doesn't need to be removed, it stays in there forever. The entire procedure takes about 45 minutes and I was extremely grateful they gave me a xanax prior to starting to help calm my nerves. My radiologist also demonstrated what the gun would sound like prior to beginning the procedure which was helpful.  It was loud and would have totally freaked me out if I didn't know what to expect. After the first sample she took, I started to cry because I was so happy that I did not feel a THING.  A lot of my anxiety was about the unknown of the pain I would experience during the procedure.  Finally it was OVER. I rested the rest of the day, couldn't shower or lift for 2 days and tried to stay off of google while I waited for my results.

On Friday I found out my results were BENIGN.  God is good and I felt extremely lucky. I had another fibroadenoma like in my 20's.  3 months after I'm done nursing Griffin, I'll follow up with my surgeon and decide where we go from here.   Going through this process, I've realized that many many women do not get the news I got.  My surgeon told me that the most common age group for MISSING diagnoses' of breast cancer is my age group...35-40.  These women are getting less mammograms (a baseline mammogram is not recommended until age 40). She also told me that breast cancer is diagnosed MUCH later in pregnant and breast feeding women making their outcome worse overall.

My point here is to encourage you to first get very familiar with your breasts.  Familiar enough that you would be able to easily identify a change.  This is a great resource for doing a self exam. I would also stress the importance of screening. If you are 35 (especially with dense breasts or a family history of breast cancer), request a baseline mammogram and ultrasound.  Go to a breast center in your community to get these tests done if possible and request a 3d Instant Read Mammogram if they have them (this is the best technology out there and there was only 1 in San Diego).  Many times insurance will cover it (mine did and has several times before).  The bottom line is that your health and body should come first and the earlier you find something, the better the outcome.  I realize this story is not typical content for me but I promised myself when I did not know the results, that if they were benign, I would be better at taking care of myself so that I could better take care of my family and others.  And if one of you gets a screening mammogram because of this post, I will feel like it was well worth it.

Tips for all of this craziness and if you happen to find yourself in this position:

1.) Bring someone with you to EVERY appointment to take notes.  4 ears are better than 2 and you'll be grateful for someone to talk to to take your mind off of everything.

2.) Do your homework, ask around for physician recommendations and get second opinions.

3.) Ask for multiple tests- mammogram AND ultrasound (remember, my mammogram did not show the mass).

4.) I am not going to tell you not to stress if you find a mass but the good news is, most breast masses (80%) are benign. So deep breaths.

5.) When I was waiting for my results, my doctor referred me to THIS website.  It is a community of women going through the exact same thing as you are. It was SO helpful and positive for me.

6.) I was told by my surgeon that there are several ways to lower your risk of breast cancer.  Scale back on the drinking. 1 alcoholic beverage per day ups your lifetime risk of breast cancer 10%.  Two drinks ups it to 20%.  This sucks for those of us that love our wine (ME!) but it has made me reconsider how often I have a drink. Work out. Make it a part of your daily life. Don't smoke...I mean this goes without saying, right?

7.) The best thing I ever read during this ordeal was this below. I took a screenshot of it, saved it on my phone and still read it often.  I found it on the forum I linked above which is basically a community of women connecting with each other while they wait for their test results.  In it, Zoh, a young Mom of two, is communicating with another young Mom who was also scheduled for a biopsy.  When I didn't know my results and constantly worried about my babies and how this would impact them, I felt stronger by reading her words. Her confidence that no matter what, everything would be ok was contagious for me.  I wrote this blog post several weeks ago.  Last night I was finishing it up and thought, I need to message Zoh and thank her for helping me through the anxiety of my situation.  I wanted her to know how inspired I was by her strength and her words and share my news with her.  When I went to message her, I found out she had passed away.  My heart is so heavy for the loss and what her family has gone through.  I plan on contacting her husband to let him know that Zoh had such a positive impact on me and that this post was written in her honor.  Thank you so much for allowing me to share this experience with you.  It has made me look at my own life differently (in a very positive way) and I hope the effects will last for a long time.  Please reach out if you have any questions at all- I'm happy to help should you need me. xo






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1 comment

  1. Kara, I am THRILLED to hear all went well! Thank you for sharing this personal and moving post. Zoh's words totally made me cry bc of how beautiful and important they are. Appreciate you bringing awareness to this important topic!

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