My Diagnosis

Realizing there might be a problem

Fast forward 7 months and a COVID/omicron spike that discouraged me from going to the hospital and I was back getting my breast pancaked in the mammogram machine in March 2022. This time though, they just barely caught some micro-calcifications that you couldn’t even seen on the mammogram monitors – only the radiologist saw them on her screen. This time I get recommended for another biopsy.

I come back the next week for my second biopsy. This time, instead of an ultrasound biopsy, I had to stand very rigidly and very still in a mammogram machine while they jammed a huge needle in my right breast to get a core biopsy. I asked what the Birads score was that landed me this experience and the radiologist told me that it was a 4. She went on to further explain that meant that usually these sorts of things were nothing, but they could be something bad so it’s important to check. After the procedure was over, I experienced a vasovagal response and almost passed out. While the nurse was explaining my discharge instructions and applying pressure to the needle wound to stop the bleeding, I found that I suddenly felt very nauseous and couldn’t listen to her. When I told her this, she immediately laid me down and they applied ice packs to my head. I quickly recuperated and was sent on my way.

Getting the bad news

It was Friday, April 8th. It was the end of the work day and I realized that I hadn’t heard anything all week from my radiologist about the outcome of my biopsy. I called the office and asked if my results were ready and they told me the radiologist would give me a call back. Sure enough, about 30 minutes later she called me.

“Hey Christina, how are you doing?”

“Um, nervous.”

“Well, remember how I told you sometimes it’s nothing and other times it’s something bad? Well, this is one of those times it’s something bad…”

I don’t really remember much of the rest of the conversation. I’m not even sure that’s exactly what she said, but it was something very close to that. I wrote some things down on a note pad while I struggled to think, breathe and see through all of the tears. Luckily, my husband was home. He googled while I cried and wrapped up the conversation with my radiologist. Ductal Carcinoma In Situ – that was my diagnosis. I learned that given the size of my fairly small DCIS lesion (about 1.5 cm), I would need to get breast conserving surgery (BCS) (aka lumpectomy or partial mastectomy) and follow-up with radiation.

And then it got worse…

I had my BCS on May 27th, the Friday before Memorial Day 2022. The surgery went really well and I wasn’t even in very much pain. But now I needed to anxiously await the results of my pathology report. I desperately wanted confirmation that it was “just” DCIS. That diagnosis was hard enough to accept, I was terribly afraid it could be something worse.

On June 2nd I was at work. I’m not able to have my cell phone with me at work, so when my surgeon called with the pathology results, I did not get the call. Instead, I got the notification in MyChart that my results were in. I had to look, I couldn’t wait. And when the report loaded, it confirmed what I was hoping would not be the case – Invasive Ductal Carcinoma (IDC). Luckily (if you would say anything about this ever feels lucky), it was small at 6 mm. This meant, in the technical staging terms, that I was Stage T1b.

With this “upgrade” in my diagnosis, I would now need to have another surgery (Sentinel Node surgery) to check if the cancer had spread to the most likely draining lymph nodes. If all of those came back positive, then I would likely have to remove more and probably do a bunch more scans. I’ll save you the long narrative, but luckily my lymph nodes all came back negative. Now I knew I was Stage T1bN0. I had also learned from additional testing of the tissue that was removed that my tumor was estrogen receptor (ER) and progesterone receptor (PR) low-positive, effectively negative. But my tumor was strongly expressing the human epidermal growth factor receptor 2 (HER2). What this meant is that my tumor was further from looking like a “normal” breast tissue cell and would grow more aggressively.

The moral of the story

I had a really hard time coming around to this realization, but I probably am incredibly lucky. It’s hard to feel lucky, because the only way I would have felt lucky is if it never had been cancer. If it had been some other type of benign breast growth. In reality, I am very lucky. I’m lucky that I was overly paranoid and asked my ob/gyn about my breast. I’m lucky that she felt something that ended up being benign but that sent me to get a mammogram. I’m lucky they asked me to do a 6-month follow-up. I’m lucky I actually went to that mammogram. I’m lucky that the radiologist had better resolution screens and saw the micro-calcifications. What could have happened is that I had not kicked off that sequence of events that would have resulted in me probably not getting a mammogram until I was 40 instead of 35. Or that I would have finally noticed a palpable lump. By that time I could have been facing a much more serious situation. Given all of the other ladies’ stories I have read as of late, I really do see that I am incredibly fortunate. While it might not have been any better, it certainly could have been a lot worse.