What’s In My Left Breast – A Three-Year Odyssey

After a routine yearly mammogram on December 17, 2009, I spent the next three years having my left breast repeatedly probed manually, by ultrasound, and mammography until my team of doctors and radiologists determined in April 2013 that that I didn’t have any cysts or worse, breast cancer.

Being proactive about our health and well being is very important. Hopefully this little story will explain why. Here’s the chronology:

• On December 29, 2009 a woman from the breast center I had been going to for twenty plus years called me to come in for a special view mammogram and an ultrasound of my left breast. I made an appointment for January 12, 2010 with her assurance I’d see the center’s director – a personal acquaintance of mine.

• Between December 29, 2009 and January 5, 2010 I stewed about it.

• On January 5 I saw my gynecologist who was cautiously optimistic about the December 17 report. She did a manual breast exam and found nothing of concern, and I know from past experience that she can be pretty picky. The only thing that concerned us both was the wording on the report – two items were checked: 1) a new finding and 2) no change from the findings from the previous year. That didn’t make sense.

• On January 12, I went in for the special view mammogram, seriously thinking all would be well. But no. That’s not what happened. After the radiologist looked at the pictures, she told me I also needed the ultrasound to look further into the mammogram results. While I was getting probed with the ultrasound stick, I asked the technician what she was looking at. "Likely cysts," she replied. Benign cysts. I asked her if my friend, the director, was reading the results, and she said no. That’s when my mind went non-linear. I had made the appointment for that day because I was told the director was available, and she was not. Instead, another radiologist came in and said it looked like I had a couple of benign cysts and suggested I come back in six months and have another mammogram and ultrasound just to be safe. It would have been fine if she stopped there. But no. Then she did some probing of my left breast herself. She determined that one of the spots was definitely a cyst, but she was only 80-90% sure of the other. I could let it go for the six months or I could make an appointment for a needle aspiration of the “cyst” now – which she recommended. However, if the aspiration didn’t come up with any cyst fluid, I’d have to have a biopsy. There she said it – the dreaded biopsy word. However, I agreed to make the appointment for the aspiration/biopsy procedure. But then it got worse. The technician came in and gave me all the biopsy caveats plus all the material about breast cancer that she said she had to give it to me because the law says so. Pretty soon I didn’t know what to think or what I had. Maybe a cyst, maybe cancer. I also asked about their original conflicting report and was told they just forgot to uncheck a box. Well, if they made that mistake what other mistakes could they make? As a result I walked away in the same state of limbo as I was in when this whole thing started. Let it suffice to say, I was totally confused, scared, and out of control.

• On January 13, I took control of my life. I woke in the middle of the night and decided that I would go to another doctor rather than go back to that breast center again because of three things that happened: 1) the mistake on the original report, 2) I didn’t see the doctor I requested, and 3) the doctor I saw was too wishy-washy to trust. The lack of a clear plan with you could come back in six months for a recheck, and then after she looked some more she recommended an aspiration, but then you could still wait six months for that wasn't reassuring. Plus, after I looked at the paper work that morning, I didn’t trust anything about it. There was no mention of an aspiration on it. I would have to sign up for the biopsy as if that was a given. My gynecologist sealed my resolve. She reviewed the report and characterized it as curious and ambiguous – a Breast Imaging-Reporting and Data System (BI-RADS) 4 classification when a benign cyst should be a 3. I got her referrals, picked one, and made an appointment for two days later.

• On January 15, 2010 I had an appointment with a breast surgeon oncologist. When he entered the exam room he was actually laughing at the report about the so-called suspicious lesions in my left breast. Before he even examined me or did an ultrasound he said he felt the radiologists at my former breast center put me through this stressful exercise for no reason. When I explained that I knew the director of that breast center, he said the junior radiologist must have wanted to be extra careful and that’s why her report was so worded. Interesting that he characterized her as a junior associate, probably to indicate that she didn’t know what she was doing. Exactly my thoughts. I told him I didn’t trust her preliminary diagnosis, and I didn’t trust her written report. And why would she characterize my “cysts” as suspicious with a BI-RADS 4 rating. The next category up from 4 means cancer. My sense told me I didn’t want someone like that sticking a needle in my breast to aspirate something that was barely visible on the screen. The oncologist agreed. After his exam I felt even better. A visual and manual exam of my left breast showed nothing, and the ultrasound, the doctor said, showed a couple of tiny spots that looked like nothing – the kind of things we all have roaming around in our bodies.

But that wasn’t the end of it. After the first meeting with the oncologist, I also had an extensive mammogram that the new radiologist characterized as “most likely normal.” This wording necessitated my returning for more mammograms, ultrasounds, and breast exams two more times that year, and twice a year in 2011 and 2012. Only at my last appointment in April 2013, when my mammogram results came out “negative/benign,” was I finally told to come back for a routine mammogram in one year. The oncologist also dismissed me. My gynecologist has resumed examining my breasts during routine office visits.  And three plus years later, I still feel I made the right choices:

I chose to leave the practice that made the iffy diagnosis

I chose the doctor the next course of action.

Photo Credit: Public Domain Photos