From the category archives:

Biopsy

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Whatever it was that showed up on my friend Elise’s mammogram, it needed a biopsy. A different doctor might have said “Let’s wait and see. Come back in six months.” But not Dr. Guru, he claimed that a biopsy was “the medically prudent thing to do.” So Elise went ahead and had her biopsy “just in case.”

It was a lucky thing too. Elise’s voice was shaking a bit when she told me they found cancer.  This was the second time in twenty years she had received this dreaded diagnosis. You’d think one gets jaded, but that is not how it works. If anything you are far more scared the second time around. You cannot help but think: “What is wrong with me?”

Dr. Guru assured her “it ” was early and extremely unlikely to have spread. She was relieved thinking she could probably avoid the much feared chemo therapy. Elise had a mastectomy, what the heck, her other breast was already gone. Why not even out the front side and avoid radiation?

That evening in the hospital, Dr. Guru stopped by her bed to check on her, and to tell her that he found a cancer cell in her sentinel node. On top of that, it was a different kind of cancer than the one he found in the breast. Elise could tell how shocked the normally cool Dr. Guru was at this unexpected turn of events.

After a review of the pathology report on both cancers, Elise’s oncologist allowed her to skip chemo therapy and opt for hormone therapy only. She is doing fine – so far. That is the horrible thing with cancer: you look good, feel good, and whoops, a little cancer cell jumps up and rakes havoc with your life.

I am telling you this to let you know: always look into something that is “probably nothing.” Yes, a breast biopsy is not pleasant, but it is no worse than getting a crown at the dentist, and infinitely much less painful than a bee sting. Remember the words from Dr. Susan Love: breast cancer is not about statistics, it is about the individual.

When you hope for the best always plan for the worst. Medically, it is the prudent thing to do.

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My surgery is expected to take two and half to three hours. Dr. Guru promises that he himself will do the whole procedure. “Won’t even let a second year student help,” he says. He will make a slit in the twelve o’clock position on my right breast,  a slit under my right arm, and a slit on the left side of my left breast (where the titanium chip is implanted.)

Everything, Dr. Guru scoops out will be sent to  pathology although both my breasts have been biopsied already.  This time the pathologist will have bigger samples to work with and it will be easier to make sure that earlier biopsy results are correct.

Surgeon at Work

The windowless operating room is surprisingly small, and seems crowded and noisy. Several people in scrubs sit by a table at the far end of the room facing  monitors lined up  in front of them. I am surprised at how many persons seem to be here. What are they all going to do? Then a voice announces that a lumpectomy is about to take place on a post-menopausal female. That has to be me! (Although I never think of myself in those terms.) All of a sudden, I realize how young everyone looks behind their masks down there by the monitors.  Medical students!

Dr. Guru II, my anesthesiologist, guides me up on the table which is shaped like a cross. Electrodes are placed on my back and my chest.  A pair of foam boots without feet are put on my legs. (They will massage my calves so I don’t get blood clots.) I lie on my back, arms stretched out.  My head is covered with a shower cap, the rest of my body, except for my breasts, is covered up with sheets.

All around me: a steady hum of activity:  instruments rattle, machinery blinks, people talk. Despite the busy  atmosphere, everything  seems under control, relaxed and congenial.

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“Here is your glass of vine for today,”  says Dr. Guru II, a syringe in one hand, as she grabs the tube I am attached to with the other.

“Oh, you really read that crap people put in your pre-op questionnaires?” I remember thinking, but I suspect I am out before I give her my flippant response.

When I wake up I am back in a chair in the same area of pre-op area where my gurney used to be.  I have no idea how I got here. Did they really lift me off the table and put me in this chair?

I don’t feel the slightest pain, nor drowsiness or grogginess. Last time I had anesthesia I was told over and over again that I had a boy and a girl. Still I kept asking: What did I have?  I remember not being able to lift my limbs. Even my eye lids were too heavy to open as if they had been glued shut.  Back then my whole body felt as if it had been filled with lead. Not this time.

“We have different drugs now,” the nurse tells me. “They are much better than before.”

I feel completely free from nausea and clear headed. Actually, I feel light as a feather, perhaps my imagined weightlessness is from the idea that my tumor is now out. I am cancer free.

Then I remember the blue ink that was supposed to stain my lymph nodes (sentinel node biopsy.)  Did Dr. Guru find cancer cells in any of them or what?

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The Mysterious Wire Procedure

August 21, 2009

Ever since my surgeon and his assistant started to babble about a “procedure with a wire” I assumed my tumor would be removed with a wire, as opposed to carved out by a razor blade or an exacto knife.  As silly as it sounds, I have been mentally stuck on the image  of a wire […]

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Dr. Guru, I Am Mad. Where Are You?

August 7, 2009

Thursday, I only have one thing on my mind, one thought circling my brain like a  hungry wolf.  I want to go under Dr. Guru’s scalpel, I need for him to get rid of my nasty, ugly tumor. Now. Not a word from Dr. Guru’s office.  Not a word about the MRI results.  Not a […]

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Hypochondria Galore

August 6, 2009

No MRI results. No pathology report on the calcification in my left breast. No surgery date  – yet – to remove the cancerous hazelnut in my right breast. Five weeks have passed since I received my diagnosis. Five weeks since I was told I may have lived with breast cancer for a whole decade. And […]

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The Stereotactic Biopsy Procedure

August 4, 2009

After the MRI, I am scheduled for a biopsy of my left breast. Do I have cancer there also? The Breast “Care” Center, where I had my annual mammogram less than six weeks ago, did, of course, not even mention these calcifications. Did they see them?  I guess I am lucky they finally noticed the  […]

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“Ask an Expert” – It May Save Your Life

August 1, 2009

You don’t understand your doctor’s mumbo-jumbo, or have doubts?  You are confused about the correctness of your diagnosis or your pathology report? You are too scared to wait six months to find out what may lurk inside your boob?  You have a family member, or a friend, with breast cancer and you want to figure […]

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My Medical History Is…Lost

July 22, 2009

My medical records have evaporated. Buried in some nuclear waste site? My “health file” at home contains a brochure regarding an ancient, and expired, insurance plan. Not a single piece of paper refers to past doctor’s visits or mammograms. Not a single reference to the benign findings of my earlier biopsy. Certainly no pathology report. […]

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Finally – First Meeting with the Surgical Oncologist

July 5, 2009

Finally, I meet with Dr. Guru, my surgeon oncologist, after a two week wait. It seems like ten light years. The waiting room is enormous, empty except for an elderly couple. I notice that they do not carry an over-sized,  brown x-ray envelope, like I do. The staff in the reception  is slow and overweight, […]

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The Biopsy Does Not Look Promising

June 18, 2009

Three people assist with the ultrasound biopsy in a dark, windowless room. How depressing to toil down there all day, glaring at a grainy screens, lathering up lumpy breasts with gel, trying to find what the patient does not want them to find: carcinoma. Suddenly I feel sorry for everyone in that room but me. […]

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