From the category archives:

Ultrasound

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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  hazelnut in my right breast.  Again, it proves that you have to be careful about where you have your mammogram, and careful about who reads them.

For the biopsy, I have to lie on my side while an x-ray machine squeezes my left breast between two plexi-glass plates until the image of the inside of my breast shows on a computer screen across the room. The room is dark, the light from the computer monitor eerie blue.

A tech cleans my breast before Doctor Kind enters the arena. He is elderly, jovial, and mild mannered. But it still hurts when he numbs me up. He pokes his instrument into my left breast, a clicking sound proceeds each plunge of the needle.

I lie there, uncomfortably, on my side in the windowless room with its low ceiling and claustrophobic atmosphere. Diagnostic radiology must  be the most boring job in the entire world. These doctors spend hour after endless hour  plunging needles into squirming patients while trying to read the images on their computer screen.  How interesting could this be?

Most of these patients will be stressed and worried about the type of specimen the hollow  needle will pull out, anxious over what the pathologist might see under his microscope.   At the same time, I feel  lucky that diagnostic radiologists choose this boring profession and are willing to spend eight years, or more in training to perfect their skills.

Dr. Kind assures me, in his soft spoken way, that he is 95% sure my calcifications will be benign.

“Should they, against all odds, not be benign,” he says. “It will be early and possible to remove without further harm.” By now I know my cancer lingo: Should the cells be malignant, I will have in situ cancer in my left breast,  not invasive, and the cancer would be unlikely to have spread else where in my body.

The good doctor inserts a titanium chip, smaller than a sesame seed, to mark the suspicious site so that if the findings are not what he hoped, the surgeon will easily find the bad spot.

That same evening, around 8.30 P.M., Dr. Kind contacts me at home to see how I am doing. I am moved by this dedication. He easily could have had a nurse or assistant call, or a computer for that matter:

“If you feel good press one, if you feel bad dial 911.”

I tell my husband that I am impressed and have a whole new opinion of the medical profession.

“Well any opinion you have would be new,” he says. “Given your limited exposure, you probably meet doctors more often at cocktail parties than as a patient.”

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As I enter the semi-dark room for my third mammogram in a month,  I notice two large X-rays mounted on a back lit panel. One shows a breast with two lumps and a calcified area, all clearly circled in red. I assume this is the view of  my right breast and freak out at the thought of having a mastectomy, after all. (It is automatic when you have cancer in different parts of the same breast.)

Then I notice the markings in the corners. The x-ray with red circles is marked Left, not Right. It is in my right breast the cancerous hazelnut lurks – without red ink drawn around it.

My knees buckle underneath me. I sink down on the chair and stare at the back lit photos. The tech comes in, and I hope it is too dark for her to see my teary  eyes. But my voice trembles when I ask : “My cancer is only in the right breast, why do you have the left breast film up there with areas circled in red?”

The tech doesn’t seem the least bit concerned.

“No, there is no mistake,” she says calmly and continues to shuffle her papers. “The requested procedure is for the left breast.”

“No, it can’t be. I have a lump in my right breast.”

The tech walks up to the films and looks, not at my film of the right breast with infiltrating ductal carcinoma, but at  the left x-ray film before turning around.

“Are you all right?” she asks. Her tone is sympathetic, yet she keeps her distance by going back to the paper work on her counter.

“No,” I admit, “I am scared. What is wrong with my left breast? What are those three red markings for? You can tell me. Just tell me.”

“Sorry I don’t know,” she lies. But I know that she knows when she says: “Only the radiologist can tell you.”

This radiologist is another female, but she is the polar opposite of Dr. Dork  at the Breast Care Center. This new radiologist, Dr. Confident, reminds me of a cheery English school mistress: a plaid skirt peaks out from underneath her white coat. She wears high heeled – yet sensible – shoes. Her hair is groomed, but unfashionable. Her face looks kind.

Dr. Competent  tells me she has good news. Well, mostly. The big lumps in the left breast “went away” on the ultrasound. The calcifications are still there though.  Do I remember which breast and year my calcifications were biopsied? she wants to know. No I don’t.  “Then it would be medically prudent to do a needle biopsy now,” she says and she doesn’t even give me a dope slap for being so stupid. In fact, she exudes kindness, along with calm and competence. My MRI, she assures me,  is scheduled for a couple of days later. But first she needs to check those milky streaks in my left breast.

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Ultrasound: The Only Way to Tell a Tumor from a Cyst

June 18, 2009

Remarkably, I am not in a funk when I show up at the Breast Care Center for the second time in less than two weeks for a diagnostic mammogram. I delude myself. I want to believe the woman who said “It’s nothing to worry about. Just routine clarification. We need to make sure.” But I […]

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