It was about 9:15 a.m. on a Saturday when I got the call.
I was cutting the grass, and I didnít even turn off the lawn mower as I answered. I recognized the prefix phone number as being from the hospital, and I was annoyed. I wasnít on call, but they didnít bother to call the office to figure out whom to phone so they called me anyway. Again.
Or so I thought.
To my shock, it wasnít the call I thought it was. Itís still a little fuzzy, but the gist of it was that the screening mammogram I had done a couple of days before was abnormal. I needed to schedule some follow-up tests.
A biopsy? Did I hear that right?
The phone call seemed to go so fast. We talked dates and schedules, and since it was summer, the busiest time of the year for me in the office, I tried to schedule the follow-up on a day that wouldnít disrupt my office schedule. That meant an appointment five weeks away.
I hung up with the lawn mower still running. And I stood there, stunned. I was 46 and hadnít had an abnormal mammogram before, no need for follow-up images in the past. This was new territory for me, and I was scared.
Try for quick follow-up
I called my mom, and she talked me off the ledge. She encouraged me to call back and move up the appointment, as five weeks was too long to wait for an answer. I was able to move the appointment up to the next week (it was my schedule that was the problem, not theirs).
I freaked out. I went right to cancer in my head. It seemed clear to me that this was the only option. I didnít know anything about breast cancer. All I knew was that other women my age had it, and now I, too, had an abnormal mammogram. You donít hear much about women who get called back and allís well, so what else could it be?
Even though it did turn out to be breast cancer for me, I wish I had known the statistics about callbacks and the frequency of abnormal biopsies. Perhaps it would have given me a week of peace. Well, maybe not peace ó but perhaps less freaking out.
Did you know that about 10 percent of women who have screening mammograms are called back for additional tests, including further mammogram images, ultrasounds and/or biopsies? Only about 10 percent of women who are called back will need biopsies (1 in 100 of all women who had mammograms in the first place) and 80 percent of these biopsies will be benign.
These stats should bring comfort to women who are called back for additional images or testing, but letís face it, we all know someone who has had breast cancer and the anxiety that being called back induces is real. Itís natural to worry.
If you get a call, though, after your screening mammogram on a Saturday morning, turn off the lawn mower, listen carefully and remember most of the time callbacks end up with normal results, not breast cancer. Donít imagine yourself bald from chemo or, worse yet, dead.
Instead, take a deep breath and call your mom.
How the testing goes
Most centers donít allow men back in the testing area, so even though you may want to have your husband or significant other there, he may have to wait outside while you traverse this process on your own or with a female support person.
First, youíll have some repeat images done of the breast in question. Theyíll compress and squish your breast like crazy, so be prepared for some discomfort. The goal here is to compress away some shadow or funny spot seen on other images. Youíll go back to the waiting area (still separate from the area where your spouse may be) while the breast radiologist reads the images. The good news is youíll get answers while you wait, a small gift.
If the questionable area persists, ultrasound will probably come next. Back to the waiting area youíll go as the radiologist reviews the images and decides if a biopsy is needed. If a biopsy is on the agenda, youíll meet the radiologist, who will numb up the area and then take a long needle and extract multiple core biopsies from the questionable area. Youíll get bandaged up and sent home.
The biopsy results can take up to a week to come back. Even in the event of a biopsy, only 2 of every 100 women called back will end up diagnosed with cancer. And remember, 80 percent of the biopsy results are benign. Itís still scary, but cancerís not a given.
When I was sitting in the waiting room, I texted with my support folks outside and kept them posted as I moved through the process. It turned out I wasnít one of the lucky ones, and was diagnosed with cancer that day. The interventional radiologist who did my biopsy clued me in and said that she was pretty sure that my mass wasnít benign. Although I still had to wait for the official biopsy results to know what kind of breast cancer I had, I left that day quite certain of my diagnosis. I was overwhelmed and drained, but at least I had a probable answer and knew what I was facing.
An abnormal mammogram is scary. Knowing what to expect and understanding the reality that most of the time the follow-up studies are normal can help ease the worry. Most centers understand the anxiety the callback brings and will get you in pretty quickly for follow-up tests. Donít delay them; get in and get your answers.
In the meantime, calling your mom can help ease your mind.
Dr. Molly OíShea is a Troy pediatrician who blogs for the Detroit News about childrenís health issues. Read more and get answers to your questions at detroitnews.com/drmolly.