Why I haven’t posted recently

Just because you’re a hypochondriac doesn’t mean you won’t get a disease.  I admit to being a bit of a hypochondriac and I was diagnosed with breast cancer this April.  First I’d like to mention a website that I found useful:  http://community.breastcancer.org/   I don’t know the specifics of how it is sponsored/moderated etc, but it’s basically a bunch of women with breast cancer (or worried about breast cancer) who interact in a supportive manner. 

If you’re a hypochondriac, you probably already get your regular mammograms, but a word of caution.  I had a mammogram in Dec 2011 and was called in the next week for additional views which were subsequently read as ‘negative’.  When I felt a lump 3 months later, April 1st (yep April Fools day), a third mammogram of the same breast was again read as ‘negative’.  No one at the breast center had the necessary ‘expertise’ to palpate the mass, which seemed a bit odd.  I felt like I had to insist on an ultrasound, which was read as highly suspicious and therefore followed by a biopsy.  I had my excisional biopsy shortly thereafter.  My main point is that a negative mammogram could have given me a false sense of security.  I have read that monthly breast self exams are not absolutely recommended; but the reasons given don’t make much sense to me.  Reasons such as…  it may produce unnecessary anxiety, some women are intimidated by the process etc.  My suggestion is to not ‘worry’ about the breast exam; just DO it, and don’t even try to follow some specific protocol, although I would include an exam standing and an exam lying down (my lump was only palpable while lying down, and I’ve heard the opposite story as well).  I agree that trying to follow a specific protocol is somewhat ‘intimidating’.  So don’t bother.  Just feel your (entire) breasts periodically and if you aren’t sure if you feel anything weird or unusual, then don’t worry about it for another month.  Lots of women say ‘I don’t know what I’m looking for’.  I can assure you that my lump was not something subtle.  It felt very hard and very different from my usual lumpy stuff.  If nothing strikes you as worrisome, you’re probably ok to not worry.

Another related comment about mammograms.  Ask your doctor if you have dense breasts.  Apparently there is good evidence that women with (very) dense breasts on mammogram are at increased risk for developing cancer.  It seems strange to me that of all the risk factors we seem to hear frequently about (estrogen, lack of child bearing, alcohol); dense breasts is rarely mentioned.  I might have been more conscientious about my breast self exams had I been aware of the increased risk and notorious unreliability of mammograms in women with dense breasts.  Also, it seems to me the radiologist should have suggested the ultrasound instead of repeating the mammogram back in December.  The good news is that most breast cancer is highly treatable these days.  Lumpectomies are a frequent option for smaller tumors, for some women sentinel lymph node sampling protocols have minimized symptoms and genetic testing of the tumor (oncotype score) helps women decide whether or not they need chemotherapy.  Radiation therapy was fairly easy for me and so far tamoxifen has not caused any definite symptoms.  In summary, get your mammograms, do your breast self exams (monthly) and find out if you have very dense breasts.

Oh… and the other reason I haven’t posted recently… I moved back to the Southwest and got a new job.