Over the past few years most of us have become accustomed to the growing presence of pink ribbons, our doctors' reminders to perform monthly self breast-exams, walks for the cure and the sale of pink-dyed baked good donating pennies of the profits to research. Breast cancer has gone from an under-diagnosed, frequently overlooked, and almost certain death sentence to arguably one of the most visible, talked about and screened for diseases in the country.
With such high visibility and awareness, I admit I often feel guilty that I don't exactly perform those self-exams monthly, or even bi-monthly. It's more like on a "when I remember and then when I actually get to it" thing. I feel even more guilty that I am so lax considering my family history- my paternal grandmother was diagnosed and had a double mastectomy in her 50s. Worst of all though, is that, I still harbor at least a slight "it won't happen to me" attitude. Which is why I am more anxious about dealing with the pain of having a needle jabbed into my boob tomorrow morning than I am about getting the results back on the sample of the lump my doctor will be removing.
I should back up. A couple of months ago, I actually remembered to do that whole boob self-exam thing and I found a bumpy spot inside my right breast. I poked and pushed until it ached and I could be certain it really did feel different the rest of the area. It definitely did. I can best compare it to a hard, round marble just hanging out in the midst of all the other squishy stuff. This may sound alarming, but I've been through this once before and the marble I found when I was in college was also poked, prodded, biopsied and diagnosed as a completely benign fibroadenoma. It looks scary as hell on ultrasound but it's not cancer and for the most part doesn't increase my risk of developing it. And reassuringly, this lump feels very similar to the one I had when I was 23.
Last week, I did my due diligence and went in for a mammogram and ultrasound to check out the suspicious spot as well as to do an overall check-up of both breasts. Having my boobs squished and pressed again wasn't exactly comfortable but I've survived worse. (HSG anyone?) The ultrasound was almost relaxing, especially since the jelly was heated instead of freezing cold. After lots of looking, the doctor agreed with my initial suspicions that this was most likely another fibroadenoma. She started talking about whether I wanted to biopsy it now to be safe or if I would rather monitor it for 6 months for changes and determine the necessity then. Until, I mentioned my history with infertility, IVF and FET. That's when the biopsy became my only option.
As if the hell of infertility and the roller coaster of treatment isn't awful enough on its own, there is this whole non-baby related list of potential health issues that affect us and may continue to do so for the rest of our lives. Not that the doctor was particularly alarmed by my IVF history. She still thinks it's a fibroadenoma and so do I, but the fact remains that the effects of fertility drugs on breast cancer rates have still only been through a handful of studies. And as is usually the case, there is plenty of conflicting information. Some studies say there is no increased risk. Others say that there is, but only for younger women. (I was only 27 for both my IVF and FET cycles.) Add to that to wide diversity of treatment fertility patients receive, and I am not willing to take the summarized version of one breast cancer survey on CNN.com as proof that the countless vials of estrogen I have injected directly into my backside plays no role in my future health. So I am having the biopsy.
Tomorrow I will walk into the office in my cute, blue, loose-fitting button up, have a large, hollow needle plunged into my breast and walk out flattened down by bulky "pressure wrap" wrapped around my chest for 48 hours. This coupled with the fact that I can't exercise or shower for those 2 days, nor can I wear deodorant or perfume to my appointment, worries me more than getting back my results next week. Or so I keep telling myself. Because no matter much I hold on to that teenage dream of "it could never happen to me" or how sure I am that this lump is just like the last one, there is always that nagging doubt in the back of mind. That thought the my grandmother wasn't exactly old when she had to have both breasts removed due to cancer. The knowledge that estrogen is the hormone most connected to increased risk and I have artificially increased my levels of it more than once (and might do it again). The images of pink ribbons and awareness posters. These things creep into my mind just when I have convinced myself that there is nothing to worry about. And the truth is, I really do believe there is nothing to worry about. This time. But I can't help but think, given my history, that it is only a matter of time before it's not "nothing". Which is why I will keep doing those occasionally remembered exams, and showing up for mammogram and biopsy appointments well before menopause dictates that I must. And I will be holding my breath just the tiniest bit when my phone rings next week, until I hear the word "benign".