10/08/10 Day Eight of Breast Cancer Awareness Month

My own personal experience-don't let the ultrasound fool you into thinking everything is fine. Yesterday we heard Theresa Wiza's story. The important reminder in that story is that her mammogram was negative just four months prior. I explained in the article about mammograms followed by ultrasounds to detect if the suspicious area was a solid tumor or a cyst. These can be false as well, as you'll see in my story. Before I begin my story, I will tell you, I have a couple benign breast conditions, not breast cancer. I feel it is important to share though as it will show everyone not to rely on what a mammogram or ultrasound says alone. Self awareness and detection is so important. It is also a reminder to not feel intimidated and to stand up for yourself at the doctor. If the doctor appears complacent about a growth or symptoms, and you know its not right, say so. You are your only advocate when sitting in that doctors office with that comfy flattering paper gown on.

Jenn's Story About Doctors and Tests and Mistakes

I had problems years ago with lumps in my breasts and other symptoms. Keep in mind I was in my twenties. Despite the fact I was told a mammogram wouldn't see anything because of my age I told the doctor that's fine and we'll try anyway. The lesions were very clear on the films. I had a breast biopsy and it came back a benign breast condition called stromal fibrosis. I was told to follow this every year with a mammogram to watch that nothing grew back, as they had removed quite a bit of breast tissue along with the lumps on the right breast and two lumps on the left. They told me after surgery that they were solid masses but benign. I followed every year, but every year it was a different doctor, as it was a clinic. Despite the fact that they had my file right in front of them, they seemed to have no clue as to what I had and what was done. A couple years passed and I started having symptoms again. They sent me for a mammogram, and then ultrasound again when they found a suspicious area. The doctor then went on to tell me not to worry, that it was just a cyst like I had before (although I had solid masses in the past) and that it "shrank" since last time. I told him it didn't shrink, it grew back, because I had had it removed. Underwent surgery again and had two new conditions.

The Two Important Mistakes and Why They Are Important

1) The radiologist and doctor viewed the follow-up ultrasound and stated that what they found were cysts.

Normally doctors use the follow-up ultrasound to decide on whether to wait and watch or to perform a biopsy. Since what they thought what they were seeing were cysts, they would have taken the wait and see approach. However, they were indeed solid tumors they realized this at surgery. Had my condition been cancerous, the typical six month follow-up would have been most likely too late. This is because the younger you are, the more likely you are to have a more aggressive form of breast cancer.

2) The doctor and radiologist both compared previous films and said that the tumor, or what they thought was a cyst, had shrunk. Neither consulted my chart to see that it had actually been removed completely and was a new growth in the same place.

This is a complete failure of the wait and see approach. When a doctor is monitoring a suspicious growth or condition in the breast, the point of monitoring and wait and see is by comparing past tests and visits and the findings with the present. Again, had this been a cancerous, it would have been left to grow out of control. When I told the doctor that I had had that tumor removed he looked quite surprised. He even started to deny what I was saying. I made him open the chart and read, and furnished my own copies of reports as well. This is why I say you need to speak up when something is not right. The doctor was not familiar with me and he obviously didn't view my file before reviewing what was going on at the present visit. This tends to happen more in clinics and larger practices. I am not putting them down, so many patients in and out and the constant rotating of doctors, it is impossible for them to know you and sometimes even review your chart prior to seeing you.

Keeping Your Own Record of Everything and Understanding Your Health History

I have also come to find that it is far easier to keep a folder with any and all records pertaining to your breast condition. Become familiar with the terminology and what it means. I don't advocate walking in the doctors office and acting as if you know it all, I am however advocating knowing exactly your condition and having records with you in case they do make a mistake. If I was unaware of this information as most people are, I would have walked out of there with a smile on my face thinking everything was gone. With more serious conditions, it would have been deadly. Remember, keep yourself armed myself with knowledge and be self aware. In my case, as I said were benign conditions. Had it been a woman with cancer, these mistakes could have cost a breast at minimum, a life at maximum. Any chance at losing one's life is not worth the risk of not knowing.

Statistics Show....

One of the problems they found during the second surgery does affect my breast cancer risk. This was a complex fibroadenoma. The other, which actually had scarier symptoms was ductal ectasia which normally is found in women in their forties and fifties, does not increase breast cancer risk. Stromal fibrosis is seen as a benign condition which in some places is said to not have a greater risk, and other places say it does. That's why it is so important to know what you have and don't have and be able to spot it if the doctor doesn't really know your history. It is important for me to continue my follow-ups. For women who have had no previous problems, how would they know something wasn't right? Ask a lot of questions and always get a copy of your radiology reports and any lab work. Sometimes the doctor decides on his/her own to wait and see. This leaves the patient walking around having no clue, and could lead to complacency in follow up.