The Biopsy That Almost Happened

Ever wake up early in the morning - after far too little sleep - and feel like you are going to throw up? Without a hangover, that is. Well, it could just be me, but that's how I felt at 5 am today when I had to get up to get ready for my core needle biopsy. It was o'dark o'clock, as my friend Christine says, and thanks to the daylight savings time, I wouldn't see the sun for two more hours. Yeah, yeah, you're thinkin' I'm a sissy and maybe you're right. But I hadn't slept well and my body was rebelling. Thankfully, coffee helped.

Kathy took the day off to come with me to the UCSF Comprehensive Cancer Center. Because it was early, we scored primo parking on the 5th floor. When we were coming out of the garage, immediately across the street from the cancer center, she started to turn as though she was going to walk the half block over to the crosswalk. Divisadero is a busy San Francisco street. But I said no. I waved her into the street and said that I cross in the middle. I always jaywalk to the cancer center.

"Really?" she asked, incredulous. "YOU jaywalk?"

I nodded, saying, "I figure it's really bad form to run someone over who is walking to a cancer center. I mean, how mean is the universe, anyway? So I take my chances!"

Kathy just shook her head in amazement and said something about me "turning a corner."

We made our way to the 2nd floor and prepared to wait. Radiology wasn't even open yet. As we leaned against the walls outside the locked door, other women started to arrive and wait with us. One woman asked how the mammograms worked at this center and I was explaining it to her. I could tell she was nervous; her doctor had referred her and she'd never dealt with UCSF before. She asked if they tell you the results right away. I said no, usually they send the report to your doctor so that she can tell you.

That's when a tall, slender woman, who had been waiting with her equally tall, slender (adult) daughter, interrupted. "Oh, they tell you."

I said, "Well, not always. They have never told me."

"They tell me every time. I come here all the time. I've had nine surgeries. I still have my drain in. I'm here with my daughter because now she has something they want checked out, do you believe it? And then I see my plastic surgeon today. But they tell you. If it is clear, they do."

I looked at her, horrified. How dare she tell this woman that the technicians will tell her if the mammogram is clear? Never mind that I am positive that is not always true, what is this scared woman going to think when her technician says nothing? My god, she'll assume the worst!

I'm sure she didn't notice my reaction, as she was off and running about how she has to drive so far to get to UCSF and it's been so hard for her because of this and that, and on and on. If anyone in the group of women - now totaling seven - said something about their experience, she was ready to top them. I was grateful when they unlocked the door so we could all go inside, and even happier when they called me in first.

I changed into a gown, then sat and waited in the inner waiting room while they calibrated the stereotactic core needle biopsy equipment. I started to chat with a woman who there to get something checked out. She was telling me that she hadn't had cancer, but they kept finding things and sending her for biopsies, over and over. Pretty soon, she said, she wouldn't have any breast left to biopsy. I was nodding and saying how I imagined that was a lot of frustration and anxiety. But then domineering woman arrived, dragging her daughter behind her like an afterthought.

"I had a lumpectomy and they took half my breast. I could have had another lumpectomy but what was the point? They took the whole thing..." and she was off and talking about herself again, effectively silencing our conversation. I opened a magazine and became engrossed in backyard makeovers.

The woman turned her attention to her daughter. "I come here so often. I can't believe that now I'm coming here for you. Who would think that? I've never heard of a ductogram, and you would think I would have, what with all I've been through."

Worried, her daughter murmured, "I hope it's not a biopsy."

"Well, if it is, it has to be done." She shook her head at the trial she was about to go through. I could feel her daughter's untended worry. I tried not to recoil from her mother physically, but without meaning to, I could feel myself leaning away from her chair. I was relieved when they called me into the core needle biopsy room.

The radiologist introduced himself and sat down to talk with me. He explained that the mammogram showed areas of fatty necrosis in my breast, from surgery, and that was normal. However, there were two clusters of microcalcifications on the margins of the lumpectomy that didn't look like the areas identified as fatty necrosis, so they needed to figure out what those were. His concern was that microcalcifications this faint don't show up well on the stereotactic equipment. If they can't see the area with the digital mammogram, they cannot biopsy it. Ah, so this is why he recommended a surgical biopsy at the time of the mammogram. This, of course, is far more than my surgeon has told me.

He said we'd give it a go and see what happened. Then left for a bit while the nurses started getting ready. I asked one if I could take a picture of the stereotactic table and WOAH, was that ever the wrong thing to ask. She wanted to know why I would need a photo and said she'd have to ask a supervisor because UCSF had a policy against photos and she didn't know what she was going to do. I could hear her spiraling upward. Finally I said, never mind, it wasn't worth the trouble. I guess they worried I was preparing a lawsuit or something. I just wanted a picture for my blog! Luckily, I found this online:

Yeah, and that's the breast hole in the middle. The less you know about the equipment underneath, the better. 

Another nurse helped me get onto the table and get in position, with one breast through the hole. It feels really weird and wrong, not to mention uncomfortable. She raised the table and started compressing my breast. Also not comfortable. People came in and out of the room, but no one talked to me beyond explaining that I needed to, "stay very still!" They took several digital mammograms and murmured in between.

Finally, the radiologist came over to talk to me and told me that they could not do the core needle biopsy. I would need surgery. While he was talking, I asked the nurse to release my breast (so I could stop doing my Elastigirl imitation). In that way that commanders do that subtle gesture to tell the troops to comply with someone else's request, he signaled her to release me. Thank you.

On the way out, I stopped by the Breast Care Center to talk to the surgeon's assistant. She told me that once the surgeon gives her orders for me (this is all sounding quite militaristic, isn't it?) she'll begin scheduling. I asked about anesthesia for this type of surgery and she said it's usually MAC; I let her know I had a bad experience with that in the past and she promised to tell the doctor. And that was that; we headed out. It cost only $10.50 in parking as we had been there under 2 hours. Yeah, such a bargain!

We stopped by Flax Art on our way out of the City. I had been looking everywhere for a tube of Golden heavy body acrylic in Azurite Hue. Lo and behold, Flax had it in stock! I was excited as this means I can start experimenting with my ideas for an alternate color mixing palette. Let's face it, I'd much rather think about colors than surgery. But I'll save the color mixing for another day; early as it is, I'm drained.

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