Breasts

I'm fine. I don't have cancer. My MRI results are in, and according to the MRI my breasts are dense, young, pert and extremely healthy.
But I have learned so much in this journey. Women are told they should get mammograms starting at 40, but the truth is that mammograms rarely pick up tumors in women in their forties. One UCSF physician put the chance of finding a tumor with a mammogram in a woman in her forties as one in a thousand. Ultrasounds help some for younger women. Together you get a better look, but you still can't see much. The mammogram basically works for post menopausal women who do not have dense breasts. Doctors pronounce to me, and all my friends, " Your breasts are dense," as if that is a horrible thing. But women in their forties have dense breasts. That is the way they are made.
If you can't see, but you think something is there, the next step is the MRI. The MRI is great, you can see every little thing. But the test picks up so much you get many false positives--that is things that look like tumors but are not. It turns out the MRI is not flawless either. The MRI must be done at exactly the right time--7-10 days after your period starts--or the hormones will make things look weird. On top of that, despite the astronomical cost of the technology, reading the MRI films is an art. Some people are better at it than others. A top hospital will know when to take the breast MRI and will have someone who specializes in tissue. A smaller hospital will have one person reading all the MRIs-bone, tissue, whatever. It makes a difference.
MRIs cost a lot of money. Insurance does not want to cover it. We cannot afford to do this for every woman. So, in the end, the best test for a woman is to find her own tumor. And to ask a lot of questions.
Today, as I was waiting for my own test results to come in--after drinking, watching too much television, doing african dance, yoga and extra grocery shopping, in an effort to anesthetize myself and not think AT ALL, I met a guy in a park with Benji who turned out to be another dad at Theo's school. Talk turned personal and he said his wife had had breast cancer in the last year. She had found a lump in her breast, and gone to her doc. Her doc referred her to the Tower Imaging Center (where my mammogram was done) for a mammogram and ultrasound. They told her she was fine. A year later she went back and the lump had grown. They said she had cancer. She had to get chemo, radiation and a lumpectomy. If they had found it earlier everything would have been different. She did everything right, and she still got a clean bill of health. I told my "breast specialist" who I met because my doc demanded a second opinion after a "come back in 6 months for another mammogram we found something weird but it is probably benign" from Tower Imaging, and she said, if you find a lump you do an MRI and you stick a needle in. But this woman had gone to a top center, and they didn't.
After hearing this story, and hearing the mistakes made with my own friend, at a top medical center, the scariest thing is that the medical establishment acts like if you get a mammogram and ultrasound and all is clear you are fine. But that is not true. These sophisticated machines are far from accurate for younger women. They may be better than nothing, but all a mammogram really does in a young woman is provide a baseline from which to measure change. Shouldn't women be told that so they can advocate for themselves? I have three friends my age who have had breast cancer. One is dead. Young women are getting breast cancer, shouldn't we be getting more information out there? Shouldn't women know how little these machines really tell you, how important it is to find a top person, and that the person you need to trust the most is yourself. Shouldn't they be told that you must demand more tests, ask lots of obnoxious questions, and never, ever rest until you have done all you can, and researched and advocated for yourself far beyond what you ever deemed necessary.
I need to write about this. This is one thing I can do for the memory of Natalie. Women need to know that they need to fight and demand and ask for second opinions and demand the extra tests, and they need to begin to fight for the insurance to cover them. This is my next battle. My next cause.