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Lumps, Exams, and Mammograms: Be Breast Cancer Aware

My first experience having a mammogram was at the age of 29. I  found a lump during one of my routine self examinations. Luckily it turned out to be fatty tissue and I didn’t need to follow up with any more tests or examinations. At the age of 33 I found another lump and went in for my second mammogram. Although that lump turned out to be fatty tissue, another lump was discovered. They requested to have a routine ultrasound which discovered a large mass underneath the areola of my right breast. The mass was then biopsied and a titanium marker was inserted. Once again, I was very fortunate and the mass was a benign tumor. Both of these masses were discovered because of self examination–something that was taught my freshmen year in health class, encouraged by my own mother, and readdressed annually with my gynecologist.

Although many women do not begin having mammograms until the age of 40, it is encouraged that women begin self examination much younger than that. According to the National Breast Cancer Foundation, adult women of all ages are encouraged to perform breast self-exams at least once a month. This should be done at least 3-5 days after your menstrual cycle.

mammograms

Below are some frequently asked questions. Although I am not a medical professional, I can give some idea of what to expect during a routine mammogram, ultrasound, and biopsy.

What should I expect during my first mammogram?

Before the exam, your doctor will request that you don’t wear any perfumes or deodorant. You will also be asked to wear a gown from the waist up so be prepared and wear a two piece outfit. When you enter the exam room you will notice a large x-ray machine. The technician will then derobe one side of your gown at a time and help you insert one breast onto the machine. This can be a bit embarrassing and awkward, but just try to keep in mind that you are being proactive in your health. Each breast is then placed flat on a tray and your head and arms are positioned so that they are not obstructing any view. Your breast is then pressed firmly against the glass sheet by the machine while the x ray takes the picture. It is important that you stand still while the picture is being taken and the technician will also ask you to take a deep breath.

After the exam you will be asked to wait to ensure that scans have been taken properly. If this is a routine check up, then you are free to leave once you are given the OK. If this is due to the discovery of a lump you will most likely see the doctor after or even take an ultrasound for further analysis.

Does the exam hurt?

Although it was definitely uncomfortable, it wasn’t extremely painful for me and I have a pretty low pain tolerance. You mostly feel a lot of pressure and some slight pinching. I think that I most felt discomfort around my armpit due to the position that I had to stand in. However, if it is too uncomfortable for you, know that you can tell the technician so that they can reposition you.

What should I expect if I am asked to have an ultrasound?

This is typically done after a mammogram and usually to give another view of the area that was concerning. I had my ultrasound the same day and did not need to make a second appointment. If you’ve had an ultrasound during pregnancy it is pretty similar except instead of placing the camera on your stomach it is on your breast. There is no pain or discomfort, just cold from the ultrasound gel.

When I was having my ultrasound the technician actually talked to me about what I was seeing. I was able to see the mass that was discovered under my areola very clearly, as it was a large black mass. My husband was with me while I was having the ultrasound done, which I am very thankful for. I recommend that if you discover a lump that someone goes with you to the appointment for additional support. I think that I would have lost my marbles if I was alone. After the exam, you will then meet with your doctor to discuss the next steps.

What should I expect during a biopsy?

I will admit that I was pretty scared leading up to my biopsy. Unfortunately we were not able to find a babysitter so I had to go alone. I highly recommend that someone go with you if you are having this done. Once again you will be asked to wear a gown, so wear comfortable clothing that can be removed with ease. You will then be asked to lay flat on the exam table and your doctor and an ultrasound technician and/or nurse will be present in the room. They will then numb the area of the breast where they will be taking the sample from. I will admit that I was pretty nervous and scared not knowing what to expect and began to cry. Remember….it’s OK to cry. My nurse was extremely helpful and kind and told me step by step what I should expect. She also looked at me the entire time and reminded me to keep looking at her so that I had someone/something to focus on. That was extremely helpful for me.

There are a few types of possible biopsies that you can have: fine needle aspiration, core needle biopsy, or a stereotactic biopsy. I ended up having a core needle biopsy. This is where they use a large hollow needle to extract tissue samples from the mass with the guidance of an ultrasound. It does not hurt due to the numbing but you will hear a loud click each time an area is clipped. The sound is similar to that of a staple gun. My doctor chose to also put a titanium marker in the area that was biopsied. Your doctor may or may not require this. Mine did this so that the area would show up on future mammograms as a safety measure.

My pain after was pretty mild. I was a little sore around the area and needed to ice it for 24 hours. I only needed Tylenol to help with some of the discomfort.

I’ve never been told or shown how to do a self breast exam. What do I need to know and what do I do?

I’m going to be honest when I say that this has become routine for me, so I do it while I’m watching TV. I think that wherever you are comfortable should work best for you. Some suggest to do it in the morning while you’re lying down in bed, in front of a mirror, or while you’re in the shower. Wherever you decide, I think that it is most important to know that breasts can be lumpy so it is good to know what is “normal” for your breast tissue. Trust me when I say that you WILL know if you come across a suspicious lump. It doesn’t feel like the rest of your breast tissue. My second one was about the size of a pea and was very hard.

Even if you’re unsure on whether or not it warrants a phone call to the doctor, I still feel like you should call. It doesn’t hurt to have it checked out. My doctor always says that sometimes peace of mind can be extremely helpful. To conduct a self exam, you should place one arm behind your head and using your opposite arm to feel the breast AND the armpit in a circular motion with your fingertips. I think that many women, including myself, forget that the armpit is part of the routine. Once you have completed the examination of one breast you will then follow the same steps for the other. Also be informed about  what to look for during an examination.

Who do I contact if I feel a lump?

Your gynecologist or family physician.

I don’t have insurance and can’t afford a mammogram out of pocket. Where can I go for help?

You can contact your local Planned Parenthood who often offers these services at no cost, or you can speak with your family physician about specific locations that offer help to low income or uninsured women.

Resources

For more information about breast examinations, mammograms, breast cancer, and women’s health please visit the following links below.

Susan G. Komen

National Breast Cancer Foundation

Breast Cancer.org


 

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