My Breast Cancer Screening Journey Part 2: Mayo Clinic, BRCA & Biopsies

My Breast Cancer Screening Journey Part 2: Mayo Clinic, BRCA & Biopsies

I posted about the beginning of my breast cancer screening journey last week at this link. As a brief recap: I'm 30 years old. Due to family history of breast and ovarian cancer, my gynecologist recommended I undergo breast cancer screening 10 years before my mom's first diagnosis at age 40. My preventative baseline mammogram on July 29th and follow-up diagnostic screening on August 12th showed that, due to the clustering and "abnormal" branching formation some microcalcifications on my left side are making, it could be a sign of early stage breast cancer. The only way to tell for sure is to conduct a stereotactic biopsy. The biopsy would tell the doctors one of three things: 1) It's cancer 2) It's not cancer but it's something to keep an eye on 3) It's an atypical cell formation and nothing to worry about.

I called Mayo Clinic's Breast Clinic because I wanted a second opinion before doing something as invasive as a biopsy. The reason I called Mayo Clinic (even though it's kind of far away in Rochester, Minnesota) is because 1) It was recently ranked the #1 Hospital in America by U.S. News and World Report in addition to being the #3 Top Hospital for Cancer Treatments and 2) My grandparents went there all the time for their annual checkups and surgeries and swore it was the best hospital in the world. After visiting yesterday I agree that it is the best and that everyone should have the opportunity to meet with a doctor there at least once in their lifetime! I was originally scheduled for an appointment at Mayo's Breast Clinic on August 30th, but was nervous about waiting that long and asked if I could be notified if an earlier appointment came up. I got a call this week that they had an earlier appointment available on August 21st, so I took it and am SO GLAD I DID!

After taking extra images (I've had over 15 mammogram images taken in less than a month) and talking me through my risk factors (which are high), my doctor and radiologist at Mayo ultimately agreed with the other doctors I talked to and agreed that a biopsy is necessary because the cells and microcalcifications on my left side are too suspicious to not investigate further. To make sure, I asked my doctor if it would be "idiotic" to not get a biopsy at this point. She kindly responded: "I wouldn't say idiotic, but yes, we would encourage you to do a biopsy." So a stereotactic core needle biopsy is the next step in this process. I'm going back on Friday, August 30th to do that and am pretty nervous about it but have peace for the most part which I know is due to the prayers of people who are praying for me throughout this journey (THANK YOU :)).

In less than one month, I went from scheduling a preventative baseline mammogram to scheduling a biopsy that might tell the doctors and me that I have cancer. If I do or if I don't, I have learned the following things about preventative breast cancer screening this month that I hope are helpful and encouraging to anyone else embarking on this journey of preventative breast cancer screening:

  1. Getting a second opinion before a biopsy is worth it. It seemed to take forever to collect all of my test results from all of my doctors, but in the course of less than a month, I collected all of the images and written reports from radiologists that I needed to bring with me to Mayo Clinic. Learning how to be an advocate for myself in the medical system has been a great thing and learning how to work the "Patient Portals" and apps that medical providers have available has been helpful. Every doctor friend I have that I talked to--including one who works at Lawndale Christian Health Center--has said that second opinions are a good idea, too.
  2. Mayo Clinic is amazing. Mayo was recently ranked the #1 Hospital in America by U.S. News and World Report, so I knew I was in good hands. After spending a day there, it's cool to see how efficient their system is: You have an intake appointment with your primary physician who then refers you to other specialists and sends you for more testing as needed. You do your testing and other appointments then meet again with your primary physician who breaks everything down for you and recommends next steps. My doctor spent over an hour in total talking with me, my husband, my mom, and my little sister about everything from my risk factors to test results to preventative screening and she answered all of our five billion questions in detail. This is what sets Mayo apart: the doctors' attention to holistic patient care. Mayo also has grand pianos placed all around the Gonda Building. It was amazing to wander around and listen to patients and visitors play concertos and I was inspired to sit down and play the piece I memorized for my 3rd grade piano recital: "Brian's Song" (I put a clip of it on YouTube and embedded it at the end of this post.) I couldn't remember all of it but had fun for the 45 seconds that it lasted! Before I go back to Mayo next week I've committed to memorizing the entire thing! In addition to the pianos they had Property Brothers on TV and a jigsaw puzzle in the robed waiting room to keep me busy while I was waiting for my mammogram appointment.
  3. I qualify for BRCA gene testing, but given my family history, I don't need it to know that I'm at high risk for breast and ovarian cancer. The BRCA gene testing is helpful for patients to better understand their chances of coming down with breast cancer or ovarian cancer. However, given my family risk factors--my mother was diagnosed with DCIS--an early form of breast cancer contained within a milk duct--at age 40; my maternal grandmother died of ovarian cancer at 50; and my maternal great-grandmother passed away from breast cancer in her 70s--I don't need to be tested for BRCA to know that I'm in the high-risk category and should consider taking preventative steps as if I had the BRCA gene. My doctor explained this to me in detail using the International Breast Cancer Intervention Study (IBIS) model that integrates my age, height, weight, body mass index (BMI), and family risk factors: My lifetime risk estimate of getting breast cancer is 40.8%, super far above the national average / high risk cutoff of 25%. My doctor walked me through these results and let me know I qualify for meetings at the Mayo Clinic High Risk Breast Cancer Center and at the Mayo Clinic High Risk Ovarian Cancer Center. She recommended that I have meetings with high risk breast cancer and high risk ovarian cancer clinics either someplace local or at Mayo Clinic to discuss blood tests, screenings and potential preventative surgeries that might be necessary for me in the next 10 years. TBD!
  4. Prayer works. I got an appointment a week and a half before I was originally scheduled to go in to Mayo which helped ease my anxiety immensely. My doctors, radiologists and technicians have all been amazing. I know this is all due to the prayers of so many people who are praying for me.
  5. It's all going to be okay. Jesus obviously decided He wanted me to go on this journey long before I started it so I'm going on this journey knowing He is with me! I have had numerous reminders of His presence with me along the way and remembering He's gone before me into every conversation, interaction and test. This helps me remember that God is good, life is a gift and everyone I encounter God has placed in my path for a reason. I read the Bible and devotionals including Jesus Calling by Sarah Young on a daily basis. Yesterday, on the way to Mayo, Jesus Calling said this: "Wait with Me for a while. I have much to tell you. You are walking along the path I have chosen for you...Stay on the path of Life with Me. Trust Me wholeheartedly, letting My Spirit fill you with Joy and Peace" (1 Kings 8:23, Galatians 5:22-23). A friend also reminded me of God's faithfulness from Joshua 24: God is the one writing our stories. :) These reminders that I am walking on the path Jesus chose for me brings me peace that surpasses understanding. :)
As a journalist, I have a lot of questions, and my doctors have given me answers to most of them, but some of the questions I have don't have answers. For example, the doctors aren't totally sure why the abnormal cell formation and microcalcifications are only on my left side and not my right, or why it's there in the first place. Whoever figures that out will probably cure cancer. The only things that I know for sure are that I'm 30 years old, I have family history of breast and ovarian cancer, and I might have breast cancer at age 30--ten years earlier than my mom was first diagnosed. I will know if I have cancer in a week and a half, after my stereotactic biopsy next Friday. Living with this reality is stressful but God is still good! After all, faith is confidence in what we hope for and assurance about what we do not see (Hebrews 11).


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