Oct 232015

I had breast cancer, but I don’t get mammograms. In fact, throughout the entire diagnostic process, I never had a mammogram.

How is this possible?

When I first noticed a breast lump, my ob-gyn recommended an ultrasound because of my age. I was only 34. She said it was almost certain to be benign. The image on ultrasound didn’t look benign to me, but the doctor doing the biopsy told me it probably was.

When the biopsy came back suspicious, I had an MRI to try to rule out cancer. The MRI involved use of a contrast agent that can cause kidney failure and death in a tiny percentage of cases, so that was a little nerve-wracking. But I figured that if it meant I didn’t have to have surgery, it would reduce more risk than it created.

Unfortunately, the MRI didn’t rule out cancer. So I had an excisional biopsy and later a lumpectomy and radiation.

My No-Mammogram Rationale

Afterward, I told my oncologist that I was no fan of mammograms and wasn’t going to do them. Radiation risks aside, I’d read a study and an article that indicated simply massaging the breast during sentinel lymph node biopsy surgery could increase the rate of micrometastases (isolated cancer cells or cell clusters in the sentinel lymph node or nodes).

My common-sense danger detector went off. If massage could cause micrometastases, what about heavily compressing my breast in a machine?

I decided not to do that.

Ultrasound Follow-Ups

Instead, I told my oncologist I was open to ultrasounds, so that’s what I’ve been doing since then. They are painless, non-invasive, and more accurate than mammograms for younger women with dense breasts.

Seven months after radiation ended, my first follow-up ultrasound showed something troubling, but the doctors at the imaging center said my original pre-biopsy ultrasound was of such poor quality that they couldn’t be sure if what they saw was new. I ignored their recommendations for an MRI (you get harassing letters when you do that!) and decided to follow up with thermography. When thermography showed no issues, I waited a few months and then had another ultrasound. Nothing had changed, so it was labeled benign, and it has stayed that way for many years — with one exception: The nodule they labeled “particularly concerning” has entirely disappeared.

Don’t Panic

A key part of this follow-up process, for me, has been not to panic. I’m on a best-in-class alternative treatment program to prevent recurrence, and it’s worked wonderfully for me, so I know I have time, knowledge, allies and weapons. Mammograms, however, are not part of my arsenal.