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Six-month Follow-up Doctor Visit

14 Mar

March 12, 2012

 

So, last Thursday I went for my six-month follow-up appointment with my breast surgeon.

 

The first thing of note happened when I was updating my information with the receptionist.  She asked, “Is Dr. Kracht still your primary care physician?”  “Yes,” I replied.   “And _____________, _______________, and _____________?”  I stared at her blankly. “I don’t know what you’re talking about,” I said.   She said, “That’s odd.  They’re right here on your chart.”  I was puzzled also. Then she must have said something about oncologists and the light bulb went off.  I said, “Oh!  I chose not to go to them.”

 

When my doctor arrived to the examining room she was very warm and friendly but also surprised and a little disappointed that I didn’t at least go and talk to the oncologists.  (One was a radiation oncologist and one a hematology oncologist.)  I replied that I hadn’t been interested in either the radiation therapy or the anti-estrogenic drug and I knew it would be hard to stand my ground if I had been face to face with them.   I knew they’d be pushing for me to go the direction they thought was best.

 

(All things considered, I still agree with my decision FOR ME!  I needed to do my own research and come to my own conclusions and decisions before allowing “experts” to exercise their sway.  However, I do, OF COURSE, honor all those who choose differently from me.  We are each individuals and we have to make our own choices.)

 

Okay, back to the doctor visit.  As I suspected, she wants me to get a biopsy.  A stereotactic biopsy.   For those who have been following my blog, my experience with a stereotactic biopsy last August was NOT pleasant.  In fact, that was the most unpleasant of all my breast-related experiences to date.  However it’s not the fear of discomfort which makes me hesitate.  It is the following two factors:

 

  1. I worry about my body having to process additional radiation.  If I were to get this biopsy done in the next month or two, that would mean that during the course of one ten-month period, my body would have been subjected to about 15 x-rays (about  7 or 8 “shots” per set of mammograms) plus two stereotactic biopsies – which would entail at least two more x-ray views each time.  That’s a LOT of radiation.  And radiation, as you know, is a great risk factor for getting cancer!  (“According to Dr. Gofman, MD, PhD, in Radiation and Human Health: A Comprehensive Investigation of the Evidence Relating Low Level Radiation to Cancer and Other Diseases, ionizing radiation is a known carcinogen, there is no safe exposure level to ionizing radiation, and the effects of radiation exposure are cumulative throughout one’s life.”  http://www.holisticcarehawaii.com/Stereotactic.htm)
  2. There are a few articles which express concern about the wisdom of “poking around” surgically or otherwise in an area that already exhibits the presence of cancer cells or cancer growth. The very act of having more surgery at that site could potentially spread that cancer farther.

 

I expressed my concerns and she heard them.  Her concern is that the one calcification showing on my January films could mean something.  If I had had radiation therapy, that one calcification could be (likely would be) a by-product of the RT.  But I didn’t, so to be safe she feels I should check it out.

 

Of course, doctors have to anticipate worst-case scenarios, while I as the patient, want to be aware of them but NOT focus on them!

 

She did say she would like me to have another set of mammograms done before the next six-month follow-up appointment.  I asked her if there were ANY alternatives.   I again expressed my concern about the radiation involved with mammograms. She reiterated that thermographs aren’t able to find anything at this earlier stage of the game.  They are not an adequate early diagnostic tool.  She said they’re working on diagnostic ultrasound technology, but it’s not ready yet.

 

So, in a nutshell, it seems I have three choices:

 

  1. Do neither of these clinical/diagnostic options (neither biopsy nor mammogram) and trust that my natural course of treatment is sufficient.
  2. Skip the biopsy and get another set of mammograms in six months’ time.
  3. Get the biopsy and then go from there.

 

When I left the office yesterday, I was leaning toward Option #2.  However last evening and this morning, I’m leaning toward the last option.  Because if this calcification represents a benign condition, then I feel I can safely wait at least a year for another set of mammograms.  If it proves to be a spot of cancer, then it would be good for me to know this now, rather than later.  However I am choosing not to worry about those decisions until I know what I’m working with!

 

Okay, it sounds like I’ve just talked myself into the stereotactic biopsy.   I guess I’d rather know for sure what is going on in my body.  Or perhaps, if I’m very lucky, I’ll be able to have the opportunity to say, “See! I’m doing just fine!”   And that would feel very good indeed.

 

Thanks for listening.

 

PS  When I woke in the middle of the night the day of my doctor appointment, I found myself thinking about my right breast and what to do about it.  I must have dozed off because I suddenly realized I’d seen an image of my breast with a vertical knife next to it.  I think that perhaps that was a sign that some surgery (a biopsy) is a good idea.