More confusion but you'd think there wouldn't be

[by the immortal Posada]


I've been getting mammograms every six months for the remaining breast. Today I went again, and the procedure is that after the mammogram, you're led to the radiology lair and sit in the radiologist's office and talk to her. The radiologist I saw today was seemed to be in her 30s and spoke without pretense. She was happy because the images showed that the (micro)calcifications, which are tiny specks of calcium that could indicate cancer but probably don't, have looked the same in all the mammograms in the past few years. So that means that nothing has changed. OK, it means that probably nothing has changed because you can't see every little thing that's going on.

I've had calcifications for a while--for years, in fact, before I was diagnosed. So I asked her if she could look at the calcifications in my cancer mammograms and compare them to the pre-cancer mammograms. My idea was that she could say, Aha, these calcifications from 2005 developed into the cancer of 2006/7, you can see that in retrospect. And then that would shed light on the specks of July 2010.

So she went through the images and arranged them on her light board and looked through her magic binoculars to see them better and said you couldn't learn anything from the comparison.It seems that the calcifications appeared next to the tumors (or masses, as they say in the biz) but did not turn into them. She also said she had other customers waiting and indicated the folders on her desk. OK, she said patients, not customers.

She told me if I was really worried that I could have a biopsy but it wasn't necessary or that I could come in for a mammogram in six months instead of a year.

I had asked her to do this extra digging because I had this idea of calcium specks as little seeds that could turn into cancer, but that seems to be wrong. Dr. Susan Love tells us: Microcalcifications, as we call these specks, are usually the result of normal wear and tear on your breasts, but 20 percent of the time they're an indication of cancer or of the precancer ductal carcinoma in situ (DCIS). If the film shows only a few very tiny specks arranged in tight clusters, then it's more likely to be something wrong that can fit into the tiny ducts. If the specks are scattered and larger in size, they're more likely to be benign and harmless.

The California Pacific Medical Center tells us: "Benign" calcifications in the breast do not become malignant. Malignant calcifications are malignant from the time they first appear. When the radiologist assigns calcifications to a "probably benign" category, the risk of malignancy is considered to be less than 2%.

My specks are scattered and the radiologist didn't seem bothered by them. She gave me a piece of paper showing the mammogram results as "benign appearing (not malignant) stable." The surgeon smiled at the results when she popped in (standing the whole time). In all everyone seemed happy and cheery with the mammograms, just stopping short of congratulating me on the films' unchanged nature, the way they did when we found out that the cancer hadn't crept up into my lymph nodes.

Aw shucks, it was nothing.

Still, nobody knows anything for sure sure, and though the physician's assistant said it was great that the cancer hadn't come back after 3.5 years, when I asked him about estrogen-sensitive tumors like I had, he said that they're usually slow-growing and are more likely to come back after 15 or 20 years than right away. I was thinking of CJ, who died last summer after having had a mastectomy and no chemo. She said that she thought she should have had chemo. She did have some good years, I think about eight, and then a couple of bad ones at the end, with the cancer growing in her brain and bones. She was working as long as she could, as a school librarian, even when she was nearly blind.

It's fine to laugh at this stage 2-a breast cancer, just garden variety, no big deal, I didn't need that breast anyway, and to read about someone with stage four whose bones were cracking at the end of her book (The Red Devil) and then to find out, hey, she just wrote a book about spending a year in India, but the cancer--even though we say its name now, not just Big C, or that someone's Sick, or Very Sick--it is a death sentence, for some people, some of the time, we just don't have all the particulars in advance.

READ MORE - More confusion but you'd think there wouldn't be

Just a Little Bit Menopausal

Years ago a friend of mine wrote an essay about her experience with in vitro fertilization, and said that indeed that it was possible to be just a little bit pregnant. I think I'm a little bit menopausal. Which is more menopausal than peri-menopausal. Ten days ago I had the FSH (follicle-stimulating hormone) test and also had my fibroids ultrasounded. I thought the elusive gyne would call me with results, but he proved to live up to his name. I finally called his office yesterday and today and then he called back. He said sometimes it takes a while for the ultrasound results to get to him and that he was sorry not to get back to me sooner. He said the fibroids are pretty much the same size as last year, that the largest is 2-1/2 centimeters or the size of a golf ball, and that the test indicated that I was probably menopausal. We'll wait until I get results from genetic tests before doing anything further. Such as surgery. If the test shows I have the breast-ovarian cancer gene, I'll donate my second ovary to the hospital. If anyone wants the stale eggs of Cancer Bitch, let me know. They're cheaper by the dozen.

I thought golf balls were bigger than 2-1/2 centimeters, and L, who was a high school letterman in golf, confirmed that. We figure that the gyne just doesn't play golf. Again I'm moved to quote Marjorie Gross: "So I had a hysterectomy, and they found a tumor that they said was the size of an orange. (See, for women they use the citrus-fruit comparison; for men it's sporting goods: 'Oh it's the size of a softball,' or, in England, a cricket ball.) " She wrote that in 1996. Now in the 21st century, I guess doctors are more gender-neutral in their comparisons.

I feel like I should be menopausal by now because it seems everybody else is. It's a relief in a way because then I don't have to fear that I'll feel feel worse with menopause. I know that's a dangerous thing to say. It could always get worse. It's hard to distinguish hot flashes from menopause with those that are a side effect of chemo. My head is often clammy. Luckily, my scalp decoration is not water-soluable.

Last night my friend S added some Picasso-esque doves to the top and back of my head. The plan was to fill in some of the designs with henna, which she did, though she was hampered by the lack of a crucial piece of henna-design equipment. Either I misplaced it or it wasn't in the package sent by the good people of Earthhenna.com.

Yesterday I went for a mammogram of my right breast at the Fancy breast cancer factory. The tech showed it to a radiologist, and reported that it looked fine. I'm not due for another mammogram until next year. Then I had an appointment with my surgeon. The physician assistant measured my arms and said that my left (mastectomy) arm was only 1 centimeter wider than the right one, which is an insignifant difference, not an indicator of lymphodema. The most confident and competent of the surgery Fellows came in and led me through my paces (hold up arms high, put your hands on your hips, breathe normally, take a deep breath) and she palpated my breast. Then the surgeon came in and did pretty much the same. Her hands were also cold. She asked, of course, if I was hanging in there (I think the Fellows aren't allowed to ask that), and she asked how things were going, saying she read about me in the paper. I didn't ask if she was reading this blog. That would seem to cross some line. Then I'd have to say, What did you think of my description of you? (Which was that she was warm and business-like. Though she does, as noted, have that widespread "hanging in there" tic.) I'm supposed to get an MRI of the right breast next month. I went into a little room to schedule it. The scheduler said that she herself had a mass in one breast that she was going to have an ultrasound to check it out. Her aunt had just died of breast cancer (that had spread to her spine and brain). One of the last things her aunt said to her was to get it looked at. Her aunt was a fighter, she said. The aunt had been living with breast cancer for 13 years. When the cancer went to her brain it put her in a coma. I hope that for most of those 13 years she was in remission.

READ MORE - Just a Little Bit Menopausal