Visual Comprehension and Justification

The MRI indicated a lesion worth a deeper look. The tech marked my breast in one room using an ultrasound machine that was new. When the radiologist attempted to locate it in the biopsy room, she spent a half an hour trying to find the exact location of the suspicious lesion. At one point I murmured, “So much flesh…” and she gently said, “No. This machine isn’t as new or as good as the one in the other room.” As time passed, though, I began to feel self-conscious and uncertain. I mean, if it’s so hard to find, should I even be there at all? The equipment, time, and expertise cost a great deal of money. If it’s so small, maybe I’m wasting all that. Just because they can see something on the MRI doesn’t mean it’s necessarily a big deal. I said something about this, and the doctor assured me (as of course she would) that certainly it’s worth looking at. She also said that yes, the highly sensitive machines and tests sometimes can find something that turns up benign, but that to be sure is better. Still, I had this feeling of wasting resources. What helped me feel like further testing is justified was a) that the doctor said if it were her breast, she’d pursue it and b) once she knew I’ve had atypical hyperplasia before she was adamant I do it (an MRI breast biopsy).

Yet sometimes it helps to actually measure something and compare. The suspicious lesion is 6 x 8 x 4 millimeters. So I went through my art supplies and found something that fits those dimensions. Then I compared this to a dime (see picture). The visual impact was persuasive. While this is not a huge lump, it is not microscopic either. It is not small, when one considers the breast. It is real, and it wasn’t there a year ago. I spent a few hours reading up on breast cancer and radiology terms. If I wasn’t convinced before that this is worth taking seriously, I am now. And yes, if it’s benign, it’s still worth checking.

The point of having this technology and being identified as high risk (42.5% lifetime chance) is to stay on top of changes so they don’t become big lumps, by which time the diagnosis is invasive cancer and/or possible metastasis requiring mastectomy, lymph node dissection, chemotherapy, and radiation. The point is that if caught early, prognosis is excellent. It’s far more costly (to insurance and to me) to wait for a lump to become palpable and treat it.

Intellectually I know that I am worth time, attention, and resources. Yet it was showing myself the physical dimensions of this lesion that settled it.

In 2011, I had a lesion that required surgical biopsy. It was 5 mm (don’t know all dimensions), and they ended up taking a not-small chunk of my breast with it. The pathology report indicated atypical ductal hyperplasia — meaning that abnormally shaped cells were reproducing at a faster than normal rate in my milk duct. It was precancerous, and thus major trouble was nipped in the bud. So yes, this suspicious lesion found by the MRI (but not a mammogram) merits a closer look.

size comparison
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