Screenings for Different Cancers

Last week I went in for a mammogram. But for me, this wasn't as routine as it might be for most people; I can trace my roots back to Ashkenazi Jews, who have an increased risk of the BRCA1 mutation, associated with breast and other cancers.

There’s no known history of breast cancer in my family, but still, the increased risk factor remains, so I get to get mammograms yearly, instead of every other year, like most women my age. Yay, I think? I mean, better safe than sorry, but still, they’re not that much fun — especially when they lead to more stress, like this one did.

The mammography tech was very nice, and noted that I was now off monitoring for a previous indistinct area found on a mammogram several years ago; that spot was troublesome enough that it led to a biopsy, which found, ultimately, that I have dense breast tissue — an issue that plagues many mammograms, even with improved imaging techniques. The tech ended up redoing several of the images to ensure that they were clear and easy to read, which I appreciated, even though it was uncomfortable at the time.

The day after my mammogram I got an email from my doctor’s office, notifying me of a scheduling ticket; when I clicked on it, it was for a routine mammogram, with an expiration date two years in the future, which seemed a little odd. I sent an email asking about it and didn’t think much of it until I got another email from my insurer, noting that there was an area in my right breast with “focal asymmetry that requires additional evaluation.”

It’s probably just another area of dense breast tissue that didn’t scan well… but I’m also three years out from treatment for follicular lymphoma (a blood cancer that’s considered treatable, but chronic and incurable), and I know that one of the long-term side effects of treatment is an increased risk of other types of cancer, especially types that the person is already at risk for.

Now I have two risk factors for breast cancer: one genetic and one environmental. Although it’s even less likely that it’s anything caused by treatment, this far out from treatment for lymphoma, there’s still a chance it’s something.

Here’s the thing most people don't understand: while I can understand that this is almost certainly nothing, I can read the standard letter sent out about such additional testing that says the vast majority of additional tests show nothing. Emotionally, after already having had cancer once and having done a little too much research into the potential aftereffects of chemotherapy, I’m terrified.

I know, from having had this happen before, and in the same area of the same breast, that it’s almost certainly nothing. But it’s that “almost” that’s given me trouble.

I had a CT scan shortly after as part of my annual follow-up for follicular lymphoma, and it showed nothing. But still, I’m horribly anxious. I talked to the scheduling office, and my appointment isn’t for a month, which means the insurance company considers it worth following up on and isn’t urgent, but that only helps so much. It’s going to be a long month.

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