WEEK 3
No, this was not on my list of 52 new things to try this year. But here I am a week after discovering the labyrinth in new territory.
In the days since I was told I must have a needle biopsy on my left breast, I find my mind wandering to the tiny flecks they found on the mammogram. Calcifications as small as sand. I walked on sand two weeks ago. There wasn’t anything to fear then.
I look at my left breast in the mirror and imagine these visitors, quiet and invisible.
Last Friday’s mammogram was completely routine—the same three images on each side as we’ve done the last 12 years. After, I met my wife and walked for miles as we often do, bought groceries and wine, cooked and watched a movie in that way time unfolds when there is nothing to fear.
On Monday morning, I got the call: “Hi Miss Silverstone this is Rebecca one of the nurses from UCSF. Nothing to panic about. We want you to come in for a diagnostic mammogram. Your right breast is fine, but on the left breast we see calcifications. These can be benign and monitored, but we need closer images to be sure.”
I think to myself, ok they need more pictures.
UCSF breast imaging is a hive of activity when I check in at 8:45am on Wednesday. It’s efficient and pleasant, and there are many of us moving in and out of the waiting area and diagnostic rooms. They take three pictures and a magnification. A special 3D image. Then the radiologist says: We don’t like what we see and want to do a biopsy.
Standing there in my patterned half gown looking at the spots on the screen, I know this is not the right outcome for today’s visit.
It’s all new. The nurse hands me a pamphlet and explains the procedure and after care. Assuming the tissue can be sampled, she said, there are one of three results: benign; atypical / monitor; cancerous. I stare. Ask a few questions. I am one test away from a potentially very bad situation.
Google is my next stop. Incredibly, I found the corner of the Internet where information is factual and clear, written to inform and instruct.
The findings on my report indicate suspicious (BI-RADS 4). I learn about this new-to-me terminology, the Breast Imaging Reporting and Data System or BI-RADS, which sorts results into categories 0 through 6. Mine is 4, meaning suspicious abnormality – biopsy should be considered. Findings do not definitely look like cancer but could be cancer. A rating of 4 is usually associated with a wide range of probability for malignancy, around 25% and possibly lower. A 5, on the other hand, is highly suggestive of malignancy.
Just one digit apart. The seriousness of these calcifications the size of sand comes into focus.
I go about the next days as I would normally: work, exercise, evening walks and catching up with Irena, cooking, eating, watching shows, sleeping (fitfully). We hang with friends. Dance. Party. Drink. We hike Montara Mountain with so many shades of green, riots of wildflowers, towering skinny eucalyptus, a distant waterfall and the blue Pacific to the west.
I fall asleep with my hand across my chest, speaking softly and benignly as I hope they are. I don’t know you yet or why you’re here. Next week they will take some of you out. I saw you on the screen and you are so small. Are you here to tell me something?