Sometimes a few days of worrying may be worth the alternative.
With the array of advanced screening practices for breast cancer — mammograms, ultrasounds, breast MRIs — many women with “abnormal results” may experience some sleepless nights until the results of biopsies are completed.
Sharon Foster knows all about it and recently has reason to be thankful. Her occasional worries were trumped by catching breast cancer early.
Fourteen years ago, Foster found a lump that an ultrasound-guided biopsy determined was not cancer, “but atypical and probably precancerous.” She had the lump removed. Because she had a family history of breast cancer, she started a six-month routine of screenings.
Foster also had fibrocystic breasts, prone to lumping and pain, and subsequently had suspicious lumps and abnormal results, or what some laypeople may describe inaccurately as “false positives.”
Though she endured the psychological roller coaster and rounds of “what if” questions, Foster was not deterred in her diligence of regular screening, which paid off this past summer.
In July, an MRI revealed a lump, initially thought to be scar tissue, that a biopsy later tested positive for ductal carcinoma in situ, an early form of breast cancer located inside a milk duct.
“When I got the news, my heart dropped, and I burst into tears,” recalls Foster, the mother of two grown daughters and the co-owner of a PostNet printing franchise with her husband, R.C. Foster III, of 30 years. “It was my worst fear realized.”
But because it was caught early, a bilateral mastectomy, which she had planned to do earlier in the year for preventive reasons but canceled, was performed Sept. 7, and she has not had to undergo chemotherapy or radiation.
“I am so grateful for that. Early detection was key,” says Foster, who is undergoing reconstruction.
Despite all of the awareness efforts of the past two decades, however, Foster says she still meets too many women who don’t take regular screening as seriously as she does. The reasons they give often involve time commitments to family, work and home.
“Women need to take their health seriously,” Foster says.
She has worked closely with Dr. Lisa Baron, a radiologist who specializes in mammography, of the Charleston Breast Center, and Dr. Paul Baron, a surgeon specializing in breast cancer, with Cancer Specialists of Charleston.
Both agree that improved screening methods can create worry before biopsy result, but that the key to lessening it is communication on the parts of the patient and physician.
Lisa Baron says, “I think it’s really important that people feel comfortable in talking with the health provider, radiologist and primary care physician, and what is the next step? What should I expect over this period of time? ... I always maintain open communication.”
Paul Baron says he sees patients all the time with lumps and that “most of the time (it) is fibrocystic changes.”
The Barons add that the prevailing recommendation for routine annual mammography screening — including from the American College of Gynecology and Obstetrician, the American College of Radiology and the American Cancer Society — for women who are not at increased risk for breast cancer is starting at age 40.
“Everybody’s breast is different, and some people are fibrocystic, which means the breast tissue tends to more active, creating cysts and calcifications,” Paul Baron says. “We’re looking for certain changes on the mammogram which would indicate cancer, such as a new nodule or mass or calcification.”
Lisa Baron adds that tests are necessary annually “because people are changing, taking medications, gaining weight or losing weight, or are fibrocystic.”
“If we see a change, we’ll take them out of the normal screening and do some additional images,” she says.
“After those tests are done, we have to make a decision. Is this something that warrants further evaluation with a biopsy, or is this something we can watch, or a normal change we don’t have to worry about?”
These images represent a dense breast normal screening.×
This MRI shows cancer in the right breast with the spread of the disease in the colors. (The colors at the bottom of the frame in the chest wall do not represent cancer.)×
An image of fatty breast tissue with a cancer mass. The cancer mass is the pure white area one-quarter of the way down from the top.×
Sharon Foster talks with surgeon Dr. Paul Baron in a follow-up consultation visit after having both her breast removed due to cancer.×