Mammogram 2023: Imaging Again, Really?
I swiped through my calendar, daydreaming of the weeks ahead, when suddenly I saw it: Mammogram- 2 PM. What? How could it be time for breast imaging again? As my chest began to clench, I took a few breaths and then swiped back to my day. I’d deal with the appointment when it got closer.
After the adventures in imaging, biopsies, and surgery in the summer of 2022, I was not looking forward to my January 2023 mammogram. Not that I ever look forward to getting my breast imaging done! The scanxiety hasn’t gone away after my DCIS, but I have gotten better at accepting it. It doesn’t take me by surprise anymore, but it isn’t fun to deal with.
My surgeon ordered a bilateral diagnostic mammogram for me for January 2023. Typically, at this point in the cycle, I will have imaging only on the cancer side (my right side). But, in the summer of 2022, I had a benign lump removed from my left breast. So, he also ordered a bilateral mammogram to keep close tabs on my left breast.
My surgeon prefers a more aggressive imaging cycle than the radiology department in my medical group. Typically, after a bilateral mammogram, the radiologist will tell me to come back in a year. But, when I see my surgeon for my follow-up appointment, he will order imaging at 6-month intervals.
While I don’t enjoy the two doses of scanxiety a year I get with this schedule; it gives me confidence during my recovery. This closer follow-up schedule means any breast changes will be caught sooner.
Night Before Scanxiety
“I’m taking a bath,” I told Dave after walking into his office. He looked at me with a confused face.
He replied, “Um, what does that mean for me?”
“Nothing, honey. I’ll see you whenever you’re done,” I replied and headed upstairs.
Note to self: maybe I should take baths more often, so they don’t perplex Dave quite so much.
With the spa music playing and the candles lit, I eased into the warm water, allowing my mind to slow down and the tension to release. My mammogram was the next day, and I felt the sparks of anxiety beginning to flicker inside.
With each breath, I savored the relaxation and felt my thoughts slow. This was a good idea.
It was easy to drift off to sleep after the soothing soak, something I don’t take for granted post-diagnosis. All too often, I am lying in bed, thinking about all the possibilities as Dave and the beagles are snoozing away.
Mammogram Day: Am I Done Yet?
The time seemed to flow at a snail’s pace all day. I knew I wouldn’t be super-productive the morning of the scan, so I’d cleared my day of all essential tasks and meetings.
This gave me plenty of time to worry. All day. It didn’t help that I was dealing with cramps as well.
Next time, I will schedule my mammogram in the morning and skip the worrisome and unproductive waiting time!
Appointment Time: Finally
With the 80s and 90s music blaring, I made the familiar drive to the medical center. It only took a few minutes to get there. As I was driving and feeling the familiar tension constrict my chest, a wave of peace suddenly passed through me.
I looked to the hills, green with all the recent rain, and realized that while I didn’t know what the results would be, God would be with me either way. It was a moment of spiritual revelation for me. The anxiety dissipated, and I drove on, surrounded by His peace and comfort.
“Y’all ready for this,” broke me out of my reverie. A grin spread across my face, and I turned up “Get Ready” by 2 Unlimited. I was back in high school, dancing and free. As I pulled into my favorite parking spot, the song came to a close, and I felt ready to see what the imaging would reveal.
I checked in at the counter and sat down to fill in the screening questions. Many were already filled in on the iPad, but I needed to update the records to reflect my latest surgery.
“Ms. Douglas, we’re ready for you,” the nurse said. I had only been sitting for a few minutes and wasn’t even done with the questionnaire.
We headed back to the changing area, and I quickly finished up. I put on the familiar pink gown, trying once again to figure out just the right way to tie it for maximum privacy and ease of use. I locked up my stuff but took my phone with me. It comes with me during the imaging, so I can stay in contact with Dave and play Disney Emoji during the waiting time. Having my phone with me dramatically reduces my anxiety during these appointments.
I waited in the secondary waiting room with one other woman. We greeted each other with a quick hello and then went about our waiting privately. She stared out the window, and I began another round of emoji.
After a few minutes, the tech came to get me. I walked into the familiar mammogram room, breathing deeply for calm.
She asked me a few questions and then got right down to business. I put down my phone, my locker key, and at her request, took off my glasses. That was a new one. I’ve never needed to do that before.
After she marked my surgery sites with special marking tape, she began positioning me for the mammogram. She took two images of each breast and stepped out of the room to talk to the radiologist.
Alone in the room, I played a few rounds of emoji and tried to assess whether the waiting was good news or bad news.
The door opened, and it was the tech again. I sighed, knowing this meant more imaging.
“The radiologist would like to look at one spot in more detail,” said the tech with a light and caring tone.
“Which side?”
“The right,” she replied.
Oh great, my cancer side. Ok, here we go!
The tech put a smaller paddle on the mammogram machine and took a few more images.
She headed out again to talk with the radiologist, and I picked up my phone again, eager to be done with this appointment.
After several minutes the tech came back in with the radiologist.
“Your mammogram is normal,” said the radiologist. “There are no new masses or areas of concern.”
I breathed a huge sigh of relief.
“Thank you! I’m curious, what is the Birads score of my mammogram?” I asked.
She replied, “ A 2.”
Oh, how I love 2s! (You can see this post about BiRads for more info)
I spent a few more minutes chatting with her about my results, breast density, and the next steps for imaging. She recommended coming back in a year for a bilateral mammogram but would defer to my surgeon’s imaging schedule.
I bounded back to the changing room, delighted with these results.
I sent quick texts to my family and then changed into my clothes.
Gratitude and Tears
With “Tahiti” by KeenV blasting, I began my drive home. As I left the medical center, I realized a dream had come true. The tears welled up in my eyes, full of gratitude and thankfulness.
In 2019, when I was diagnosed, Dan was starting his first year in high school. As I was making treatment choices, my goal was to do the appropriate treatment with as short of a recovery time as possible. I wanted to return to my virtual school parent role quickly. I hoped and prayed that this would be my only incident of breast cancer while my boys were still in high school.
I remember talking about these goals with my medical team. They recommended a lumpectomy plus radiation because it would effectively treat my DCIS and have a shorter treatment pathway than a mastectomy plus reconstruction. I hoped and prayed they were right.
As tears began streaming down my face, I realized it was finished. Dan would graduate in June 2023, and I had just had a clear mammogram. Am I out of the woods for the rest of my life? No way! I will always need to be vigilant about my self-exams and imaging with my personal history of DCIS. But, we wouldn’t need to deal with another breast cancer incident while the boys were in high school.
Breast Surgeon Appointment- Getting Patient
A week later, I arrived at my appointment with my breast surgeon for a follow-up. I was just a few minutes early and hoped it would be a quick, easy afternoon appointment. When I checked in, the attendant told me he was running about 35 minutes late. “Well, I guess I’ll go out to my car and get my iPad,” I responded.
As I walked out to my car, I reflected on my evolution as a patient. The fact that my surgeon was running late didn’t phase me. A few years ago, I would have been annoyed. But now, I realize there were other patients whose cases required more time. Maybe a surgery had gone late. Or perhaps a patient needed more than her allotted appointment time. Someone needed his time, and rather than letting the schedule run him, he took the time necessary with each of us.
Cancer and surgery are complicated, and sometimes we need to stay flexible. It was my turn to get comfortable and wait.
I watched the waiting room empty. Soon I was the only one left. One of the staff returned from lunch and checked in with me to ensure I’d checked in. I laughed and said yes, but I wished I had had my afternoon coffee before I showed up!
Eventually, the door opened, and my surgeon’s medical assistant called me back. It turns out he was running about an hour late. There were clearly more of us than him that day! I was only in the room for a few minutes with my gown on when my surgeon came in.
After a quick greeting, he pulled up my chart, and we talked about my recent imaging. Then, it was time for the physical exam. He checked on my scars- which are pretty faded at this point. He checked my breasts and lymph nodes for any new masses.
“Okay, Jennifer, you can come back in a year to see me after your mammogram,” he said after taking some notes in the chart.
“A whole year, wow,” I said, startled.
As we chatted, he mentioned that he moves his lower-risk patients to annual mammograms after about three years of twice-yearly scans. Since I don’t have any genetic factors, and my DCIS was low-grade, that is the new plan.
I thanked him as he walked out and then excitedly got dressed. I will not miss the twice-a-year doses of scanxiety, that’s for sure!
After getting the next appointment on the calendar, I headed out, relishing my new freedom. This is a year of evolution for me, and I’m excited to be able to face it without more breast imaging!
Here’s to annual mammograms (again)!
Jennifer Douglas
Jennifer is the author of "A Breast Cancer Journey: Living it One Step at a Time," breast cancer survivor, and patient advocate. Her book, published in 2023 by Bold Story Press, is an encouraging guide for breast cancer patients. It contains first-hand information, organized by topics, to help readers navigate the diagnosis, treatment, and recovery from breast cancer. Her writing emphasizes emotional, mental, and physical well-being along with empowered decision-making.
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