Every 6 months, I get monitored. MRI, then a mammo, then MRI, then mammo. Until I decide to round out the Ms with my mastectomy, this will be my life. It's a lot to manage, a lot of anxiety and a lot of time in waiting rooms. I feel lucky I have Basser so close because I'm able to take one day and cram it all in, but it's still a lot.
Since my last MRI in May found a small fibroadenoma, I had another this go-round instead of going back to the mammogram. The mammogram is still considered the "gold standard" of breast imaging, but there are quite a few issues with it in a case like mine and many other young BRCA+ women.
First, I'm young, relatively speaking. The younger you are, the more likely you are to have dense breasts and on my mom's side, we have cystic and dense breasts for longer than most women. Mammograms do not necessarily handle density well. My boobs probably look like a mass of whiteness on a mammo (much like the photo here), making it very difficult to identify any abnormalities.
If you are high-risk or old enough to begin annual mammograms, you should know your breast density. It's a law in nearly 20 states that the mammography report must tell you if you have dense breasts and a technician or physician should explain the implications of that to you, one of those implications being that early-stage breast cancer will be harder to detect.
Additionally, mammograms rely on radiation rather than magnetic imaging like the MRI. For carriers of a BRCA mutation that find out early on (25 or younger), annual mammograms might be more radiation than necessary. There aren't huge links to it being an issue, but there's also a line of thought that we could just have MRIs, without the radiation and with better detection, or include breast ultrasounds in our screenings.
All that said, breast MRIs suck as a physical experience. First, I have to get the IV with contrast, which usually happens maybe 15-20 min before I am taken back for the actual procedure. Luckily, today's nurse was quite skilled and there was not much in the way of trauma with the IV placement.
When you go back for the MRI, you lie face-down and literally hang your breasts between some cold plates with a hard, flat piece against your breastbone. You put your face in a pillow holder (like a massage or chiropractor's table) and stick your arms straight out. Doesn't sound horrific, but try holding that position -- totally unmoving -- for about a half hour...while you are forced to endure just about every flight-or-fright-inducing sound is blared into your claustrophobic tube.
First there's the office building fire alarm. The one that makes you jump 10 ft on a normal day and take any excuse to leave your laptop behind. Then there's the car alarm. The one your kids like to set off and cause you to fumble around in embarrassment. Then the you-broke-your-computer-like beeeep beeep beep noises. This is all in between machinistic grinding noises. Last time, they tried to get my favorite music playing. This time, they just handed me ear plugs -- probably more for the preserving of my hearing than my comfort level.
About halfway through, they inject the contrast, which is this weird mix of cold and burning tingling.
|Me, rocking the post-MRI markings|
Mentally, it takes all the voices of my former yoga instructors to induce a savasana-esque calm for myself and not squeeze the crap out of the stress ball the tech handed me for emergencies only.
After a lot of breathing and out of body escape, the tech finally tells you that it's over. You try to sit up and find you cannot feel your arms from the shoulders down. Then your shoulders start tingling and the blood rushes in, along with the anxiety of hoping you'll hear the words I heard a few hours later:
"Everything looks great."
Until next time, MRI.