You dutifully go for your annual physical, and the nurse says, “You’re 40. It’s time to schedule your first mammogram. It’s routine so might as well just do it.”

You go in for your first mammogram. 

You marvel at the job of the technician that spends the day contorting women into strange postures and smooshing breasts between metal and plastic plates. It all feels very impersonal and is over relatively quickly. You go home and continue on with your day.

Then you receive an email saying you need to come back. Your breast tissue is dense and they need more images. But don’t worry! It’s just to make sure they have the best possible images. 

You put off the second visit for a little while because COVID-19 happens, and, afterall, they said not to worry. It then occurs to you that it might be more important than the doctor is letting on and you make your next appointment. Upon arrival you discover the doctor has ordered both a mammogram and a breast ultrasound. This was not explained to you when making the appointment and things suddenly seem more serious. 

For this mammogram, they focus exclusively on the left breast. During the ultrasound, also only of the left breast, you see the dark hole on the screen, the one the technician keeps taking picture after picture of. The room is silent except for the soft sound of self-help mantras the technician is playing. To soothe you? Or her? Or both of you? It’s not clear. She finishes, tells you not to worry, and you get dressed and go home. 

A few hours later, the doctor calls. The doctor reviewing your breast screening results is not a person you’ve ever met. She tells you, “Don’t worry, but I want you to come in for a biopsy. There’s an area indicating a low suspicion of malignancy. So we just want to be sure. And don’t worry.” 

All the prompting not to worry is no longer making sense. Though it may be well intentioned, it then has the effect of making you feel like worrying is the incorrect response, and somehow weak. Of course you’re worried! And so is your family. 

When you make the appointment, you’re told it will be quick and you’ll be fine to continue on with the rest of your day. So you make no accommodations at work to take the day off and expect you’ll be back online by lunchtime. 

Your parents insist on taking you to your appointment that morning and picking you up after. You resist initially, then, gratefully accept. 

You follow instructions and arrive 30 minutes early, only to wait an hour because they’re behind schedule. Finally it’s time. The nurse preps you and explains you might not need a biopsy after all if the first needle the doctor uses for a sample deflates the cyst. She says, “That’s what usually happens. It’s fast and easy and then you get to go home. So don’t worry.” 

No one yet has told you that it’s going to be painful. Nobody has shown you what they’re actually going to put in your body. 

The doctor comes in and gives you a similar speech, explains the process with slightly more detail, and again tells you not to worry. That it will be fast and easy.

They stick a needle in your breast to anesthetize the area. The purpose, of course, is to reduce pain. In fact, the anesthetizing needle is shockingly painful with a sharp pinching and stinging sensation. Tears spring to your eyes and flow down your cheeks for the rest of the procedure. 

The next needle that goes in is to collect a fluid sample. You can feel the needle searching around inside of you. It’s a frightening feeling, and also painful. The self-help mantras are playing again in the background. You tune into it and hear, “You are completely alone. You are completely alone.” And you wonder if this message is supposed to be comforting. 

The cyst does not deflate as expected. 

They stick the third prob in you, this time for the biopsy, to get a larger sample. Again it hurts like hell and the tears keep flowing. You hear a vacuum sound as they suck out the sample. It might be the most horrifying sound you’ve ever heard. 

The doctor abruptly finishes and it’s over. He tells you about what he did, and that you can expect to hear results by Thursday. Did he say don’t worry again? You can’t remember. You just want to go home and be nurtured by your parents.

As the nurse is bandaging you up, you tune into the mantra again. You discover that your original interpretation was incorrect. The mantra is saying, “You are completely lovable. You are completely loveable.” How did your brain get it so wrong the first time?

You sit up and the nurse tells you it’s time for another ultrasound. Got to make sure the metal clip the doctor just implanted into your breast is visible in imaging. You are in utter shock that after all that you have just experienced, you have to now get your boobs smashed again, with no prior warning. But you do it because that’s what they say you have to do.

You are thoroughly grateful that your dad is there to pick you up. And when you arrive back at your apartment, your mom makes you scrambled eggs and takes your dog out for a walk. After they leave, you clear your day at work and spend the rest of the afternoon crying and sleeping very very deeply. 

The truth about a breast biopsy is:

It’s incredibly invasive. 

It’s incredibly painful. 

And it’s incredibly emotional. 

All the messages to not worry and the implication that it’s all very routine, quick, and simple do nothing to prepare you for the inevitable fact that you will worry and that the entire process can leave you feeling both emotionally raw and thoroughly exhausted. 

If you have an upcoming breast biopsy, here’s what I suggest:

• Ask for support and have someone with you the day of to make sure you have everything you need.
• Have nourishing food prepared.
• Clear your schedule for at least that day and probably the next. It took me 3-4 days to feel recovered. 
• Take the time you need to rest and recover, give yourself permission to worry, and allow the emotions to flow. 

Epilogue

The results came back benign. I am much relieved. 

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