This blog post is the 39th in a series about my (and twin sister’s) preventative breast cancer screening journey that began when we were 30 years old in July 2019. Here is a list of all of the posts written about our journey at Mayo Clinic’s Breast Clinic in Rochester, Minnesota, to date. To keep tabs on new posts, sign up for the “A Daily Miracle” email list at this link. You can also follow on Facebook, Twitter, and Instagram.
At 32 years old, thanks to a successful double mastectomy with immediate reconstruction operation I had at Mayo Clinic in Rochester, Minnesota, in December 2019, I have been a DCIS breast cancer survivor for 18 months now, and I just found out a few months ago that I’m pregnant!! My husband and I are excited and terrified all at the same time!
Being pregnant is stressful enough in and of itself. Bringing a little life into the world is no small thing! Doing it as a breast cancer survivor is anxiety inducing because estrogen and progesterone–two hormones that surge during pregnancy–are two hormones that my breast cancer thrived on. Taking this into consideration, I’m being watched carefully by my OBGYN and by my Mayo Clinic Breast Clinic care team(s).
I’m grateful I’m being watched carefully, but that also comes with a roller coaster of emotions. During my 8-week pregnancy physical exam at my OBGYN, she found an “area of concern” on the left side of my chest that she wanted my Mayo Clinic care team to take a look at.
Mayo Clinic took a look, agreed the area of concern on the left side of my chest was “suspicious,” and ordered me an ultrasound to investigate further followed by an ultrasound-guided biopsy. That biopsy ultimately came back negative for breast cancer (WOOHOO!), but the trusting God in the waiting for all of that was incredibly challenging and painful. We are so grateful for my negative test result and do not take that mercy for granted!
So here we are: I’m 32 years old and 18 weeks pregnant as an 18-month DCIS breast cancer survivor. In this post, I want to share how my breast cancer surveillance during pregnancy has unfolded so far in hopes it’s encouraging to breast cancer survivors and their families, friends, and communities everywhere! So, this is the story of my breast cancer screening during pregnancy so far.
Praise!: I am 18 weeks pregnant and baby is strong and looking healthy!
Praise!: I have now had all of the kinds of breast biopsies Mayo Clinic has to offer, and my most recent biopsy was negative for recurrent breast cancer! My ultrasound-guided needle biopsy of a 13mm x 7mm “area of concern” on the left side of my chest in May ended up being “benign fat necrosis,” praise the Lord! This is my third breast biopsy after my stereotactic core biopsy in August 2019 and my MRI biopsy in October 2019, which both ended up leading to DCIS diagnoses. I don’t take this “all clear” for granted!
All of the details about my pregnancy, ultrasound-guided biopsy, and what pregnancy surveillance as a breast cancer survivor look like are included in the ~5,000-word blog post below. Thanks so much for your continued prayers and encouragement as my husband and I navigate these uncharted waters!!
Our Pregnancy Test(s) and Announcements
I took a pregnancy test on February 18, 2021, and it looked positive based on what the stick diagram was telling me. I screamed at my husband who was in the shower to look. He stuck his head out of the shower full of soap and water. He squinted and looked at the test and said, “Take another one!!!”
So I took another one.
That one was positive too.
Then my husband said “Wow! I think we’re going to have a baby!”
We prayed together and then he went to work.
I took one more pregnancy test to make it an even three, then I FaceTimed my family panicking and wondering what I should do next. They recommended I call my OBGYN and make an appointment, so I did!
Then I decided to call my extended family and let them know via FaceTime. I know lots of people take time to make fun and exciting baby announcements, but to be honest, I was feeling more stressed than creative and just wanted everyone at that point to know what was going on so they could pray for us!! As I mentioned earlier, being a breast cancer survivor and becoming pregnant is pretty anxiety-inducing, so we appreciate all the prayers we can get! 🙂
My First OBGYN Checkup
I had my first ultrasound and appointment at my OBGYN on March 17th, 2021, right around 8 weeks. I couldn’t believe I had to wait 8 weeks to go see my baby doctor but I guess that’s how they do it nowadays!
My first OBGYN checkup was pretty cool. My husband got to come, and we got to see our baby for the first time! It was approximately 2cm big, and it was just chillin’ on the ultrasound screen (pictured above). Then I went to my physical exam, which included a urine sample, them taking a bunch of blood, and asking questions about my medical history. It took me about a half hour to explain all of my surgical and cancer history, they asked some questions, then conducted a physical exam.
Everything was looking good, except for a small spot on the left side of my chest that my doctor said felt a bit “different” than the other tissue she was feeling.
“When is the next time you’re going to see your breast doctor at Mayo?”
“I’m scheduled to see her in June!”
“Could you get an appointment with her sooner? It would be great if you could see her at some point during the first trimester!”
“Sure! I’ll send her a note and get all set to see her soon.”
I wasn’t too concerned, but was excited to go see my breast clinic doctor at Mayo. It’s always good to see her!
Preparing For My First Pregnancy Checkup @ Mayo Clinic’s Breast Clinic
I scheduled my first pregnancy checkup with my doctor at Mayo Clinic’s Breast Clinic for April 26th because my OBGYN was very interested in me seeing her ASAP to check things out. I would have gone earlier but my April schedule was a little nuts and when I explained everything to my Mayo doctor through the patient portal, she said “Congrats!!!!!” and that an April 26th visit at 14 weeks pregnant would be just fine.
Plus, my breast clinic appointment ended up being the same day as my twin sister’s first remission visit with her oncologist, so I got to go with her to that appointment and she was able to come to my appointment with my husband and me! (You can read all about my twin sister’s hip pain, oncology appointment and MRI that showed NO CANCER at this link!! :))
The night before my Mayo Clinic appointment, I had a sinking feeling in my stomach. I was excited to go back to Mayo, but I was nervous that my OBGYN had found an “area of concern” they wanted my breast clinic doctor to investigate. I also had a sneaking suspicion that I would need to have advanced imaging of that area of concern. In a majority of my breast cancer screening experiences, advanced imaging often leads to biopsies, which then tend to lead to breast cancer diagnoses.
What was the worst case scenario? That I had recurrent breast cancer at 14 weeks pregnant. I tried not to think about that too much as I focused on God’s goodness in delivering my twin sister from her corneal cysts and recurrent breast cancer and how grateful I was to be under some of the best medical care in the world. My family tried to keep my mind off things too by buying me a banana split from Culver’s (it’s healthy, cuz it’s fruit :)).
My First Pregnancy Checkup @ Mayo Clinic’s Breast Clinic
When we arrived at Mayo’s Breast Clinic Monday afternoon, to welcome my Mayo doctor into the exam room, we did the wave! We started with my sister at the end of the couch, then my husband, then me. She saw us and laughed.
Then she got to her desk and exclaimed, “Congratulations!!!,” and gave me a big bear hug.
My husband and I said, “Thank you!!”
She asked how I was feeling. I said tired and kinda nauseous but that I was glad to be at 14 weeks now, which means I was excited to be hitting second trimester, because I had heard that things start getting better at second trimester! She said, “Well, you should be feeling better, but I was exhausted for my entire third pregnancy! The exhaustion never went away!”
And I said, “Well, you were also raising two other young kids, plus working full time! So that probably had something to do with it!”
She smiled.
“Do you know the gender?” she asked.
“Not yet!,” I said. “We’ll find out June 11th then we’ll hit exploding golf balls at a gender reveal to show what gender it is.”
She laughed and said, “Don’t cause a lawsuit!”
We said we would do our best to avoid that. 🙂
My First Pregnancy Clinical Breast Exam
“So your OB found something on physical exam? What exactly was it?” my doctor asked.
“Yeah, so on my left side she found some tissue that felt different than the other tissue around it. And she couldn’t find it on the right side. I can’t feel it myself, but you guys are the experts, so I’ll let you see what you think,” I said.
“Let’s take a look!”
While I was getting changed, she commented on our bright pink “Team Mayo!” shirts that we were wearing and that we’d made for all of our Mayo doctors in 2019:
“I am so mad!! I set out my pink tshirt on top of my dresser last night and I was going to bring it to change into for your appointment today and I forgot it!! I really wanted to do that!”
We laughed and said, “Wow! We’re flattered you still have the shirt and it’s not in a trash can!”
And she said, “Of course not!”
And we said, “Well there’s always next time! Maybe we will just buy you another one to keep in your office for opportunities like this, haha!”
Then I was ready for my exam. For the exam she wasn’t feeling anything on the right side. Then, on the left side, she said the left lymph nodes felt “normal.” Then she asked if anything felt tender and it didn’t.
Then she examined the left side of my chest where the OBGYN had pointed something out and said: “I do feel a small something here. The good news is this area is soft and not hard. But I’m not feeling it on the other side. The one thing we can do is put an ultrasound on it to make sure nothing is going on here.”
My heart sank. I wasn’t very excited to hear I’d need to get an ultrasound. In my breast cancer history, my ultrasounds tend to lead to biopsies, which tend to lead to cancer diagnoses. But I trusted my Mayo doctors 100% and knew I’d be heading into advanced screening later that week, hoping for the best!
So I looked at her and said, “I’m down for whatever you think is best!”
“One thing it could be is leftover tissue from the surgery on that side, or it could be something nodular,” she said. “We will do an ultrasound to figure that out! I’m not going to take any risks with you.”
I was a little bit encouraged by that–maybe it was some tissue that got left behind during my double mastectomy! But I think my surgeon would be insulted if she’d left any tissue behind so I was kind of confused as to whether or not it might be that. I tried not to think about the worst option: That I had recurrent breast cancer at 14 weeks pregnant.
Then, at the end of my exam, I asked her three more questions about breast cancer recurrence and pregnancy:
Q: Does risk for breast cancer recurrence increase with every pregnancy?
A: No, it actually decreases every pregnancy, because as you get farther away from the time you had DCIS, chance of recurrence gets less and less. Recurrence would happen sooner after your first diagnosis. Also, if there were any estrogen receptor cells in your system, they would have been woken up by your first pregnancy, so here we are checking things out!
Q: Alcohol and breast cancer recurrence: What are your thoughts?
A: American Cancer Society (ACS) says no alcohol, and other standard medical societies say 3 drinks per week. So let’s keep it somewhere between there.
Q: Would full genome sequencing at this time be beneficial?
A: Yes, but we don’t want any false leads, like, “This could mean this,” so I might want you to meet with a genomic MD instead of a specialist to make sure you’re doing the best thing with a 350-gene genetic panel. I don’t want it to be a waste of time! I’ll send a note to them to see what their thoughts are.
So we’re waiting to hear from our doctor whether a full genome sequence would be a good use of our time and blood.
Then, as we checked out and got my ultrasound scheduled, my doctor said, “Okay! Let’s plan to see you back in 5 to 6 months, depending on what the ultrasound shows. Then, I’ll want to see you 3 months after that. Because I DEFINITELY want to meet the baby!!!”
My Breast Ultrasound at Mayo Clinic in Rochester (and my twin sister’s hip MRI)
Three days later, the same day I had my ultrasound scan at Mayo, my twin sister had a hip MRI scheduled. We, along with our family and friends, were pretty much freaking out about these two tests because both of them could show that both of us had recurrent breast cancer–or that something else was going on. We’d alerted all of our prayer warriors to pray for us because we were really hoping for negative test results!
Two of our good friends from church stopped by my sister’s house before our departure to Mayo with Starbucks coffee for us and to pray for us and for our family. I cried like a baby as they prayed, which was therapeutic and exhausting. Then we hugged everybody and told them we loved them. (I wasn’t able to get a selfie because I was a blubbering mess.) Then we took off!
My twin sister’s oncologist had ordered an MRI to investigate some intense pain she’d been experiencing for the past month in case it might be a cancer recurrence in her hip. HALLELUJAH praise the Lord, it just turned out to be a “labral tear,” not more cancer! So we were thrilled! (Her hip MRI story is at this blog post link.) One prayer answered!!!
Then it was my turn–to go to an ultrasound. My ultrasound tech was also a twin! She told me all about her sister and congratulated me on my pregnancy and asked if we knew the gender. I said not until 20 weeks, on June 11th we would find out, then we’d hit exploding golf balls at a gender reveal party. She thought that was funny.
She took about 30 minutes to take some photos and then said she was going to confer with the radiology team and she’d be right back. 10 minutes passed, then 15, then 20. Then 25.
“Uh oh,” I thought to myself. I tried to distract myself by taking some selfies with a photo in the room I thought was pretty, of the sun shining through trees in a shaded path through the woods.
Ultrasound Results: Time For (another!) Breast Biopsy
After 25 minutes, two radiologists came in with my ultrasound technician.
“Oh no!!!” I thought to myself when I saw not one, but two!, radiologists. Last time they sent two radiologists in to see me, it was back in 2019 after my first “suspicious” mammogram when it took two radiologists to recommend I go to biopsy. That biopsy ultimately ended in my breast cancer diagnosis (you can read all about that experience in the post at this link). Oh well, I thought, let’s see what God’s up to here!
“Hello!” radiologist #1 said.
“How are you today?” radiologist #2 said.
“Just fine, thank you!” I said.
“We’re just going to take turns taking a closer look at this spot here if that’s okay,” radiologist #2 said. “Also, congratulations on your pregnancy! How far along are you?”
And we exchanged pleasantries and baby basics while radiologist #1 took some photos. Then they switched while they talked about the dimensions and what they were looking at. After about 10 minutes of more photos, radiologist #2 said:
“So we are looking at about a 1cm spot here on your left side that might be a fat necrosis,” she said. “Given your history and the fact that you’re pregnant, though, we’re going to recommend a biopsy just to be sure. I don’t know if we can get that done today, but we’ll get you dressed then in touch with our scheduler to get you a spot on the calendar soon.”
“Okay, that sounds great!” I said.
I was more or less in shock at this point, and just wanted results ASAP. What did they mean, BIOPSY?! I didn’t even have breast tissue anymore, so what exactly were they looking at?! The thought that I actually might have recurrent breast cancer while pregnant was terrifying. I also knew then why I’d had that sinking feeling in my stomach the Sunday before my appointment on Monday: Jesus was preparing me to trust Him and buckle up for another wild ride!
I scheduled a biopsy for the soonest available which was the next morning. I’d been hoping it would be that afternoon but they assured me they were all booked up. I called my husband to make sure he could bring me back to Mayo again the next morning–this would be the third day of the week that he’d have to miss or be late to work!! :-/ He assured me it was fine so I scheduled the appointment.
Then I went out to my twin sister and our husbands in the Breast Clinic lobby and said, “Welp, I need a biopsy!” Their faces fell. They were shooketh. And they wanted me to get one that afternoon so I didn’t have to travel back or wait for another day. But I assured them I begged for an appointment that afternoon and there were none. Oh well, God had a reason for making me wait!! I thought. My sister told me that too.
Then the ultrasound report came in and read:
IMPRESSION: Suspicious heterogeneous mass/region measuring 1.3 cm in the left reconstructed breast
RECOMMENDATION: Biopsy Recommend ultrasound guided biopsy of the small suspicious heterogeneous mass/region in the left reconstructed breast Findings were discussed with the patient upon examinations completion and she is agreeable to return for ultrasound-guided biopsy.
ASSESSMENT: BI-RADS: 4: Suspicious.
The last time I had a Bi-Rads 4: Suspicious note on a radiology report, it turned out to be cancer. But I tried not to think about that heading into my Friday biopsy. What a wild ride!
Preparing for My Ultrasound-Guided Needle Breast Biopsy* at Mayo Clinic Rochester (*even though I don’t have breasts anymore. The irony!!)
I scheduled a biopsy for the next morning, Friday, April 30th, which was the soonest available appointment after Thursday afternoon. My entire family–and all of our prayer warriors–were very confused.
“A breast biopsy? But you don’t even have breasts?”
“What are they looking for?”
“I thought all your cancer was gone?”
Letting them know that the doctors really thought it might be just scar tissue but were being extra cautious because of my history and pregnancy was reassuring, but there were still lurking concerns in the back of everyone’s minds. Except my husband’s. Following the lead of my breast clinic doctor, he kept telling me and asserting that he was “not concerned at all” and “knows it’s nothing.” 🙂
That morning, my baby sister offered to bring my husband and I coffee for the road! So she dropped off our coffee and prayed with us before we headed out and enjoyed our Americanos on the way down while discussing what the heck was going on. Of course we knew this procedure was necessary, but it was so crazy to wrap our heads around what we and baby were going through!!!
Before we left, my baby sister said, “Mom and I talked and decided this is all happening because God wants us to trust Him more.”
That “trust” word is a tricky one! Trusting God in the good times and the not-so-good times–like times when you have to go in for a breast biopsy when you’re 14 weeks pregnant and don’t even have breasts anymore, just implants–makes it harder to say but it’s no less true!: God is (still) good all the time!
My Ultrasound-Guided Fine-Needle Breast Biopsy* at Mayo Clinic Rochester (*even though I don’t have breasts anymore. The irony!!)
I checked in for my breast biopsy at 9:30am, right on time. They called me back within 30 seconds, and I was off to the races! I was changed and checked in for my consent video in a matter of minutes–they must have been ahead of schedule!
As the checkin nurse dropped me off in my room and told me to watch the 2-3 minute video, I asked, “Do you have any popcorn available for these videos?”
She laughed and said, “Sure thing! I’ll go pop some right now!”
Mayo Clinic doctors and nurses are the best. 🙂
So watching the consent video was all fine and good–this was my third breast biopsy after my stereotactic core biopsy in August 2019 and my MRI biopsy in October 2019, after all, so I pretty much knew what to expect–but one line from the video stood out to me this time:
“This procedure comes with risk of rupture. Be sure to discuss this with your doctor.”
YIKES! I thought. This was my first breast biopsy with implants, so I wasn’t quite sure how this is going to go! I texted my husband and family quickly and they told me to bring up my implants with the doctors every five minutes.
When one of the radiologists came in, he explained the procedure to me and asked if I had any questions. I told him I’m pregnant and that I have implants, so if the procedure can get around both of those things, that would be fantastic. 🙂 He said that would be no problem. Then he asked if I needed to use the restroom (I did, because I’m pregnant, and I go to the bathroom at least twice an hour!). Then we headed into the procedure room!
When I arrived, there were two nurses. One of them was named Jennifer!
“That’s my sister’s name!” I said.
“Awesome!” she said.
We discussed the procedure, how long they’d each been at Mayo (3.5 and 43 years each!!), Minnesota sports teams, and my pregnancy until the doctor arrived. It turns out I was the only ultrasound breast biopsy of the morning! Maybe that meant my results would come back sooner!, I thought to myself.
“So, you’ve had nearly every biopsy we have to offer here,” one of the nurses said.
“I sure have!” I said. “I’m a seasoned veteran!”
The doctor chuckled in the corner, and asked if I had any questions for him before he started the procedure. I realized as he stood there and talked to me that he was the same doctor that did my lymph node biopsies in October 2019, and I was so excited! He’d done a great job with my lymph node biopsies, had been at Mayo over 30 years, and I was glad to see him again because the lymph node biopsy he did was the only negative biopsy I’ve had! 🙂
“Well, I have implanets, so I’d prefer you not pop them during the biopsy today,” I said. “I guess that’s not really a question.”
He smiled and said, “We’ll take special care to avoid those!”
I also said, “And I’m pregnant, so I brought a baby along with me today!”
He smiled again and said, “Excellent! I’m glad to have another spectator in the room!”
He was funny. I was grateful for that.
He came over and discussed the procedure with the other radiologist and nurses.
“You don’t mind if we talk about you while we work, do you?” he asked.
“I’d be insulted if you didn’t!,” I said.
“Okay! So we all agree this is the spot we’ll be working on today?” he asked.
“Yes,” all the doctors and nurses said in unison.
“You’ll see we are inserting the needle laterally here to take special care to avoid the implant,” he said. “We have about 2cm to work with.”
2 cm?!?! I thought. That’s not a whole lot of space!
Then he clicked the biopsy instrument for me so I’d know what it sounded like.
“I’ll count down for you,” he said. “3, 2, 1, then you’ll hear this <click>. I wanted you to hear it so you don’t get startled and jump!”
“Duly noted!,” I said. “I’ll stay totally still!”
I wasn’t about to move at all–even if I had a crick in my neck and my arm was falling asleep!–because I wanted to be sure to do my part to keep that needle far away from my implant! 2cm is not a whole lot of space to work with!!!!
He inserted the local anesthetic, which he said would burn. It hardly hurt at all. Then I felt nothing for the entire procedure.
He took 4 passes at my biopsy site, then they closed me up by applying pressure to the biopsy site and putting steri-strips over the top of the incision.
“You should have results in 2-3 business days,” my nurse said. “If you haven’t heard anything by Wednesday lunch, call us.”
“You bet!” I said.
I asked what I should do for pain, because I’m pregnant, and am trying to avoid painkillers.
“Definitely ice packs,” the nurse said. “You’d be surprised, you may not even need painkillers. Some patients are totally fine without them!”
So I hoped I’d be one of those patients who didn’t need them! And sure enough, I made it through the weekend without them. 🙂 Even while uninstalling and painting our front door (don’t tell my doctors!! ;))
God is good!!!
Trusting God While Waiting For Test Results
Last time I got a biopsy on a Friday at Mayo Clinic, I didn’t get results until the next Friday (you can read all about that experience at this link). Waiting that entire week for results was killer. Because this most recent biopsy happened on a Friday, I buckled up for a week-long wait this time, too.
But my hopes had been high that I might hear something the same day of my test–after all, if it was fat necrosis like they thought, shouldn’t those
results come back super fast? 🙂 Also, the one and only time I’ve had a
negative biopsy result, my doctor called the same day with those results. That was the only time I had a negative biopsy result and results came back super fast! So my heart jumped when I saw I had a new message in my patient portal from my doctor a few hours after my biopsy. It said:
Sorry to see that the area of concern looked abnormal enough to warrant
a biopsy but glad we were able to get you in today. I anticipate results should
be back Monday or Tuesday and will give you a call as soon as I receive them.
My heart sank. No results yet. But I only had to wait 2-3 business days, and
I still had hope things would be okay! So I crafted a response:
Yay!! Thanks so much!! I look forward to seeing what’s going on!! This
pregnancy thing is turning out to be much more exciting than I’d anticipated! Also this ultrasound guided biopsy was by far the favorite biopsy I’ve had. Quick and painless! Now I think I’ve had every single type of breast biopsy that exists! Hooray! Have a great weekend.
Then close of business Friday rolled around, and I got a little worried. No
news today meant buckling up for an entire weekend. My husband helped keep me busy with some house projects like painting our front door a beautiful “Salty Dog” blue and playing on the worship team at church.
“He makes us wait.
He keeps us on purpose in the dark.
He makes us walk when we want to run,
sit still when we want to walk,
for He has things to do in our souls
that we are not interested in.”
Elisabeth Elliot, Secure in the Everlasting Arms
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Trusting God While Waiting for Test Results
Still Waiting…
On Monday, my mind and time were occupied by a bunch of interviews I had lined up, which was a huge blessing. Then I watched baseball with my husband (MLBTV is the best :)) and played some video games (Mario Party on Nintendo Switch :)).
Tuesday rolled around, and I still hadn’t received any messages in my
patient portal or calls from my doctor. Plus, I didn’t have any meetings on my work calendar. Yikes!
Because it had been 3 business days at this point, the text messages from my prayer warriors started to roll in.
“Any updates??”
“Any word on the results of your biopsy? Continuing to pray!”
The Elisabeth Elliot quote above came in from a friend via text too. I especially related to the line: “…for He has things to do in our souls that we are not interested in,” because that’s always been the case with me. I’ve always been told to “WAIT,” or to “Be Still.” These are biblical principles, yes!, but so hard for me, ever since my initial breast cancer diagnosis! Which is probably why God keeps asking me to do them. I laugh because if I didn’t, I’d cry. :’)
I initially resisted asking the “Why God?!” questions that come with
the territory of waiting for test results. Eventually, around day 2 or 3, I started asking them, and I’m so glad I did.
As I laid down for a nap on day 3 of waiting (pregnancy has caused me to appreciate catnaps more than ever before in my life, haha), God told me (not audibly but you know what I’m saying!) that He just wants me to slow down and rest and appreciate life’s little things, trusting Him with a slower pace and blessings like my husband and baby on the way. This was a comforting revelation to have as it kept me from jumping to extremes and quieted my mind for a short time at least!
That revelation didn’t change my reality, though.
One of my good friends said she’d been waking up with a deep sick feeling in the pit of her stomach the entire week thinking I may have cancer again. My dad asked me what the worst case scenario we were looking at was. I told him, “Having cancer while pregnant. If I do have cancer, they can take it out surgically now, then I’ll do chemo after I deliver, and radiation if I need it. If that happens, I’ll just need extra help with the baby!” My dad said, “Okay! We will be prepared for that!”
Mid-day Tuesday, another friend and prayer warrior sent me a sermon from her church in Michigan about encountering Jesus in the middle of life’s storms (you can watch it embedded above and at this link).
At one point during his sermon, the pastor said: “When you encounter
Jesus, you 1) learn more about Jesus and 2) learn more about who you can be with Jesus.”
As I continued watching the sermon, the pastor said:
“In life, you have storms. Some of them are very unexpected. It’s one
call, when a doctor leaves a message on your voicemail that sounds
urgent…”
And my phone started to ring. And I knew, based on the “507” area
code, that it was my doctor. Based on what the preacher on the YouTube was saying, I was NOT going to let this call go to voicemail!!
Freaking out, I picked up the phone.
My Doctor Call and “All Clear!”
“Hello??” I said.
“Hi!” she said.
“How are you??” I asked.
“I’m good. So. It’s not cancer. It’s fat necrosis.” she said.
“HOLY CRAP!!!” I exclaimed in spite of myself. “I’m so relieved!!
AAAAHHHH!!!”
She laughed and said, “You have NO idea how worried I’ve been
this past week…”
As I (rudely) interrupted, “I have no idea?!?!”
She laughed.
“Well I guess you have an idea, it was your test after all…”
We both laughed.
“I just couldn’t figure out what was taking so long for results!,” she
said, “So I finally called over there this afternoon and said, ‘Just tell
me something!!!’ It turns out that the pathologists wanted to do some
additional staining and testing just to be sure it was fat necrosis. It’s a 24 hour stain, so after those results come in, pathology will confer with radiology. Those final pathology and radiology results should be in by Thursday morning.”
“That makes sense,” I said. “So what are the chances things could
change here?”
“None,” she said. “I’m certain it’s fat necrosis. They are just
doing this extra staining out of an abundance of caution for you.”
“Well I appreciate they’re being thorough and all of that–but wow!” I
said.
“And the—”
“What are the—”
“Sorry!”
“Sorry!”
As we talked over each other, I asked, “I was just going to say, what are
the chances this could turn into cancer?”
“None,” she said. “It’s indolent.”
“Indolent?” I asked.
“Oh! Benign. Totally normal.” she said.
“I learned a new word today!” I said. “You’re expanding my
vocabulary.”
She laughed.
“So, fat necrosis is when you have a mastectomy and scar tissue forms,”
she explained. “The tissue can harden or shift and change, and this
usually happens 1-2 years after the surgery. That’s where we’re at now. Believe it or not, we actually biopsy quite a bit of fat necrosis because it looks so suspicious on imaging. Biopsy is the only way to really figure out what’s going on, especially in a high risk case like yours.”
“So the tissue is just there and showed up now and could have been there
since surgery?”
“Basically, yes.”
“Could it show up somewhere else too?”
“Potentially. With regard to follow up, there’s a chance they’ll want to see
you back in 2-3 months for another ultrasound. Pathology is going to confer
with radiology and come up with a recommendation. Depending on what they say, I’ll plan to see you back in 5-6 months, right at the beginning of third trimester!”
“Wow. That sounds great!! So I’ll wait for the final pathology and radiology
reports but those shouldn’t show any surprises?”
“Right.”
“Then we’ll go from there!”
“Yes.”
“This is so excellent. Thank you so much!! This is the best message I could
have received!!” I said.
“You’re welcome! Have a great night.”
“You too!”
Next Steps
The radiology and pathology results came back that Thursday as benign fat necrosis just like my doctor said they would. Radiology and pathology recommended “clinical management,” so I’m headed back to Mayo in September 2021 for another physical exam to keep an eye on things! Here is the official report:
PATHOLOGY: Fat necrosis
CATEGORY: Benign
RAD-PATH CONCORDANCE: Yes.
RECOMMENDATION: Clinical Management Further management to be based on clinical grounds with additional imaging as clinically appropriate.
ASSESSMENT: 8: Pathology Benign.
ASSESSMENT/PLAN
#1 Personal history of bilateral DCIS s/p bilateral mastectomies with reconstruction
#2 Negative germline genetic testing
#3 Lump left upper outer quadrant- corresponds to biopsy proven fat necrosis, concordant
#4 Second trimester of pregnancy
FINAL RECOMMENDATIONS: Clinical breast exam next due in September 2021. Breast self-awareness encouraged and the patient is advised to seek medical attention for any breast related concerns.
My doctor sent me a message in my portal to confirm:
“Hello!! The keratin stain was done and confirms benign fat necrosis. Pathology agrees this is concordant with what they see on imaging and recommends clinical follow-up. Therefore, I would like to see you back toward the end of September if you are able to make it then 🙂 Continue to monitor the area over the next several months. If you do notice significant changes, let me know and we may get you back sooner. Thanks!”
While we are VERY relieved to have these test results, the waiting game is one of the worst things in the world. Stress, sick feelings, and worst-case-scenarios are so real. I’m convinced the waiting is almost harder for empathetic prayer warriors (especially my mama!) than it even is for me!! I do understand, though, that the trial of trusting in the waiting brings a joy and peace at the end of the waiting that is vivid, tangible, and real.
God is good, and yes, He is good even with “bad” diagnoses.
God would have carried me and baby through this either way, but this “all clear” is a severe mercy that I don’t take for granted! Through this, God has reminded me of what’s truly important: Slowing down, trusting him, and appreciating the gifts I have in my husband and baby coming up.
To be honest, this whole crucible has made pregnancy seem like a cakewalk. BRING ON A NEWBORN!!!!
I am now 18 weeks pregnant, with OBGYN visits every 4 weeks for now and moving to 2 week visits after my 20 week checkup on June 11th. We will find out the baby’s sex on June 11th, too! Here are some praises and prayer requests heading into the summer:
Praise!: I’m 18 weeks pregnant and baby is looking strong and healthy! My delivery date is October 25th, 2021.
Prayer Request: That my twin sister and my’s breast cancers would stay far away and that we’d be protected and delivered from breast cancer forever!
Prayer Request: For my baby sister’s 6-month preventative breast cancer screening appointment and MRI coming up in July 2021 to be totally clear!
Prayer Request: For baby to continue growing strong and healthy, and for the sciatic nerve pain and flare-ups I’ve been experiencing to subside!
Praise & Prayer Request!: My twin sister and her husband got the green light from her oncologist to take a timed break from her daily dose of Tamoxifen in 2022 to conceive using IVF. Prayers are appreciated for their health and discernment as they move forward with family planning later this year!!
This blog post is the 39th in a series about my (and twin sister’s) preventative breast cancer screening journey that began when we were 30 years old in July 2019. Here is a list of all of the posts written about our journey at Mayo Clinic’s Breast Clinic in Rochester, Minnesota, to date. To keep tabs on new posts, sign up for the “A Daily Miracle” email list at this link. You can also follow on Facebook, Twitter, and Instagram.