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The Dreaded Call-Back Mammogram: A Therapist’s Tale

**Author’s note: If you are not inclined to read about breasts, fibrocystic breasts, and those of this author, then you are forewarned to read no further. Selective self-disclosure was chosen by the author to help those in similar situations.**

This blog entry is dedicated to women everywhere, women who are battling breast cancer, both those who have won and lost the battle,  and most especially for my colleague, Anise Ojeda Smith, who is battling fiercely as a metastatic breast cancer suvivor, or metavivor. 

The original post is found on the author’s blog, From Andrea’s Couch

I wasn’t expecting to start breast cancer screening in my 30s, but due to fibrocystic breasts, it was recommended by my physician to start mammography earlier than the generally recommended age 40. Fibrocystic breasts are normal. They are just really dense breasts with lots of tissue in them (ducts, lymph nodes, and lobes). And when a woman goes through pregnancy, childbirth, breast-feeding and then perimenopause, the breasts go through changes.  60% of women have fibrocystic breasts, and with that comes tissue changes as hormones, aging, and reproductive life events impact the density of the breast tissue (webmd.com, 2018). Women with fibrocystic breasts are not at greater risk of breast cancer, but they do have a higher rate of false positive mammograms and call-back mammograms.

Medical guidelines these days encourage women to begin mammography at age 40  ( komen.org, 2018). For those with a family history of breast cancer or other risk factors, mammography can begin earlier. For women with fibrocystic (or dense) breasts, often times it is recommended to begin screenings before age 40 (mayoclinic.org, 2018).

So when I had my routine mammogram, I was not expecting to get a call-back on my voicemail. The strained voice on the message stated, “The doctor would like to get some additional pictures with a diagnostic mammogram. Please call our office right away to schedule that appointment…”  My first thought was this is the third call-back mammogram I have had in the last two decades, and both times before, there was no malignancy. I am sure this is just a precaution, and because they are being thorough, if there is anything there, they will catch it before it gets any more problematic and then blast it into oblivion. I was pleased I could do some cognitive restructuring voodoo on myself, like I help my clients. Then distraction and a walk with the dog.

Then, my mind went into “what if “scenarios. And suddenly, I went from 0 to 10, sky-rocketing in anxiety. What if I was one of those small percentages of women whose cancer is not detected in a mammogram and it’s more like inflammatory breast cancer that’s already metastasized? What if I leave my children motherless before they are able to launch to independence? What if my husband is widowed unexpectedly and left to raise our sons alone? Suddenly, my brain catastrophized, and I was not doing well containing my anxiety.

Fast forward a week and a half later (and what seemed like a light-years time), I went in for my diagnostic mammogram, and by divine intervention, many warm wishes and prayers, I had a benign reading. There was just a folded tissue on the original mammogram that looked like “asymmetrical density” on one side. The diagnostic mammogram found nothing abnormal. The word “benign” was music to my ears.

So why do I write about something so personal? Because half of the people on this planet have breasts. It’s not “just” a personal story about breasts. It’s about self-care, managing anxiety, and supporting women who live with the unknowns of health outcomes on a daily basis.

I realize I am fortunate for many reasons. I am fortunate to have health care, and good health care where screenings are taken seriously even if a false positive happens. I know the doctors work very hard for preventative medicine in all possible scenarios. I also do not have a family history of aggressive breast cancer. I have a very strong support network of compassionate family and friends. And I do have internal resources to manage anxiety, even when it’s through the roof. Above all, I am fortunate to be cancer free. I know not all are so lucky. And I know and love some of them.

Without a shadow of a doubt, this adverse experience was speaking with me to look at things differently, if only to remind me of what’s important. Here’s what I got:

1) Don’t sweat the small stuff. How many times have I told this to clients and now to myself? Too many to count. And it’s true. If you have your health, you have everything.

2) Continue to build and lean into your social support network, near and far. These individuals get it, will listen, pray for you, send you well wishes when you need it, and help you through life’s ups and downs. When we have strong social supports, we are less likely to get long term depression or anxiety, and we are more likely to live longer.

3) Place your self-care as number one. Always. Good nutrition, good sleep, exercise (preferable in nature).  Say no to things that don’t serve you well and yes to experiences and people who are health-enhancing.

4) Be grateful for what is going well in your life.   There is always something to be grateful for, and often we don’t realize how very lucky we really are until the threat of losing what’s importance smacks us in the face.

5) Connect with your spirituality. It could be prayer, meditation, a Higher Power, nature, whatever connects you with a divine source and meaning for being on the planet. Allow those who share your spirituality to embrace you in comfort.

6) Take care of your ta-tas. Get them screened as often as your doctor recommends (most are yearly after age 40).

7) For medical professionals: Consider a diagnostic mammogram yearly for women with fibrocystic breasts so that false positive mammograms don’t send women into anxiety unnecessarily.

8) Manage anxiety.  Life will always present unknowns. When faced with an exam result that is ambiguous, anxiety inevitably skyrockets. Practice cognitive restructuring, mindfulness meditation, distraction, deep breathing, massage, aromatherapy, positive social supports, yoga, and exercise in nature.

By sharing my experience, I hope this blog is helpful to others in similar situations. You are absolutely not alone. Healing wishes to all. Namaste.

 

​Retrieved from the web, February 9, 2018:

https://www.mayoclinic.org/tests-procedures/mammogram/expert-answers/mammogram-guidelines/faq-20057759

https://ww5.komen.org/BreastCancer/BreastCancerScreeningforWomenatAverageRisk.htmlhttps://www.mayoclinic.org/diseases-conditions/fibrocystic-breasts/symptoms-causes/syc-20350438

https://www.webmd.com/women/guide/what-are-fibrocystic-breast-changes

https://www.mayoclinic.org/tests-procedures/mammogram/expert-answers/mammogram-guidelines/faq-20057759​

​http://www.metavivor.org/

 

Photo by The MisAdventures of Maja

The Dreaded Call-Back Mammogram: A Therapist’s Tale

Andrea Schneider, MSW, LCSW

Andrea Schneider, MSW, LCSW is a licensed clinical social worker in private practice in Los Angeles, CA. She provides psychotherapy for individuals experiencing trauma and loss (ranging from women's reproductive mental health to recovery from toxic relationships in love/work/family, from special needs parenting to grief work). She is also a writer, educator, and podcaster. Website:

http://www.andreaschneiderlcsw.com/


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APA Reference
Schneider, A. (2018). The Dreaded Call-Back Mammogram: A Therapist’s Tale. Psych Central. Retrieved on August 18, 2018, from https://blogs.psychcentral.com/savvy-shrink/2018/02/the-dreaded-call-back-mammogram-a-therapists-tale/

 

Last updated: 13 Feb 2018
Last reviewed: By John M. Grohol, Psy.D. on 13 Feb 2018
Published on PsychCentral.com. All rights reserved.