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Anecdote about breast biopsy

[00:00:00] I wanted to share an anecdote about anxiety. with regard to mammograms, cuz this is a perfect example of what I want to do to decrease the fear that you guys keep talking about, right? So, lovely patient that I've known forever. This is a de-identified, um, example because her demographics really are so common in my practice that she could, you know, she could be patient X and I could be like generically putting together a lot of different people into one. 

I'm not, but I could. So she's 47. Her mother had postmenopausal breast cancer in her, I believe, late sixties, which, you know, confers a slight increased risk to the patient, but not a lot. Not as much as if she was a premenopausal mother with breast cancer or multiple first degree relatives. Like if her mother, and God forbid her sister had breast cancer, that increases her risk. 

So she was called because her mammogram came back with a small, abnormal. Which is meaning she needs a biopsy. [00:01:00] So first it was mammogram needed more focused views on the focused view. The radiologist felt that there was an area that is likely benign for different reasons, but felt like she should have a biopsy to prove that it is benign now. 

is it benign? For sure. If we think it's benign, why do we have to bother doing a biopsy? Well, because we don't know, and most radiologists are deeply thoughtful people who are not just doing this to cover themselves, they're doing it because at least the ones that I treasure and love, this one in particular, is doing what he would do if it was his wife. 

So it's what I would recommend. It's what I would do if it was my sister. Now, this delightful patient who actually is not really the type who gets so anxious, of course on the phone I call her and she. , you know, anxious. And when we talked about when she's doing the biopsy next week, when are we gonna get the results? 

I don't know if I want the results before Christmas. And I said, wait, let's just talk about this for a second. The vast majority of time, this is gonna be normal. And I'm telling you, the radiologist has told me [00:02:00] definitively that he felt good about. X, Y, Z features, meaning there were certain things on that mammogram and about this abnormality that were less concerning than other abnormalities, and he typically tends to be correct. 

So if he thinks it's gonna end up being benign, I trust him. Not enough, cuz he says himself, you still have to do the biopsy. But I trust him, um, that it's probably gonna be okay. So we can already go into this anxiety-provoking situation saying, yes, it's gonna cause anxiety, but the likelihood is the biopsy will be benign. 

But what if it's not benign? And she said, you know, I'm just, she said, what y'all say? I'm just so scared. And I said, okay, let's stop for a second to talk about that. What are you scared of? What is your. and she said, well, I just, I wanna be alive to be with my kids. And I said, of course. And guess what? I cannot guarantee you that the biopsy is gonna be normal. 

I can tell you it's likely normal, but it could end up being an early stage [00:03:00] cancer. , but I can pretty much guarantee you in this case, because it was found on a mammogram and it looks very early and very small and very isolated, that it's likely normal. But God forbid it's not normal. You are fine. You are surviving that particular cancer if diagnosed with it and not because, oh my God, you're a survivor. 

That's a whole nother topic I could talk about, but because in this particular case, what we're looking at would be a very early cancer. Of course, nobody wants any kind of cancer, but we have to remind ourselves, what are we really. , what are we really nervous about? We're not nervous that we're gonna get diagnosed. 

What we're nervous about is that the diagnosis is going to lead to death, and in most cases, not every, but most cases, it is not going to lead to that. So if we can remind ourselves and train ourselves, and this is the thought model that I really wanna work on to help all of you guys with your anxieties and fears as you use the term, even though I wanna urge you not to, [00:04:00] That would help. 

So again, mammogram in her case is leading to a biopsy, which will likely be normal. And if, God forbid it's not normal, she will be fine. It will be an early stage cancer that she will be able to be completely okay with. All right. So that's very important because that means she should enter this with, ah, kind of sucks. 

I really don't wanna be diagnosed. That would suck. Versus, oh my God, I'm so. . You see the difference, right? It's all in our mindset, mindset, mindset and how we approach it. Okay? So that's a little anecdote for any of you out there. I hope that if you approach that in the next couple weeks and you have to have a biopsy or something, remind yourself, as long as it's the type of biopsy where the likelihood is, it's nothing. 

But if, God forbid, it's something, it's caught early. . Don't waste your energy of fear and anxiety on that. There's so many other things that might happen in our lives that we cannot control for. This is something manageable. Bye.