A lump

Like every blogger in the universe, I struggle with how much I should talk about. My mom and my mother-in-law both read this blog. A future employer will very likely find it. (Hi future employer! Hire me!) Who knows – my sons may someday find themselves reading about it. (“Mooooom! How embarrassing?!” “What? Your Iron Man undies were soooo cute!”)

So it is with a certain hesitation that I tell you that I found a lump in my breast.

But wait! Before you panic, I’ll also tell you: the story is completed and it ends well.

I’d noticed the lump a few months ago, but as a nursing mom, well, Tigris and Euphrates are moving targets. They change a lot, all the time when you’re nursing. So I didn’t worry much about it. But now that I’ve dialed back and the girls seem to be returning to more normal proportions, it was time to pay attention to the lump that didn’t go away.

I’ve found lumps in my breast twice before. The first time I was maybe 23. I was newly married and so in love with my husband (still am, for the record, it’s just too late to die as newlyweds) that I was superstitiously afraid it would be poetically appropriate for one of us to die young because the universe just doesn’t like for people to be that happy. I spent a week convinced I was going to DIE of breast cancer! I went to my dr. She agreed it needed to be looked at. I went to the Breast Center at Faulkner Hospital (to which I could and did walk). They ultrasounded it. They mammogrammed it. They let me feel up a model boob. The result? Just normal but lumpy breast tissue. No problem. Let us know if it grows big or something, but it won’t because it’s just normal breast tissue.

Phew.

The second time was Grey’s first birthday. I panicked only slightly less than the first time because I had a baby! Imagine him being orphaned, never knowing how much his mother looooooves him. (Good thing I have the blog so he can now read about it in excruciating detail should I die in a tragic chopstick accident, eh?) I went to Lawrence Hospital and they ultrasounded and mammogrammed me. Shockingly, this too turned out to be lumpy breast tissue and perfectly normal.

So you can understand that I wasn’t ready to get all that worked up about what felt to me very much like lumpy breast tissue. But, as it remained through weaning etc., I decided that even though I was pretty darn sure that this one is just like the others, and even though due to changes in our health insurance, this time I’d likely have to pay for a good portion of that testing myself, it would really suck to self-diagnose as lumpy breast tissue and be wrong.

So I went to my midwife. And I went to get ultrasounded. I provided them entertainment by being a nursing mom (still at night) which totally messes up mammograms, so they didn’t even bother. The diagnosis? Well, as the charming, Russian-accented radiologist said, “Your breasts are lumpy-bumpy-happy.”

I do very much think about how this kind of health care plays into the larger debate. On one hand, all three of these lumps were significant enough that my primary care physician could feel them and not be certain that they were normal. (Of course, how much malpractice plays into that, I can’t say.) For two of the three, even after an ultrasound they wanted the second look with the mammogram. (Fun!) But none of these are dangerous, precancerous, anything. I would be perfectly 100% healthy if I’d never seen a doctor for any of them. What is the responsible healthcare decision to make? Should I keep going in every 3 years when I get a new lump? Is the best systemic financial decision for me to get some training in the difference in feel and morphology between my normal lumps and cancerous lumps? Is it best for my family and the system if I go in every single time to get them checked out, even though past history indicates my boobs are lumpy? How much does that cost? How much would it cost if one of them was a problem and I missed the chance to catch it early? What about studies that show (ok, that I think I read like 5 years ago) lumpy boobs are more likely to eventually get cancer? What is the rational treatment for the ongoing care of my lumpy ladies?

I don’t know the answers to these questions. The part that dismays me is that I’m not sure anyone does. My healthcare providers default to doing all the tests because THEY have no motivation to do otherwise. I follow their recommendations because I can, because I’m not a trained medical professional, and because the cost of being wrong is so high. But I’d love better training instead to know what cancer looks like and how it acts, so I can spot the difference. Or a statistical study saying that 90% of lumps aren’t cancerous and you should only go in with these criteria. Or even a study that says the most efficient outcome is to get every lump checked, every time.

I hope you will forgive me if I fail to include a picture with this post. My future employer and sons are reading.