let's talk about boobs, baby

© Mario Testino for Dove, 2017. Yes,    that    Mario Testino  .

© Mario Testino for Dove, 2017. Yes, that Mario Testino.

Our family is back in Houston, safe and sound. Thanks for following us on our European vacation, friends. It’s good to be home.

So I wanted to share an experience that I had before I left for our vacation, because I feel like this sort of topic isn’t talked about enough. (Gentlemen, this one’s for the ladies, so feel free to sit this post out).

About a month before our trip, I had my yearly mammogram, and the radiologist saw something that she didn’t like. So I was invited back in for a second mammogram and an ultrasound, and then eventually a third mammogram and a second ultrasound, and finally a stereotactic breast biopsy. When we were in Windsor, I got the call from my doctor letting me know that everything was benign, and they didn’t need to see me again until next year, but it was a tense few weeks until that point, I tell you what.

Now that I’m on the other side and everything is okay, I wanted to share my thoughts on yearly mammograms — what to expect, what they’re really like, and why I think they’re important. Of course, I’m not a doctor, so this is an entirely patient’s-point-of-view; however, I think there’s some value in that, especially if you haven’t had a mammogram before.

What age should I start getting yearly mammograms?

Some places say 40, some say 45, and some say 50, but honestly, I think a lot depends on your own family’s history of breast cancer. Check with your doctor to get a definitive answer. (I began getting them at 45.)

Do I really need a yearly mammogram? I do monthly breast self-examinations on my own.

In my opinion, absolutely. See, what the radiologist found on my mammogram this year is what she called an architectural distortion — and that’s not something that a monthly breast self-examination would’ve picked up. Had my situation turned out to be cancerous, it would’ve been very early stages, which of course, improves likely prognoses. As uncomfortable as this entire experience was, I’m determined more than ever to stay on my yearly mammogram schedule.

What are mammograms like?

They’re not fun, but honestly, they’re no big deal — I’ve had mammograms when I’m in and out of the clinic in 30 minutes, and half of that is filling out paperwork and getting dressed and undressed. Years ago, my friend Angela described the mammogram process beautifully on her blog, and I’ve never seen a better description, even with the advances in mammography that have happened since she wrote her post. Here’s what she said. Seriously, go read it — it’s both detailed and brilliant.

Speaking of uncomfortable experiences, I heard that mammograms really hurt. Is that true?

Honestly? It depends. Most of my mammograms are absolutely no big deal, but there have been a few that brought me to tears. I think a lot depends on when during your monthly menstrual cycle that you go (as you know, some times of the month your breasts may feel more tender than others), as well as the skill of the mammography technician. But for the most part, I suspect you’ll find the experience more uncomfortable than painful.

Karen, you mentioned they “invited you back for a second mammogram.” Was that terrifying?

Not really. The truth is that it’s not uncommon to be invited back for a second look, especially if it’s your first mammogram, or your first time at a mammography clinic, because they have no historic images or anything to compare your images to. So if it’s your first mammogram, or you’re visiting a new clinic for the first time, or the mammography technician comments on how “dense” your breasts are (* raises hand *), do not be alarmed if you get invited back for a second look. They just want to be absolutely, positively sure. I’ve been invited back for a second look many times. And often, a second look also involves an ultrasound, which is truly no big deal — they just put imaging gel on your breast, and use a wand, similar to what I imagine a prenatal ultrasound is like. No pain involved at all.

(I did start getting alarmed when they asked for a third look. And then yes, telling me I needed a biopsy freaked me completely out.)

I bet needing a biopsy freaked you out. Was it horrible?

Actually, not nearly as horrible as you might expect. Yes, of course, having to have a biopsy and then waiting for the results was terrifying, but the biopsy itself wasn’t nearly as bad as I expected, not even close. In a stereotactic breast biopsy, they do the biopsy “under compression,” which is to say that you’re actually in the mammography machine as it clamps your breast, and then while clamped, first the radiologist anesthetizes your breast so that you don’t feel anything when she inserts a needle to get a sample of the breast tissue to send off to the lab. The worst part of the procedure is that they have to make sure you’re positioned absolutely, positively perfectly, so that they don’t miss, and that can require you getting clamped multiple times by the mammography machine; however, once they had me in position, the whole procedure took about 5 minutes (the radiologist said it would take 15 minutes, but she was way faster than that).

The trick to the biopsy? Remaining completely still while you’re in the mammography machine and they’re anesthetizing your breast and inserting the needle. My radiologist was kind enough to let me listen to music on my phone while she worked (I have a “dentist playlist” that I play when I’m at the dentist, that calms me), and that helped a lot, along with deep breaths and self-compassion breaks while she was working. But the entire ordeal was far less uncomfortable than even the second mammogram that I’d had.

Another tip: be sure to wear a bra to your biopsy, because the radiologist is going to want to stick an ice pack in your bra when you leave to reduce swelling and pain. But I was able to drive myself to and from the procedure (although I didn’t have to, Marcus came with me). Also, for the record, even though I was told to take Extra Strength Tylenol to help manage pain, and I did when I got home, the truth is I had absolutely no pain after the biopsy. The most inconvenient part was keeping the wound clean, since I was traveling to Europe days after; however, that wasn’t really much of a big deal either. (Be sure to ask your radiologist how to clean the wound — I didn’t, and had to resort to Google. Best to get the advice from your doctor.) And now that I’m all healed up, there’s no scar — just a small dot, that looks like a mole. No biggie.

Okay, so I think that’s everything! If you have any questions about mammograms that I didn’t cover, feel free to leave them in the comments below, and I’ll answer them as best as I can. The upshot? Get your yearly mammograms. Seriously. They’re made out to be far more uncomfortable than they really are, they take less time than you probably imagine, and it’s an important part of self-care. Really, really.