Tuesday, October 7, 2008


Several of my friends in the blogosphere have blogged about Breast Cancer Awareness month. It occurred to me after reading this and this and this and this that I might have something to add to this topic. I usually try to keep my job separate from my blogging world…..But…..By day I am the office manager of a breast surgery practice. Before you get all excited, Slick, it is not a plastic surgery practice. We treat breast cancer and other diseases of the breast. As you can probably imagine, I am very aware of breast cancer as I encounter women and men daily who are diagnosed with this terrible disease. I would be remiss if I didn't join ranks with the others to encourage you to have your annual mammogram and I most certainly urge you to do so. But heres a few other random little bits of advice that I would like to offer:

  • Once you've had the recommended mammogram, follow up if you haven't heard back from the ordering physician in a week. NEVER assume that no news is good news. While 99 % of the time, any abnormality will be brought to your attention, you cannot disregard the possibilities of a glitch with the fax machine, email or other mode of communication between the diagnostic facility and the referring physician. You also can never assume that all healthcare workers are conscientious and or competent. Be pro-active. If you haven't received word of your results within a week, call and ask about them.
  • Not all abnormalities are cancer. And not all abnormalities are an emergency. I know, I know….when it's your breast, it's an emergency. Between 30-40% of all women have fibrocystic breast disease. This accounts for the majority of call-backs for additional imaging. It is sometimes painful but almost always benign.
  • If you are diagnosed with breast cancer, please take a family member or friend with you to your doctor appointments. After hearing the words, "you have cancer" most people only hear, "blah, blah, blah, blah, blah, blah, blah" after that. You will need someone with you that will remember what you're supposed to do next.
  • Write down your questions as you think of them and take the list with you to your appointment. Once in the examination room, you will no doubt forget what you wanted to ask without the list to remind you.
  • If you're recommended for a biopsy, whenever possible, ask the referring doctor's office to make your appointment with the surgeon. They will be much more effective in getting you an appointment that is in line with the urgency of your case.
  • If your doctor calls you in earlier than your original appointment, do NOT put them off because you have to meet the cable guy, take your horse to the dentist, attend a luncheon with the girls or you have to work. If you are diagnosed with breast cancer, this is just the first of many appointments you will have to make. You, your cable guy, your horse, the dentist, your friends and your employer will all just have to get used to it. (These are just some of the real life excuses we have been told when trying to work a patient in earlier after receiving suspicious diagnostic reports.)
  • Never be afraid to get a second opinion. It's never a bad idea and any physician worth their salt should not be offended by your desire to have one.
  • There is no excuse for a healthcare worker to be rude or insensitive to you. Most offices are under-staffed and over-worked but that is no excuse. You are the reason they have a job. I tell people when I interview for a position (which thankfully hasn't happened in awhile) that the job requires them to always be courteous, respectful and pleasant regardless of how the patient is behaving. (with the exception of abusive behavior) Our patients are at the worst time in their life and if they are a little cranky, they're entitled to it. (cookies make up very nicely for bad behavior)
  • Never hesitate to give expensive gifts to the office manager. If expensive gifts are not in your budget, flattery will do wonders also. This is a person who can write off your bill. *wink*

I could probably come up with more but it's past my bedtime and I really NEED my beauty sleep. So make your mammogram appointment immediately. Do not stop, do not pass GO, just do it. RIGHT NOW! You heard me. What are you waiting for?

I neglected to mention when I posted this that I know a little bit about the other side of the desk also. A few years back abnormalities were found in my mammogram. I had five different areas in both breasts biopsied. Thankfully, all were benign.


If you landed here as a result of a link from Bear Naked (Don't you just love the Bear), I hope you find this post worthy of her praise. And don't forget: Get your mammogram!


Anonymous said...

GREAT POST and great pointers from someone on the other side of the desk!!...i'll be printing some of this off to keep in my file of 'stuff i need to know'...thanks so much!

and thanks for the shoutout too!

Bookworm said...

I did! I got my mammo last month, and it came back clean! Yay!! I even opted for the extra screening; I forget what it's called. Digital something? I guess it's where a computer scans the image, also? Something. I forget. (Midlife brain fart. Hey, I'm sitting here at 10:15 in the evening with the A/C on and its 40 degrees outside because I'm HOT!!). LOL

Anyway, fortunately, my insurance covers the extra screening. But even if it didn't, my husband said it's worth paying the extra $40 for it.

Okay this comment is getting long, but here's a question for you that I've always wondered: A blog I read said awhile back that she had an "abnormality" on her mammo. Then she had to go back for a second, more painful, more squeezy mammo, and it still was unclear. So then they had her do a breast ultrasound, which cleared everything up -- she was fine.

So tell me -- if the ultrasound is a better diagnostic tool than the mammo, why in the world don't they do that instead of the mammo?? And why did they make her go through all that second one and the waiting and the scary uncertainty, when they could have cleared up the first mammo reading with the ultrasound?

Are doctors just naturally sadistic?? Me no understand. LOL

Vodka Mom said...

okay, you're right. I missed mine last summer, and will call TODAY. god-dammit. (my sister has to have a biopsy next week. Keep your fingers crossed.)

qtpie said...

I just passed your message along to about 20 of my women friends. You made some really good points. Thanks!

Bear Naked said...

This is a post that every woman should read.
Thanks for the information.

Bear((( )))

Anonymous said...

Okay, okay. I know you're right. I need to have a mammo. My last one, lead to the every enjoyable biopsy - even more enjoyable than the mammo. I loved laying on that table with my boob hanging through that little hole in the table...I've been avoiding a repeat performance. All was okay. I know, I know. I still need to make that appointment.

Anonymous said...

Great information and thanks for sharing this with us!

Midlife Mama, I always request an ultrasound for the reasons you mentioned but usually they don't do them as routine because most insurance companies won't pay for them. They consider them extra and unnecessary.

Bookworm said...

Midlife Slices: Seriously? Even though an ultrasound could detect cancer better, and earlier, and easier with less pain, resulting in less treatment, resulting in less payment by the insurance company, let alone the less pain and suffering by the patient.

Wow. What part of THAT makes any sense?? But then yeah I know. We're talking insurance company here. Doesn't have to make sense. Amazing.

Anonymous said...

Love seeing people post about breast cancer awareness...

After all, it's the first line of defense...

Smart Mouth Broad said...

Thistle,QTPie,Bear and MLS-Thank you and you're welcome.

Vodka Mom-Please do that and I will keep your sister in my prayers.

Fancy-Yes, you do and get on it, girlfriend!

Mama-Good for you! Here's the deal to the best of my knowledge. Remember, I'm an administrator and have no real clinical experience but after 10 years with the Boobiologist, you pick up some things. A mammogram and an ultrasound are both good tools to detect abnormalities in the breast. They see things differently. The mammogram at present is still the best screening device that's offered. Mammography is better at detecting microcalcifications which sometimes group together in a way that shows they are thinking about startin' some trouble...aka cancer. Ultrasound can sometimes detect an abnormality that wasn't seen on mammo but is very good for detecting if a mass is filled with fluid (a cyst) or solid. We also use MRI and it will sometimes see things that weren't picked up on either of the other two. In our office, we always order mammo and ultrasound annually. (more often for some high-risk patients) Insurance companies do not see the ultrasound as a screening tool so in order to have one, you have to first have some sort of symptom to justify order. I don't really think it's about $$ as the reimbursement for an ultrasound is pennies compared to other diagnostics. It's just not as effective for screening by itself as the mammogram. There are lots of things on the horizon. Scientists are working on diagnostics that don't put your boob in a vice and squish. But for now, we just have to suck it up and take it like a big girl.

Smart Mouth Broad said...

Slick, I told you...You are an inspiration.

Anonymous said...

Thanks for taking the time to educate us. ECUCATION is POWER !

Be sure to visit my place if you have a few extra seconds.

Your very expensive gift is in the mail...

Smart Mouth Broad said...

Swampwitch-Thank you and you're welcome. I'm so excited! Could it be something in a little blue box?

Reader Wil said...

This is a very important post.Thank you.I had a mammo last year and will have another one next year. My mother and two sisters had breastcancer and all of them lost a breast. My mother died in 2000 of old age; she was 93 1/2.

Lori said...

Thanks for sharing your wealth of information. I will pass this information on to other women!

Pseudo said...

Your post should be in a Women's magazine. Best advice ever. I'm going to forward this post to my women friends.

Anonymous said...

Just flew back over to let you know I checked your "thises" and I appreciate the linky dink.

Anonymous said...

This is a great post! I am due for my mammogram in the next 2 months. Thanks for a great and informative post!

Smart Mouth Broad said...

RW-So, you only have a mammogram every two years?

Smiles-You're welcome. Now get back to your vacation, girly.

PHST-You are too kind and I love it. Thank you.

Swampy-You're welcome. Now where's my dang gift!

24-Thanks. Make your appointment now so you don't forget.