Part 2: A Spiculated Mass

“Cancer” is named after a crab, but it’s more like a spider. Actually, it’s like a spider and web in one, expanding through your flesh with deadly filaments and tendrils.

In contrast, benign growths tend to be solid. My right-side fibroadenoma was comfortably compact and opaque. Clean lines. “It doesn’t look like cancer,” the radiologist had reassured me in 2015 before taking the biopsy sample, and she was proven right. Every year, the ultrasound and mammogram reports confirmed that the fibroadenoma wasn’t spreading. Dr. Stratton would contact me to let me know, and I also started reading the reports myself for reassurance.

The first report from my Brooklyn mammogram was not reassuring. In all caps it shouted:

IN THE UPPER, OUTER LEFT BREAST AT MIDDLE TO POSTERIOR DEPTH, THERE IS AN INDETERMINATE MASS WHICH APPEARS SPICULATED.

Immediately I Googled “spiculated.” It is medical-speak for “spiky.” Something that grows quickly and unevenly. Cancer.

I palpated my left breast but couldn’t find any lump. I don’t do regular breast self-exams, but I liked to think I knew my breasts fairly well from settling them into underwire bras, bathing them, and occasionally allowing other people to touch them for fun. Every now and again I would poke around in the right one to feel the fibroadenoma, but I’d never felt anything solid in the left. Then again, I hadn’t noticed the sizable right-side growth until my doctor put my fingers on it.

I was quickly referred for a bilateral ultrasound, which, after a series of anxious phone calls and a bit of pleading, I was able to schedule and undergo in early November. The Brooklyn ultrasound tech was still out of the office, so I had to go in Manhattan.

When undergoing a bilateral ultrasound, you might think you’d lie down on the table topless and just let the tech take turns with your breasts, but they never expose both at the same time. After they examine one, they gently pull and arrange the gown to cover it, and, more gently, ease the gown off the other breast for its time in the spotlight.

The ultrasound report had a bit of good news:

At the right 6:00 axis, retroareolar location there is a 1.6 x 1 x 1.2 cm lobulated hypoechoic mass which is smaller in size when compared with prior ultrasounds dating back to 10/1/2015.

The right breast is trying to keep me alive, shrinking its fibroadenoma. The left breast, however, is not a team player.

At the left 1:00 axis, 8 cm from the nipple, there is a 0.9 x 0.9 x 0.8 cm irregular hypoechoic mass which likely correlates with the spiculated mass seen in the upper outer left breast on mammography. An ultrasound-guided core biopsy is recommended. No sonographic abnormality is seen to account for the architectural distortion in the anterior lateral left breast on mammography.

Translation: In addition to the spiky mass (“hypoechoic” means it made itself known to the ultrasound waves) threading its way through my left breast, there was an “architectural distortion.” That seemed to be something the radiologist couldn’t figure out. Was it a benign tumor? A malignancy? A piece of shrapnel? Nobody knew. I took it to mean that my breast was erecting a hostile edifice, a fortress in its war against me.

But it’s not just my breasts. All of my reproductive organs have taken up arms against me. This rebellion isn’t random. Research indicates that as a childless woman and a survivor of childhood sexual abuse, I’m much more vulnerable to gynecological woes and cancers than women who’ve had children and/or less traumatic lives. Apparently Nature or the universe thinks I deserve to suffer for never suffering through pregnancy, childbirth, and raising a family.

Along with the right-side fibroadenoma, I suffered from monstrous uterine fibroids for many years. They caused horrifically heavy, 8- or 9-day menstrual flows that drenched boxes of tampons and pads—think “The Shining”—and nasty bloating. In 2016, I underwent surgery to excise about 7 pounds of their densely vascular flesh.

Five years later, Dr. Stratton palpated my abdomen and informed me that the fibroids had struck back, including one perched atop my bladder—a likely cause of some recently emerging incontinence. I had attributed that to menopause, which brings with it so many delightful harbingers of deterioration; lower estrogen levels mean weaker pelvic floor and sphincter muscle tone. It cheered me to learn that the occasional damp spurt was due to resurgent fibroids, not advancing decrepitude.

My uterus and ovaries weren’t as lethal as my left breast, but they were almost as industrious. In the busy month of November, between biopsies and three types of breast imaging, I managed to fit in a pelvic ultrasound. Instead of stroking the wand along your abdomen, the tech coats it with lubricant and slides it up inside you. This revealed three fibroids I’ve grown since 2016, accompanied by a sizable “paraovarian” (which I Googled and learned means “near the ovary”) cyst nestled among my fallopian tubes.

Dr. Stratton’s hospital system uses a website to communicate with patients. You can email with your doctors, review test results and reports, and even look at your MRIs, X-rays, and other scans. I checked out my pelvic ultrasound images and saw the beautiful paraovarian cyst, glowing like a pearl amid some dark fleshy background. I tried to look at the Brooklyn mammogram, marbled in shades of white, gray, and black, but despite the helpful little arrow someone had drawn on it, I couldn’t see any spiculation. It just looked like a streaky white blob within a breast-shaped shadow. My respect for the Brooklyn radiologist increased.

Dr. Stratton did a heroic job saving my uterus in 2016, when I still had hopes of using it, although she had to punch five laparoscopic holes in my abdomen to carve out all the fibroids. Now she alerted me to the ultrasound results and suggested a pelvic MRI as the next step if I wanted to consider harvesting the fresh crop.

“Right now I'm more worried about the spiculated mass in my left breast,” I responded. “Is there a chance any of the abdominal growths could be malignant?” Dr. Stratton found that very unlikely and reassured me that a pelvic MRI could wait.

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