The Value of a Second Opinion
I didn’t realize I had a large mass in my right breast until my primary care doctor detected it in a routine breast exam at my annual physical. I had been struggling with a number of strange symptoms since giving birth almost two years prior, and at 32 years old, felt like my body was falling apart. My energy level was unusually low but often attributed to chasing around my toddler. I had experienced strange, transient pain, in my back, my hips, my ribs, that couldn’t easily be explained away. I struggled with my post-baby weight and felt like my body was falling apart. My husband and I had been trying to conceive a second child, and I wanted to gather some better information for us before we got too far into another pregnancy.
Sent for further diagnostic testing
The mass surprised us all, but it was likely a cyst, I rationalized. I had stopped breastfeeding only a few months before and had no real family history of breast cancer. I was relatively healthy, and the thought that it could be anything but benign didn’t even cross my mind. When I went in for an ultrasound, I said to the tech cheekily, “next time I have one of these, I hope I’m seeing a baby!” She smiled thinly at me, and a few moments later, informed me she was going to get the radiologist. Never a good sign, the radiologist looked at my breast under the ultrasound wand, and told me she didn’t like the way things looked and was sending me for a mammogram. At my age, it felt surreal to get a mammogram and looking around the waiting room, I began to feel years older than I was.
Most likely breast cancer
The mammography tech was surprisingly cheery and kept reassuring me that it was routine, and it’s usually nothing, and, then, her rhetoric shifted, and she began to reassure me that breast cancer is really treatable these days. I felt dizzy and confused. After the mammogram was over, my husband and I met with the radiologist again, who gave me a likely breast cancer diagnosis. We went on to meet with a number of other members of the care team, including the breast surgeon, oncologist, and plastic surgeon. All three reassured me that my cancer was very treatable, my lymph nodes didn’t feel swollen at all, and that my bone pain couldn’t be related to my breast cancer. I went forward with further imaging and appointments, including a bilateral breast MRI, to determine if there was any cancer in my other breast. That breast was clear, the radiologist informed me, and she had not seen any additional abnormalities.
A second opinion
Still, I felt unsettled and sought out a second opinion with a much larger local cancer treatment center and research facility. Immediately upon the exam, the conversation shifted significantly. My lymph nodes were very enlarged, the breast surgeon and oncologist told me, and they would not have enlarged in such a way in the past few weeks. The other hospital must have missed them, they surmised. As the exam went on, I mentioned my bone pain, and the oncologist meeting with me mentioned that she was also concerned about them, after seeing some lesions on my sternum bone in her review of the breast MRI. I was confused - why hadn’t the first radiologist mentioned those? After additional imaging through the second cancer center, my now-oncologist determined that my cancer had metastasized significantly to my bones. My husband called the first radiologist in a rage, demanding to know why she had missed such an obvious diagnostic indicator. She stumbled on her words, sputtering, and finally admitting that she just hadn’t looked that hard. We were shocked and stunned.
Going with my gut
Going forward with my medical care, I cannot undervalue my gut instincts. I felt that something was off with the first hospital, and there was. I was nervous to drag out my diagnostic timeline longer than necessary, but in doing so, I avoided significant unnecessary treatment, and was able to obtain the proper care - and appropriate diagnosis - from a team I could trust.
Editor’s Note: We are extremely saddened to share that on Sunday, March 29, 2020, Emily Garnett passed away. We know that Emily's advocacy efforts continue to reach many. She will be deeply missed.
Have you gained new friends in your metastatic cancer journey?