The B-Word More Black Women Are Hearing

A follow-up biopsy after a breast exam isn’t cause for alarm. Here’s what I wish I knew before scheduling this screening procedure.

By

Sharon L. Mitchell

 
Published October 13, 2023

I was in my early 30s when my doctor told me, “Your breasts are quite fibrous. It’s best to begin mammograms now.”

Shocked, I thought mammograms would be in the far future. I was a relatively new mom, and such a thing was not on my radar. Nor was I looking forward to that type of “squeeze.”

The outcomes of my first few exams were, thankfully, negative. Breast cancer does not run in my family. But the disease is definitely not uncommon. With each test, I breathe an uneasy sigh of relief — a needed respite from worrisome thoughts.

Early detection can save your life, and a biopsy may be the best screening method in your case. Fortunately, 80% of women who move forward with biopsies do not have breast cancer. 

A few years later, a radiologist called me into his office as I awaited the results of my sixth mammogram. With a dry tone, he asked, “Do you have a family member here? I think you should call them in.” As I ran out to grab my husband from the parking lot, all the worst-case scenarios constantly at the back of my mind leaped forward. Is one of my greatest fears about to be realized? I thought.

“You need a biopsy,” he said. “We saw something in your images that’s a bit troubling. When are you available to come back?”

Biopsy. It’s a fear-inducing word I was more likely to hear on an episode of Grey’s Anatomy, not concerning myself. Yet, I needed this test to find out what my future held.

After a tension-filled week, I returned to have the procedure done. I spoke with my doctor about expectations. But it did little to alleviate my concerns. Gratefully, two wonderful nurses who performed my biopsy understood. They comforted me and dried my tears — making a nerve-racking experience tolerable. A week later, the head radiologist at my facility was happy to report, “Your results are negative!”

According to a study published last year in JAMA Oncology, Black women are at the highest risk of not having a biopsy within 90 days of an abnormal mammogram. The study suspects structural racism may be a major contributing factor. Your doc’s prompt follow-up is a sign of equitable health care.

Since then, I have had two additional biopsies (also negative). But I’ve realized that the topic of Black women and breast biopsies is not one heard in everyday conversation. Neither was it talked about among female friends or family. A biopsy is not as frightening as it seems when you know what it entails.

Your doc uttered the B-word? Keep calm and carry on

Here are six things Black women should know in case they require a breast biopsy in the future.

Sooner is better — and a sign you’re in good hands

Why do I need a biopsy? I wondered the same thing when my doctor said that word to me. Afterward, I discovered that mammograms don’t always give enough information for a precise diagnosis. So further steps, which may include a small removal of tissue for examination, may need to be taken. Yet according to a study published last year in JAMA Oncology, Black women are at the highest risk of not having a biopsy within 90 days of an abnormal mammogram. The study suspects structural racism may be a major contributing factor. Your doc’s prompt follow-up is a sign of equitable health care.

Our breast density can affect diagnostics 

Did you know that fibrous or dense breasts make it more difficult to detect issues in mammograms? Donald Northfelt, M.D., a Mayo Clinic oncologist and breast cancer researcher, explained in the clinic’s Comprehensive Cancer Center Blog, “It’s possible for breast density to hide cancer in the breast.” That’s why your provider may request additional screenings such as a breast sonogram or a biopsy.

Black women are more likely to have dense breast tissue. And we face higher breast cancer mortality rates than our counterparts, about 40 percent. Several studies and risk tools, like the Black Women’s Health Study (BWHS) Breast Cancer Risk Calculator, have been implemented to understand and eventually address these disparities.

Chances are very good that you don’t have cancer

Early detection can save your life, and a biopsy may be the best screening method in your case. Fortunately, 80 percent of women who move forward with biopsies do not have breast cancer.

Ask all the questions you need to

After the first biopsy, I understood that gaining knowledge was the best remedy for my fear. If facing a possible biopsy, talk with your doctor or nurse and determine what to expect before, during and after the procedure. What’s the purpose of the biopsy? Will I experience pain? Are there any side effects? How long will my recovery time be?

Getting the facts can calm your fears

Don’t allow the possibility of a cancer diagnosis to deter you from getting a biopsy if needed. It is perfectly normal to be nervous, but shouldering the weight of a “what if” can negatively affect you.

In a recent Health Matters newsletter, Vivian Bea, M.D., director of the breast program at NewYork-Presbyterian Brooklyn Methodist Hospital, discussed what Black women should know about breast health.

“It’s important that Black women know their risk for breast cancer so that they can educate themselves and be proactive about their health,” said Dr. Bea. “Some patients have expressed concern that if they receive a diagnosis of cancer and have surgery, the surgery could cause the cancer to spread. This is false.”

Schedule time with your support system in mind

Having backup, such as family and friends, is always a big help during a stressful situation. If faced with the possibility of a biopsy, reach out to your loved one for support and then book the clinic visit with both of your calendars in mind. The idea of a biopsy might trigger feelings of depression, worry and even anger. As I learned firsthand, having someone there with you on the day of the procedure can bring peace of mind.

Sharon L. Mitchell, a freelance creative writer from Richmond, Virginia, is working towards publishing her first novel.