VIP

It's slowly dawned on me that maybe I should be checking out the hard spot on the top of my breast that appeared after DIEP reconstruction. It's where my two tumors were and it's my original breast skin. That makes it possible, although not probable, that this area I've been calling fat necrosis might be something worse.

My doctors offered a lot of discussion and different opinions on what's the best way to determine if something is fat necrosis or cancer. The answer is there is no great way short of a biopsy, but I'm not just going to run out and do that.

I also refused a mammogram--new girl required a nine-hour operation and six-week recovery, there is no way I'm putting her in a grape press!

So I went for the sonogram. It turns out you get great service at screenings once you've had breast cancer.

The sono tech and her trainee did their thing and said they thought it was most likely fat necrosis but they wanted to show the images to their new head of reading that kind of stuff, a woman my cancer center recently wooed from Northwestern University's breast and cervical cancer program.

The head woman ended up calling me back in and doing another sono so she could see some things. She said her guess is fat necrosis, but she recommended an MRI to be sure.

She also noticed that I haven't had a mammogram since my diagnosis in '06 and wanted me to get one asap. I explained to her my distrust of mammograms and my fear of getting new girl near one. I'm glad I did because I finally got someone to say: "I think in your case it's best to get a mammogram on the right breast only and an MRI to check on everything, including the reconstruction and lymph nodes."

Awesome! That's exactly what I think my screening plan should be. I think I will ask her to write this recommendation up and put it in my charts so they can send it out when the insurance company refuses to pay. (By the way, I recently won my $6,100 appeal for this year's MRI and I'm crazy-happy about it!)

Since I'd already made a day (or at least a morning) of it, I agreed to have the mammo on old girl right then. The mammo tech also ran the results down to the chief lady, who said everything looked good.

I guess that just leaves the MRI and the follow-up visit to my radiologist to get the results. Great, two more mornings. But at least then I'll know for sure that it's fat necrosis and they'll have a baseline to know if anything else that comes up is weird or not.

I often hear that once you have reconstruction you don't have to worry about screenings or cancer anymore, but it's really not as simple as that. In many ways, it's actually more complicated now that I've had reconstruction.

I'll keep you posted.