by Carolyn Thomas ❤️ Heart Sisters (on Blue Sky)
About a week ago, in the shower, I felt a lump in my right breast.
Coincidentally, I’d already had a similar experience decades earlier in my mid-30s (a lump – same breast, same spot – also discovered while showering). The lump was surgically removed under general anaesthesia – a procedure called at the time a quadrant resection. I was a wreck back then. I was worried sick. I felt so frightened. I cried. A lot! Luckily, the final pathology report at the time described that lump as a “benign mass” (meaning: non-cancerous).
All that stressful pre-op worry – over a benign mass.
Fast forward to this past week: my first reaction to this new lump was absolute and unrelenting denial. In fact, the sound coming unbidden out of my mouth while still in the shower this past week was a loud NO! NO! NO! – followed by a few dozen more NOs !
No! I cannot have breast cancer.
No! This is not happening to me.
No! I’m barely able to cope as it is with ongoing cardiac symptoms, painful osteoarthritis and this humiliating “loss of nouns” caused by my weird brain fog. And now this, too?
NO! NO! and NO!
I spent another day or two this past week repeatedly poking at this lump – almost as if to check if it were still there. Maybe it has disappeared overnight? Could that happen?
The trouble with denial, however, is that it doesn’t make worry go away. In fact, denial just lengthens the time we have to ruminate endlessly about the worry. See also: How ruminating hurts your heart
I have to credit Holly Osterman’s “Real Insights” podcast for this next part of my story. Holly had interviewed me for her podcast during Heart Month (which was February, of course). I typically check out podcasts myself before saying YES to interview requests – and that’s how I happened to hear Holly’s intriguing guest, Dr. Catherine Pittman and her profoundly simple 3-step worry-plan-action approach to managing anxiety. Here is the basic approach she uses in her own practice:
1. First, you are worried.
2. Then you make a plan (big or small) based on how you interpret that worry.
3. And then you take action based on that plan.
Dr. Pittman’s advice is clearly focused on moving us onward from the “All Worry, All The Time” phase. So now, instead of worrying myself sick (which is pretty isolating and also a waste of precious time and energy), I called my Nurse Practitioner – knowing she could help me make a plan.
And she did, encouraging me to stop saying NO! NO! NO! – while immediately arranging a mammogram appointment for me at the Breast Imaging Clinic at our local hospital.
Plan? Check! ✅
My only job after that, according to Dr. Pittman, was to take action – to get myself from home to hospital for that clinic appointment. And three days later, I was sitting in the Breast Imaging Clinic waiting room – on time for my noon appointment, surrounded by half a dozen other women wearing identical bathrobes, all of us waiting to be called in for our mammogram appointments.
Take action? Check! ✅
BUT WAIT. . .
. . . my mammogram turned up something suspicious, so it was followed by an ultrasound test, which turned up something else that looked suspicious, so the ultrasound was followed by the radiologist telling me that we needed a biopsy of that lump.
And that’s when things got interesting:
I knew that I didn’t want to repeat all that stress and worry of my last lump experience back in my 30s – since neither I nor any of the hospital staff have enough accurate information yet.
This time, I’ve been thinking hard about Dr. Pittman’s worry-plan-action recommendation. Let’s wait until we know some actual facts before reacting. As the saying goes (usually attributed to the late Leo Buscaglia):
“Worry never robs tomorrow of its sorrow. It only saps today of its joy. “
I feel like I’m postponing worry this week. It’s not denial. It’s more like focusing on lots of other things until I learn more. So I went out for breakfast (waffles and blueberries) with a friend yesterday morning, and today I joined three of my crafting buddies for our annual Paper Sale outing. The sun rose in the sky as expected today, and will safely set when it’s time for it to go.
When I learn more, I can decide how much worrying I’m okay with. Or not.
The most remarkable experience I had at the hospital this week was seeing the tremendous improvements in diagnostic breast imaging technology since my last breast lump was surgically removed in my 30s.
My first test this week was a new-to me 3-D mammogram, for example, which – I’m amazed to say – was completely pain-free! ( I’ve often found that my routine screening mammography appointments are really uncomfortable).
But I hadn’t expected how much breast biopsies had changed over the decades.
I was stunned when the radiologist told me that he would do the biopsies right there, on the spot, in the Breast Imaging Clinic! This newer procedure, done under local anaesthesia, is what’s called a Core Needle Biopsy, first introduced to breast cancer care in the 1990s. It uses a hollow spring-loaded needle to remove small samples of breast tissue (each about the size of a grain of rice) to send to the pathology lab for analysis and diagnosis.
So the radiologist first injected a numbing anaesthetic into my right breast (which worked well (just pressure, no pain) – until the third zap of four from the Core Needle. That third attempt was so painful, it actually made my whole body jump. The radiologist immediately apologized, adding: “I must have hit a spot that was not quite numbed!”)
I told him: “Don’t do that again!” He promised not to. . . and true to his word, his fourth and final zap was barely perceptible. It was amazing.
My 30-minute mammogram had by now morphed into five hours of tests and procedures, with a break for a late lunch in the hospital coffee shop. Tomato dill quiche with a puff pastry crust.
I think it was the shock of having my lump biopsied on the spot that made me feel shaky and queasy once it was all done (never mind having my bare breast pulled and prodded by strangers). That morning, I thought I’d be having a 30-minute mammogram, but because of my long-ago and clearly outdated experience with a breast lump, I had no clue that these same-day Core Needle Breast biopsies were even a possibility in 2025.
By then, the Breast Imaging Clinic team had taped several ice packs onto my right breast because of a “large hematoma” (a deep bruise) that was already forming on that breast – no doubt assisted by the anti-platelet drugs which I and most other heart patients take routinely. That’s when the staff asked me if I were on blood thinners or anti-platelet drugs. Anti-platelets can help to make future blockages in heart patients’ coronary arteries less likely, but bruising and bleeding far more likely. The whole right side of my chest still looks like I’ve been in a street fight.
Because of this known bleeding side effect, there was also blood on the paper sheets that surrounded my right breast by the end of those biopsy procedures. That shaky, queasy, light-headed feeling is what doctors call vasovagal syncope – considered a normal response to certain triggers (like emotional stress or the sight of blood) – a response designed to lower blood pressure and heart rate in order to reduce bleeding. It may be considered “normal” – but it’s still very unpleasant if you’re the one feeling shaky, queasy and light-headed.
The helpful Breast Imaging Clinic staff were wonderful through all this – offering me apple juice, a recliner chair, two pillows, heated blankets (luxury!) and packages of cheese and crackers – the classic no-frills menu of hospital clinics. The only thing missing was flat ginger ale.
By then, five hours into my Clinic visit, I realized I was in no condition to drive myself home from the hospital, so the staff called a taxi for me, leaving my own car in the hospital parking lot (where I would retrieve it the next day).
The Breast Imaging Clinic staff were, again, wonderful – they called the contracted parking authority to explain that their patient’s procedures had taken more time than anticipated – and that office agreed to extend my hospital parking pass to cover the next 24 hours at no charge. A small gesture – but for me it was one less thing to fret about.
Meanwhile, I learned that the B.C. Cancer Agency, here on the beautiful west coast of Canada where I live, reports that up to 90% of all breast biopsies turn out to be benign – a comforting statistic for me. But if it turns out that I’m one of that small percentage whose breast lump is cancerous, I’ll have more shared decision-making, more planning and more actions to consider at that time.
When I know more, I can decide more. The odds do favour benign – and it seems like I’ll know for sure either way fairly soon.
The radiologist at the Breast Imaging Clinic sent a total of four biopsy samples that day to the pathology lab. I was told the lab needs 4-5 days to report results. So I have an appointment with my Nurse Practitioner to share those pathology results next week.
Until then, I wait. And try not to worry. . .
.
♥
See updates on this “new” diagnosis
The “not wonderful” new diagnosis I didn’t see coming
This is much more than a hospital waiting room
Image: Geralt, Pixabay
Q: How have you handled waiting for medical test results?
NOTE FROM CAROLYN: I wrote more about coming to grips with a frightening diagnosis (cardiac or otherwise) in my book, “A Woman’s Guide to Living with Heart Disease” (Johns Hopkins University Press). You can ask for it at your local library or bookshop (please support your favourite independent neighbourhood booksellers, or order it online (paperback, hardcover or e-book) at Amazon – or order it directly from my publisher, Johns Hopkins University Press (use their code HTWN to save 30% off the list price).
Heart Sisters 
Hi Carolyn,
Sorry for the slow response.
We have been on holiday, our first since C0VID! We are currently sitting at the airport in Costa Rica, where our flight to Toronto has been delayed for 4.5 hours due to freezing rain which has covered Ontario with a coating of ice. Our hometown has declared a state of emergency due to downed branches and widespread power outages. So I’m typing using the old hunt and peck method on my tablet! Sorry for any typos!
I was so sorry to hear about your suspicious scans. I’m holding you in my thoughts and prayers.
As another heart patient on a blood thinner, I sympathize with the bruising caused by your biopsy. I too had a technicolour, purple breast.
I’ve got more to share depending on the pathology results. There is a whole world of support out there.
Sending positive vibes your way.
Sincerely,
Linda
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Hi Linda – first of all: BRRRR-R-R! Hope Ontario thaws out for your return soon. I didn’t hear about this freezing rain story until now so I just looked it up – hundreds of thousands of Ontarians still without power!?! Cold AND dark!
Thanks for your kind words. This hematoma on my right breast is indeed technicolour and purple! But it doesn’t hurt at all – except when I’m stepping out of the shower and I give myself a little fright by just looking in the mirror! How can something that looks this dramatic feel so normal?
Take care – I sure hope you get home safely, and that your power will be restored soon.
❤️
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Hi Carolyn,
My husband’s family suffer from severe bouts of vasovagal syncope. It has affected his Mom, siblings and our sons.
With them, they begin to sweat profusely, and their BP drops so low that they pass out and sort of “froth at the mouth”. They also often vomit before/after passing out. A trigger can also be an upset stomach as the vasovagal nerve runs across it. They can go several years between episodes; but when my husband was really ill, he had 5 or 6 within a few months.
Once we knew what it was, we learned to have him lie down immediately, or at least get his head down between his knees.
Ice storm update: We got home at 3 am Monday morning and we had power!! Unfortunately 43% of people in Peterborough city and county still didn’t have power. Our daughter, who lives in the city, got hers back on Thursday and our son, who lives outside the city, got his on Wednesday.
A convoy of hydro trucks from New Brunswick were seen heading to our area. So, there has been help from afar. Fortunately we had our big blue spruce in our front yard cut back last fall, including all the branches that were hanging over our house and driveway! It still lost 12 more big branches and some other damage in our back yard but we consider ourselves very lucky.
Sincerely,
Linda
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Hello Linda – first, I’m glad you had power during that incredible ice storm that did so much damage in your area – especially when you arrive home in the middle of a freezing cold night.
This vasovagal syncope response, as I wrote above, is considered “normal” BUT while it may be considered ‘normal’ – it’s still very unpleasant if you’re the one feeling shaky, queasy and light-headed.”
I didn’t think much about this condition until I remembered that it’s happened to me before (once years ago while sitting on my bed happily chatting with my daughter after having oral surgery – and suddenly keeling face-first onto the floor (breaking my glasses) – and another time fainting in the movie theatre (!) while watching Million Dollar Baby during the scene in which Hilary Swank gets her nose broken in the boxing ring. Next thing I knew, I was waking up, collapsed back in my seat, with my girlfriend shaking my shoulder yelling “Carolyn! Carolyn!” and the theatre manager leaning over us, asking “IS SHE AN EPILEPTIC?”
That vasovagal nerve is a powerful one!
Take care. . .❤️
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Hi Carolyn,
Gosh, I’m sorry to hear you’ve been dealing with all this. While reading your article, I found myself saying, “NO!” too. I mean, another potential disease for you to worry about? Umm, NO! Just, NO!
You’ve already met your quota in the disease department.
While it was nice to get the biopsy done right there on the spot, the appointment you had expected sure did evolve into one of the unexpected sort – in length anyway. You must’ve been exhausted by the time you got home.
My experience with a biopsy was similar to yours. I’ll never forget that popping sound. I’ll also never forget the kindness with which I was treated that day by the entire team taking care of me.
I am hoping your pathology report indicates benign. Fingers crossed. As you might remember, I’m a procrastinator. I’m fairly good at worry procrastination, too. I tell myself worry can wait until I know for sure there’s something to worry about. Sometimes, this strategy works. Sometimes, not so much.
No matter what the results show, your readers are here. I’m here.
Sending lots of love and support. And gentle hugs, my friend. x
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Hi again Nancy – I think it was the lack of knowing what was coming next that threw me for a loop. It was exhausting by the end of the day – especially when I took a taxi home from the hospital (I knew I was too shaky and queasy to drive) Well, we were almost home – until I remembered that my house keys were still locked in my car back in the hospital parking lot (45 minutes away!) I had to think hard about what to do – but I couldn’t seem to form a useful thought! – and with only minutes to go before the taxi would arrive at my home, I blurted out to the driver that I didn’t want to go there, but now to my daughter’s home instead (where I knew she had a spare set of my house keys). She was out of town on holidays, but she and I texted back and forth for the info I needed (e.g. the security code to open her back door keypad so I could get in to retrieve the house keys – and even her street address – which I could NOT remember! )
The next morning, a friend I was meeting for breakfast drove me back to the hospital to rescue my car – but when I was finally driving my car home, I couldn’t remember the usual route from the hospital, took a wrong turn and got quite lost. I must have sacrificed a few brain cells affected by that day’s events!
I really appreciate your take on how procrastinating works fantastically for worrying. I’ve had a terrific week with family and friends (and long solo walks, too) since that biopsy day. As one of my wise readers reminded me: “Let’s not worry until there is actually something to worry about!”
And I did not know before that 80-90% of all breast biopsies are benign – so I think I’ll just focus on that stat!
Take care, Nancy ❤️
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Carolyn, you are so kind and thoughtful to turn your breast lump experience into a teaching/learning opportunity.
I especially appreciated your acknowledgement of the vasovagal response—which typically includes legs that feel like pudding for me – and the worry/plan/action model – which is a great tool for preventing, reducing, or eliminating excessive worry, and for conserving much needed energy until we need it most.
I’ll stay hopeful that you will have the best possible biopsy outcome. As a person with history of breast cancer x 3, I also have had lumps or masses that were revealed as non-malignant. Sweet relief!
I hope you experience sweet relief as well. Gentle hugs….
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Hello Bren – what a nice note! Thank you for that. I was surprised to learn (depending on which study we are reading) that 80-90% of all breast biopsies are benign.! That’s a lot of relief out there!
One of the reasons I decided to write about my breast lump/biopsy experience here was also mentioned by another of my readers: “Limit how often you repeat the story!” If I can refer friends and neighbours to my HEART SISTERS post, it saves me the draining experience of re-activating my nervous system every time I tell and re-tell that story. And over time, that story won’t be nearly as important to me as the eventual outcome – as you know well from your own 3 x breast cancer experiences!
“Legs that feel like pudding” – that’s such a creative description. It makes sense when your blood pressure drops and you feel faint. The human body is so endlessly fascinating isn’t it?
I am looking forward to that “sweet relief”!
Take care. . .❤️
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RE: “My first test this week was a new-to me 3-D mammogram, for example, which – I’m amazed to say – was completely pain-free!”
Contrary to the official narrative (which is based on medical business-fabricated pro-mammogram “scientific” data), there is marginal, if any, reliable evidence that routine mammography, both conventional and digital (3D), reduces mortality from breast cancer in a significant way in any age bracket but a lot of solid evidence shows the procedure does provide more serious harm than serious benefit (read the books: ‘Mammography Screening: Truth, Lies and Controversy’ by Peter Gotzsche and ‘The Mammogram Myth’ by Rolf Hefti.
IF…….. women (and men) at large were to examine the mammogram data above and beyond the information of the mammogram business cartel (eg American Cancer Society, National Cancer Institute, Komen), they’d also find that it is almost exclusively the big profiteers of the test, ie. the “experts,” (eg radiologists, oncologists, medical trade associations, breast cancer “charities” etc) who promote the mass use of the test and that most pro-mammogram “research” is conducted by people with massive vested interests tied to the mammogram industry.
Most women (and men) are fooled by the misleading medical mantra that early detection by mammography saves lives simply because the public has been fed (“educated” or rather brainwashed) with a very one-sided biased pro-mammogram set of information circulated by the big business of mainstream medicine and their allied corrupt pawns in the governments. The above mentioned two independent investigative works show that early detection does not mean that there is less breast cancer mortality.
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Jean – what is wrong with you? If you’d bothered to read this post, you’d already know that – other than one brief mention – I was NOT writing about SCREENING mammography or anything else you included in your pompous knee jerk lecture on “the mammogram business cartel.”
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I’m so sorry you’re going through this, Carolyn. Your writing is so relatable, and I’m sure many readers can identify with the ‘NO! NO! NO!’ feeling.
Wishing you all the best and hoping for a benign result. . .
Marie Ennis O’Connor
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Thanks so much dear Marie. . . I too am hoping for a benign result – but I also see this as beyond my control. I’m trying to just focus on “one day at a time” with family and friends – like that Doris Day classic song from 1956: Que Sera, Sera (“Whatever will be, will be!”)
Take care. . . ❤️
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Thank you for this post. As I read it, I am awaiting results on a vulvular biopsy. I am a cancer survivor of 13 years, and awaiting a biopsy doesn’t get any easier. The word “biopsy” itself puts any of us into a different stress level.
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Hello danechick – You’re so right: that word “biopsy” is frightening because it’s invariably invasive (compared to an ultrasound or non-invasive test. I hope you get your pathology results very very soon – and that they will be benign and uneventful.
Good luck to you. . . ❤️
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It’s okay to feel whatever you feel, Carolyn. Give yourself grace and gentle comforts.
Offering you a non-judgmental listening ear and {{{ hugs }}} throughout this week of waiting.
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Thank you Teri for that wise advice – grace and comforts, a beautiful combination at any time, but especially when what we’ll hear is completely out of our hands.
Take care. . . ❤️
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A gentle, non-invasive, cyber hug to you, Carolyn.
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Thank you Deborah for your kind words (and cyber hug!)
Take care. . . ❤️
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I salute your resolve and bravery under challenge, Carolyn.
You have a community of friends along with you on the sidelines sending their concern and support.
I’m among them.
Maxine
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Hi Maxine – thanks very much for your kindness. I’m really so touched by this “community” of concern and support. It means a lot to me.
Take care. . . ❤️
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Thank you, Carolyn, such a helpful article.
So sorry you are experiencing this. I went thru something similar over the Christmas holidays, which turned out fine, thankfully and I sure hope your results will be good.
A couple of additional thoughts: I look at possible outcomes, rank them, start with worst and identify the plan. Having a plan of action really helps, as you wrote. If i can deal with the worst possibility, it helps me relax. Recognize that whatever is there was there before you became aware there might be a problem – it was only when you found the lump, had the bad test result, etc., that you became worried.
But knowledge is power because by knowing there’s a question, you have a much better chance of addressing the problem if there is one. Limit ruminating as you indicated, but also good to limit expectations on yourself. Read the information you are given, but be careful about internet scrolling.
Great time for wallowing and regrouping with something to occupy your mind. Crossword puzzles and books for me. Limit how often you repeat the story. Each time you repeat it feels like you experience again!
Sending peaceful, healing thoughts your way!
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Oh, Helen. Thank you for sharing your important and helpful perspective. Dealing with the “worst possibility” can help to make anything that’s not the worst seem easier. And whatever is there, was there before I even became aware. YES!!
Occupying my mind is what I’ve been doing (unconsciously, not deliberately marching out in search of distractions (although I am overdue to start a new jigsaw puzzle!) Spending time with friends for the past two days (when the topic of my hospital experience did not even come up) was just pure fun. And also such good advice about limiting how often I repeat this story.
Coincidentally, my friend Dr. Barbara Keddy in Halifax once wrote about a support group in Toronto for people living with fibromyalgia, where the unusual group rule is “No talking about fibromyalgia” – only about wellness and sharing things that have helped. She believes that staying focused on the problem can affect our central nervous system – and make us feel worse, not better over time.
I’m starting to think that there are so many things I’ve already known, but sort-of forgot lately.
Thank you, Helen. ❤️
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Yes, also- for those of us with heart issues – kind of a good idea to keep an eye on your pulse. I saw my family doc last week, who noted my resting pulse had jumped significantly in the past 6 months, only difference being anxiety levels, so she recommended a med change and doubling down on self-care…
For me, puzzles of any kind – my personal favorites being jigsaws, crosswords, sudokus- keep my mind focused on something neutral or fun…
Self-care: meditation, walks, being with good friends, being outdoors, focusing on clean and fresh food, limiting over-exposure to national (US) and world news.
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Hi Helen – so many wise options for good self-care. Thanks for such useful reminders!
I know what you mean about damaging exposure to world (and especially U.S.) news – particularly while we here in Canada entertain these offensive threats to become Trump’s 51st state – which is NEVER going to happen.
Enough dreadful things out there that our precious hearts need protection from!
Take care. . . ❤️
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Oh, Carolyn, sorry you have to deal with this, when there is already so much grieving in the world.
I’m glad you’re able to manage your anxiety. Let’s not worry until there is actually something to worry about…and then make a plan.
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Hello Margarita and thank you for that important reminder: “LET’S NOT WORRY UNTIL THERE IS ACTUALLY SOMETHING TO WORRY ABOUT!”
I’m going to embroider that wisdom on a pillow. . . 🙂
There’s already a built-in tendency among many of us to ruminate over our problems – especially health problems (which I’ve written about a lot over the years because we know it’s so bad for our heart health! All those stress hormones and cortisol flooding our bodies nonstop!
I was also thinking this morning that I have two choices here: dread or joy. I don’t mean pretending to feel joyful about this lump, but seeking ways to help protect my body from the harm of chronic worry. Dread is an awful way to spend time.
Today, my almost-10 year old granddaughter Everly comes home from her spring break holiday with her parents – a perfect opportunity to feel lots of joy!
Take care and thanks again…❤️
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Thank you for this post. As I write, I am awaiting the results on my vulvular biopsy. I’m a cancer survivor and the waiting is not any easier the second time around.
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