D = Dense

A mammogram is an X-ray of the breasts, complete with a dose of radiation exposure, boob-squishing plates on an impressively 360-degree-rotating machine and front-opening gown with no sleeves. Mammograms are currently recommended for women age 40 & up, or earlier for those with findings such as lumps, breast changes, family history, history of breast cancer, or BRCA1/BRCA2 genes.

I turned 40 last year, and after many reminders from my primary and much procrastination, finally got my first mammogram. In Imaging, a nice technician regaled me with stories of another facility popping someone's breast implant during the same procedure I was undergoing (presumably to make me feel better about clearly not having implants). She also informed me I was very dense, or at least my boobs were. The ultrasound impression confirmed that on a scale of A to D, A being mostly fatty tissue and D being almost all "dense" tissue, I scored a D, the first D I ever received in my life, and the first D ever associated with my bust.

The nice technician had squished something of an "architectural distortion" into my white-out mammogram, which they couldn't make out anything from anyway, so a few days later I received a somewhat pushy followup call that informed me I HAD to return for a second mammogram and ultrasound of both breasts. I groggily agreed to an appointment, having been woken up while trying to sleep between back-to-back night shifts. A week after that I received an official-looking, aggressive letter that I thought was going to say, "You are being sued" in English and Spanish on the top. The letter stated that some states (e.g. California) required a patient be notified by certified mail of abnormal mammogram results and be scheduled for followup within 30 days, because, well, everything causes cancer in California and I had not been sufficiently intimidated by the handkerchief gown, the squishing, distortion, aggressive followup-appointment-scheduler, and legal-looking envelope.

Last week I got the second mammogram, from a decidedly less gentle technician with popsicles for fingers, who then sent me to another room for an ultrasound. The ultrasound tech arrived with a healthcare-student-looking person whom she said would be "standing in" during my ultrasound (a statement informing me that this person would simply be there, instead of asking for my consent). 

"You guys have the staff for chaperones?" I deliberately asked. 

"No, she's a student," the technician finally admitted.

I was a student not that long ago, too, so I didn't object, but I did briefly imagine a bunch of sonography students debriefing later and discussing all my mammillary abnormalities during an animated post-conference, and I could already see the student busily filling out clinical paperwork/homework about my freakish, very-dense breasts later that night.

The techs were kind enough to send results to the radiologist right away, so ten minutes later, they returned and told me the radiologist said, "Everything looks great," and I can go home. I wasn't sure if that meant the images were high definition with excellent 3D visual detail, therefore great; or the stupid breasts looked cancer-free, therefore great; or if it was just some kind of borderline-inappropriate, general, compliment coming from a heterosexual male radiologist, but I accepted the words at face value because it was past lunchtime and I wanted to go home and sleep before my shift.

A few days later I accessed my official ultrasound results online. The ultrasound was "negative," which in healthcare is generally good, as in, "I just got tested and am covid negative." It also said regular follow-up will be due in December 2022. Good grief, am I to go through all of the above every year (or every two years after 55) until I finally kick the bucket?