The Diagnostic Days: Tests, Scans, and Questions

November 7th and 10th, 2025. What started as a Friday afternoon consultation became a week of diagnostic imaging - mammogram, ultrasound, biopsies, and finally MRI. A journey from hope through concern to comprehensive understanding.

Friday Afternoon: First Consultation

Walking into the Consultant Breast and Reconstructive Surgeon’s office on a Friday afternoon, there was nervous energy mixed with cautious optimism. He performed a thorough physical examination of the breast lump.

His initial impression? Reassuring. The characteristics he felt suggested it might not be cancer.

But he was thorough. “Let’s get some imaging done today to be certain,” he said. No waiting weeks for appointments - straight to diagnostic imaging. Same afternoon.

The Mammogram: First Look

What it is: X-ray imaging of the breast tissue. The breast is compressed between two plates to spread the tissue out for clearer images.

What it feels like: Uncomfortable, sometimes painful, but brief. The compression lasts only seconds per image.

What they’re looking for: Masses, calcifications, architectural distortions - anything that looks different from normal breast tissue.

Our experience: Four views taken - two of each breast (MLO and CC views). The technician was professional and kind, making the uncomfortable more bearable.

What they found: A 3 cm spiculated (star-shaped) mass in the lower outer right breast. The radiologist classified it as M5 - “highly suggestive of malignancy.” The reassuring consultation suddenly felt less certain.

The Ultrasound: Detailed Assessment

What it is: High-frequency sound waves create images of breast tissue and lymph nodes. Unlike mammogram, it can distinguish between solid masses and fluid-filled cysts.

What it feels like: Like a regular ultrasound - gel on the skin, a probe moved around the area. Painless, but anxiety-inducing as you try to read the radiologist’s face.

What they’re looking for: The exact size, shape, and characteristics of any masses. They also check lymph nodes in the armpit (axilla) for any signs of spread.

Our experience: The Consultant Radiologist took her time, examining not just the breast mass but multiple areas of the right armpit. Her expression grew more serious. She found something.

What they found:

• The breast mass measured 22 x 17 x 19 mm (about 2 cm)
• Multiple enlarged lymph nodes in the right armpit - between 5-7 nodes showing abnormal characteristics
• The largest lymph node measured 22 mm

This was the moment the surgeon’s reassuring words from earlier started to fade.

The Core Biopsies: Getting Answers

What it is: Using ultrasound guidance, hollow needles are inserted to remove small samples of tissue from suspicious areas. These samples are sent to pathology for microscopic examination.

What it feels like: Local anaesthetic numbs the area first (10ml of 1% lidocaine). You feel pressure and hear clicking sounds as the biopsy gun fires, but it shouldn’t be painful. Some people feel faint - it’s the idea more than the sensation.

What they’re looking for: Cancer cells. The pathologist will examine the tissue under a microscope to determine what type of cells are present and their characteristics.

Our experience: Two biopsies taken - one from the breast mass, one from the suspicious lymph node. The radiologist was skilled and explained each step. A small titanium marker (T4 hydromarker) was placed in the breast mass - like a tiny roadmap pin for future reference.

The wait begins: Samples sent to pathology. Results typically take a few days, though it feels like forever.

The Radiologist’s Concern

During the ultrasound examination, the Consultant Radiologist’s concern was evident. Multiple pathological lymph nodes. The characteristics of the breast mass. She didn’t need to say much - we could read it in her measured words and careful documentation.

She spoke to the surgeon immediately. His response was swift: “We need an MRI.” Scheduled for the following week.

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The MRI Scan (Following Week - November 10th)

After the intensity of Friday’s testing, the MRI appointment arrived on the following Tuesday.

What it is: Magnetic Resonance Imaging (MRI) - the most detailed imaging available for breast cancer. Uses powerful magnets and radio waves to create highly detailed 3D images of soft tissue. Performed with contrast dye (gadolinium) injected through IV to show how blood flows to different tissues - cancer lights up differently than normal tissue.

What it feels like: Challenging. You lie face-down on a special table with your breasts positioned in openings. Arms above your head. Completely still for 30-40 minutes. The table slides into a narrow tube.

What they’re looking for:

• Complete mapping of disease extent
• Any additional tumors or satellite lesions
• Exact measurements of primary tumor
• Assessment of both breasts (ensure left breast is clear)
• Lymph node involvement visualization
• Full picture before treatment planning

Our experience:

Claustrophobia. The tube is narrow, close. You’re face-down, unable to see out, unable to move. The panic starts creeping in almost immediately.

Noise. Nobody quite prepares you for how loud an MRI is. Banging, clanking, rhythmic hammering sounds that go on and on. They give you headphones with music, but you can barely hear it over the machine. Each sequence has a different pattern of noise - some like jackhammers, some like alarm klaxons.

Duration. What feels like forever. They tell you 30-40 minutes, but when you’re lying perfectly still, unable to move, in a confined space with relentless noise, every minute stretches.

The contrast injection. Midway through, the table slides back out briefly. Contrast dye injected into your IV line. You feel a strange cold sensation rushing through your veins, a metallic taste in your mouth. Then back into the tube for more sequences.

Staying still. The hardest part. Any movement blurs the images. Have an itch? Can’t scratch it. Uncomfortable position? Can’t adjust. Just breathe, stay still, count the seconds.

What they found:

• Primary tumor measured precisely: 24 x 25 x 20 mm
• Possible 5mm satellite lesion 10mm anterior (in front of main tumor)
• If satellite confirmed: total disease extent 35mm
• At least 2 pathological lymph nodes in right axilla (up to 11mm)
• Additional indeterminate 8mm node higher up
• Left breast: Two tiny foci (5mm and 7mm) - low suspicion, likely benign
• MR6 classification (biopsy-proven malignancy)

The MRI provided the most comprehensive map yet - precise measurements, 3D visualization, complete assessment of both breasts and lymph nodes.

Processing These Days

Friday afternoon: We walked in expecting reassurance. We left with:

• A 3 cm mass
• Multiple abnormal lymph nodes
• Tissue samples in a lab somewhere
• A hydromarker clip in the breast (a small piece of titanium that would become a companion through this journey)
• An MRI appointment scheduled
• Questions. So many questions.

The surgeon’s reassurance - “might not be cancer” - felt like it belonged to another lifetime, though it had only been hours.

Following week: The MRI was its own ordeal. Physically uncomfortable, psychologically challenging. But necessary. It provided the complete picture - precise measurements, full disease mapping, comprehensive assessment.

Between appointments: Waiting. The days between Friday’s biopsies and the following Tuesday’s MRI. Then more waiting for all the results to come together. Biopsy results take days. MRI images need radiologist review. Each day, the cancer sits there while we wait for information.

What We Learned

About the process: Medical teams don’t mess around when they’re concerned. Same-day imaging. Immediate MRI orders. No waiting weeks to “see how it goes.”

About the technology: Modern diagnostic imaging is remarkably precise. Mammograms find it. Ultrasounds measure it. Biopsies tell us what it is. MRI maps it all in 3D detail.

About the experience: Each test has its challenges. Mammograms are uncomfortable. Ultrasounds are anxiety-inducing as you watch the radiologist’s face. Biopsies are scary despite numbing. MRI is claustrophobic and loud. But they’re all necessary pieces of the puzzle.

About waiting: The hardest part isn’t the tests themselves - it’s the days between them. Between Friday’s biopsies and Tuesday’s MRI. Between scans and results. Between question and answer.

The Technical Details

For those who want the specifics:

Mammogram classification:

• Right breast: M5 (highly suggestive of malignancy)
• Left breast: M1 (normal)

Ultrasound classification:

• Right breast: U5 (highly suggestive of malignancy)
• Right axilla: U5 (highly suggestive of malignancy)
• Left breast and axilla: U1 (normal)

Core biopsies:

• 2 x 14-gauge samples from breast mass
• 2 x 14-gauge samples from axillary lymph node
• T4 hydromarker successfully placed

Looking Forward

Waiting for biopsy results. Waiting for complete MRI report. Then… well, we’d face that when the results came.

The surgeon’s early reassurance - “might not be cancer” - kept echoing. But Friday afternoon’s imaging told a different story. And the MRI confirmed extensive local disease. Now we needed the pathology to confirm what the imaging had already suggested.

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Dates: November 7 and 10, 2025
Location: Local Private Hospital
Friday (Nov 7): Initial consultation, bilateral mammograms, bilateral breast ultrasound, core biopsies (breast and lymph node), hydromarker placement
Following Week (Nov 10): MRI with contrast - comprehensive disease mapping
Next Step: Wait for pathology results (biopsy analysis) - typically 3-5 days