The Path Diverges

Two weeks ago, I dropped the boys off at school and stopped in for a quick routine mammogram before work. A thought flashed through my mind but didn’t fully stick until about three hours later:

“I have a sickly feeling that something bad is going to come of this.”

Like the countless other daily feelings of dread, fear, and worry we carry as women and mothers, I swatted it away. I’m an overthinker. It isn’t a sign. I have no family history. I always worry about bad things, and they almost never happen. Carry on.

This was my second routine mammogram — my first was when I turned 40, and then I missed last year’s (gulp). Other than the discovery of “very dense breasts” both proved uneventul. This day I even posted a lighthearted IG story about how I was in and out of the clinic in eight minutes. Eight minutes! Nothing bad can come from an eight-minute mammogram.

The tech told me I should see the results in my patient portal within one to three days. Three hours later, I was sipping Monday coffee #2, curled up on my couch working from my laptop, when I saw the clinic name and number flash across my phone screen.

The woman on the phone informed me they’d like me to come back for a follow-up mammogram to get some “additional images.” As if I wouldn’t immediately require all available information. Clearly she didn’t know I have a full-time second career as a professional Google researcher.

"Should I be concerned?" I asked, already knowing in my guts that I should.

"Not yet", she replied.

Oh ok, cool.

So I scheduled mammo #2 for 2 days later and then immediately hit up the patient portal where I found NOTHING. Naturally, I turned to Google.

"What does it mean if my routine mammogram calls for a follow up diagnostic?"

"How many diagnostic mammograms turn up cancer?"

"What are the symptoms of breast cancer?"

"Can you have breast cancer with no lump?"

"What happens in a diagnostic mammogram?"

When Google failed to assuage the rotting ache in my gut, I messaged my PCP through the patient portal with a modestly desperate plea for insider information. My doctor responded promptly with a convincingly positive message explaining that these callbacks are very common and almost all of them end up being nothing at all.

But the ache persisted.

Mammogram Number 2

At this point I still had heavily promising statistics in my favor. I walked into the Breast & Bone Health clinic feeling optimistic that additional images would confirm the stats — nothing to worry about.

In an ironic twist of coincidence (I don't believe in those anyway), the smiling woman who came to retrieve me for my photoshoot is a family friend. Maybe she's just extra incredible at her job or maybe she sensed my quiet desperation for information, but she gave me what I asked for:

"everything you can tell me".

She explained that the cluster of microcalcifications they were focused on could be totally harmless, or they could be the telltale sign of early ductal carcinoma. Further, there were certain things they looked for to provide more clues — the shape of the white dots, the number of them, and whether there was one cluster or multiple. Google would later confirm just how much reason I had to worry.

She wrapped a warm blanket around me and explained the possible outcomes before leaving the room to speak with the radiologist.

• It’s nothing to worry about, and life goes back to business as usual.

• It’s vaguely notable, and we monitor it more closely with mammograms every six months.

• It looks suspicious enough to warrant a biopsy.

She told me to sit tight, warning it could take as long as 30 minutes. She came back about six minutes into my IG doomscroll.

Unfortunately, it was the latter: biopsy.

She gave me a ton of information she couldn't have known I had already covered in my Google thesis, and asked if I had any questions.

“I read that they give you a BI-RADS score after a diagnostic. Will I be given one?”

She told me she thought the radiologist would likely give a score of 4 or 5 — her guess was 4.

For reference:

BI-RADS (Breast Imaging-Reporting and Data System) is a standardized risk-assessment and quality-assurance tool developed by the American College of Radiology. It’s used by radiologists to universally describe, categorize, and report findings on breast imaging tests, including mammograms, ultrasounds, and MRIs.

Category 4: Suspicious abnormality. The finding is suspicious but not definitively cancerous. The likelihood of cancer ranges from 2–95%.

Category 5: Highly suggestive of malignancy. The findings are highly characteristic of breast cancer. Likelihood is greater than 95%.

I was calculating percentages as I walked to my car. She said maybe a 4, maybe a 5, so I called it a 4.5, which somehow translated in my mind to somewhere between 50% and 95%, so let’s call it 70%. That meant I had about a 30% chance this wasn’t cancer.

This is the logic I clung to for the next five days.

And when I say “clung to,” I mean I couldn’t catch my breath, couldn’t calm my thudding heart, couldn’t think straight, and couldn’t sleep.

I said to my husband, Gerald, “I feel like I’m standing at the edge of a fork in the road. One path loops back to my normal life, and the other veers off into scary, uncharted territory filled with hidden horrors like chemo, mastectomies, and death sentences.”

During those five days, my mind deployed every unhinged trick imaginable to get me through the absolute torture of the unknown.

I told my mom, dad, aunt, husband, and boss, but I was too afraid to tell anyone else because I didn’t want to make them worry — and because I’d convinced myself that if nobody knew, it would somehow be less dramatic when it turned out to be harmless dense breast tissue.

I looked for signs from the universe (and boy, did I get them).

I’d think, “I just know something is wrong,” and then immediately chastise myself for putting that energy out there. Put down the shit-sticks, you hypocrite!

I thought about what I would do if handed a death sentence. I thought about what I would do if it turned out to be nothing.

I convinced myself 30% was actually a huge number. There was no way it was cancer. Then I convinced myself I was insane because that’s only 3 out of 10. Did I really think I was the 3?

I convinced myself the friend who did my mammogram had a look — an energy — like she knew more than she was telling me. Was that sympathy in her eyes?

I talked Gerald’s head off. I mean really talked his head off, even more than usual. I didn’t know where else to put all those feelings, so I bounced them off him like my own personal soundboard.

He never stopped listening.

My sleep was hard and short.

By the time Tuesday rolled around, I was a wreck.

That morning, our 11-year-old son was presenting a scholarship at the high school in front of hundreds of people. I was so proud of him, and I wouldn’t have missed it for anything — not even a breast biopsy — but I was such a wreck that I almost had to run back home because I was sure I was either going to vomit or shit myself.

But I made it through, and he absolutely nailed his speech.

So I dipped out early to make it to my 11 a.m. appointment.

The Biopsy

The only thing worse than waiting for life-changing test results is enduring the torture of a hollow needle being rapid-fired into your tit while pancaked into a mammogram machine in order to get those test results.

I’m fairly confident my pain tolerance is high, but that did nothing to talk me off this ledge.

Let me paint you a picture.

The room was dimly lit and split down the middle by a windowed half wall — desks and monitors on one side, a suspiciously serious-looking mammogram-like machine on the other. A tray of metal torture devices sat nearby, along with a mauve-pink vinyl hospital chair that folded at the head and feet, parked beside a small curtained area presumably provided for my modesty.

I wondered why the chair needed to lay flat.

Do people pass out?

Were they going to strap me down like Girl, Interrupted when I refused to continue?

Why is everything in a medical setting always that awful mauve, blue, and green color palette? Isn’t there a single color-theory psychologist they can hire to make better design choices?

My nurse-friend — the same one from my mammogram — told me to undress from the waist up and put on the fabric vest, open in the front. She explained everything that was going to happen as she rolled me toward the machine.

It was like a regular mammogram machine except turned on its side, so you’re squished left to right instead of top to bottom, and the compression paddle had a cutout that gave the doctor access to the breast.

You know, for the torture devices.

Nurse-friend and another nurse behind the window wall spent about 10 minutes manhandling my breast into the machine at just the right angle, taking test shots and then trying again. Each time, they placed another little blue marker line on my boob.

So there I was: left boob just balls-out in this insane contraption, left arm flung up over my head resting on the machine. My face was positioned to the right — probably so I couldn’t see what was about to happen.

She told me to hang tight while they called in the doctor.

Dr. Lady came in (I have no idea what her name was) and introduced herself politely, though in a tone far more serious than made me comfortable.

Nurse-friend said she was going to hold my arm because it would probably get tired, but I assumed it was really so she could hold me down when the torture started.

Here we go.

"You're going to feel the local — lot's of burning".

I felt nothing.

"Okay, she's going to make a tiny incision"

Still nothing.

"You're doing really great. She's going to insert the needle and you may feel pressure but not pain. You're going to hear a poof of air".

I heard the poof. I felt nothing.

"Great. You're doing really great. You're going to hear some suction sounds, that's the device getting the samples. You're almost done".

I heard the suction. I felt nothing.

"We're just going to take a pic and make sure we got the cells and then we'll place a little titanium clip in the breast to mark the spot for future reference".

The pic is good.

The dr mutters some doctory stuff I don't really hear and promptly leaves.

Nurse-friend released me and rolled me away from the machine, where she promptly laid the chair flat — turns out it wasn’t for strapping me down after all — and held pressure on the incision for about 10 minutes.

Then it was one last trip into the mammogram machine to make sure the clip was in the right spot.

It was.

I was done.

Holy shit, I was done.

I stood up slowly and put my clothes back on. She placed an ice pack in my bra and told me results usually take two to three days, though sometimes — if you’re really lucky — just one.

She said they’d go directly to my portal, but typically a nurse calls right away as well.

By the time I got to my car, I was so overwhelmed with emotion that I closed the door and just sat there… numb.

Then I did what any reasonable elder millennial would do: I pulled out my phone and recorded a video of myself talking… to myself — explaining what had just happened and what I was feeling.

This is how I process: by talking out loud or writing things down. I have to tell myself the story so I can confirm the reality I just lived through.

That’s what I’m doing right now.

That’s why I started a blog 10 years ago, which turned into an Instagram vlog, which turned into a TikTok that somehow became several hundred thousand people listening to my very public audible on life.

“Dear Me… yeah, wait until you hear what just happened. You were there. I was there too.”

“Yeah, you’re really sitting in your car trying to process the very real possibility that you have breast cancer at 42.”

And then I put my phone down and cried.

A side note about me and crying: I don’t.

My therapists say it’s a coping mechanism from growing up in an abusive environment. As a child, I learned to turn it off as a way of proving:

“You can’t hurt me. You can’t make me cry. I’m unbreakable.”

So my brain began associating crying with danger and shut it down to protect me.

Over the past three or four decades, I’ve done everything — except crying — to either avoid big feelings or drown them out.

Alcohol. Food. Public vlogging. Therapy. Running. Dieting. Talking.

When I do cry, it’s typically reserved for pet deaths, human deaths, and my kids’ holiday recitals.

But that day, it came screaming out of every dark, secret place it had been hiding for 42 years.

Maybe it was sheer nerves. Maybe it was a quiet knowing.

I think that was the moment I started accepting the diagnosis I didn't yet have. In many ways it all suddenly felt a bit lighter — like the moment you leap from a rocky cliff and trust you'll land safely in the waters below.

It is what it is.

You're in it now.

The Call

The next morning, I got up like usual, dropped the kids off at school, and came home to start my workday.

I told myself to put it out of my mind. You won’t get results today anyway. And then I proceeded to check my patient portal every 30 minutes because anything more frequent would’ve been unreasonable.

The boys had a half day for teacher something-or-other, so at noon I drove back to the school to pick them up. I checked my patient portal while sitting in the McDonald’s drive-thru line.

Nothing, obviously.

I got home, set the boys up with screen time, and went back to my laptop. Before diving back into work, I checked the portal again.

This time, I saw:

“Pathology Report Pending.”

I just sat there staring at the screen.

It wasn’t clickable. It was probably just a placeholder, like when you click a UPS tracking link and it says, “Label Created.”

Fuckers.

And then my phone rang — my primary physician’s name scrolling across the screen.

There was only one reason she would be calling.

I swear to you the next 5 minutes played out like the dramatic screenplay of a 90's Lifetime movie. Time slowed down. Sound was muffled by the pounding of my heartbeat in my ears. My mouth went dry.

"Jesus Christ, here it comes."

In the calmest, sweetest, most comforting voice, she says:

"Hey Shandra, it's Dr. B. So, I've got the results of your biopsy and unfortunately it is Ductal Carcinoma In Situ — DCIS."

All I could think was "I have to call my husband".

She said a bunch more things:

Do you you have questions? I know this is scary. This is the best kind of cancer. Breast surgeon. Excellent care. Caught it early.

All I could think was "I have to call my husband".

I hung up the phone and briefly contemplated crying, or vomiting, but I turn around and see my son standing behind me with the saddest, most sobering face I've ever seen on his precious little head.

My brilliant, emotionally intelligent, bright, beautiful boy knows exactly what he just heard.

He looked right at me and said "I know. Y

ou're sick. I'm fine".

To be continued....