Testing and diagnosis
The women we interviewed described testing as a step-by-step process involving different stages and types of tests before a definite diagnosis could be made. The tests that seemed common to most women we spoke to included a mammogram, an ultrasound, and a fine needle or core biopsy. Some women described the testing period as fast or at least some parts of it as being fast. Nadia(B) for example, went to the ER (emergency room) the night she first noticed a lump and was booked straight away for an ultrasound the next day.
When Annie heard she needed a follow-up she underwent most testing within a day in a private clinic.
Transcript
It is not often that a doctor tells you that he is worried. So I panicked a little bit. I thought that I had insurance so I went to a private clinic and I got an appointment right away, three days after. On Monday morning, I spent the whole day […]
In Canada, there is currently a benchmark time within cancer care of 7 weeks from the initial screening to providing a diagnosis if a biopsy is required. This benchmark, is the time by which ideally 100% of patients should have received the first treatment appropriate for their cancer. Even though testing went relatively fast for most women it was still not easy to wait for the results during that period.
It was difficult for Shelley's family to wait for the diagnosis. It took time to get answers.
Transcript
The hardest part I think during that time was the waiting and knowing you had this cancer growing inside of you and you just want it out. You just want it out, but that sensation, it was always kind of lingering in the background, that burn that itch and, of […]
Women also spoke about how different circumstances affected the time it took for testing and diagnosis. Deann and Lorna underwent testing for several years before the diagnosis could be made. Deann underwent a follow-up two years prior to her diagnosis but nothing was found. Lorna had concerns for a couple of years but because of the density of her breast the technicians were unable to make sure if there was a lump. She was relieved when the lump was finally detected. Gaye on the other hand noticed a fast growing lump one month after her regular screening and was able to follow-up rapidly. Debbra felt lucky that she happened to have a senior technician who discoverd a rare form of cancer that is difficult to detect.
Testing in Nalie's case was slow to start for several reasons. Once tested, however, follow-up was considered urgent and happened fast.
Transcript
And so she felt it and she’s like, “Don’t worry it’s probably just a cyst,” so I didn’t even worry at all either but she gave me a referral paper just in case. And so when she gave me the referral paper I didn’t really do anything with it because […]
Interactions with healthcare professionals or the healthcare system were sometimes cited as the reason for delays with the speed of testing or in receiving the results. Julie lost confidence in her doctor when the results were lost and she decided to go to another clinic to be tested again. May-Lie did not feel she was taken seriously and decided to make an appointment with her gynaecologist. You can read more about relating to professionals and about changing doctors in the topic page relating to health professionals.
Malika decided to ask for a second opinion she did not feel ready to accept the first results.
Transcript
So I didn’t see my doctor; he was on vacation. I saw a resident and I was prescribed an ultrasound, which I had done in a radiology centre. I had an ultrasound and I had insisted to have a mammogram also, knowing that I was still breastfeeding at that time. […]
Issues during testing
Most of the women we spoke with underwent a mammogram, an ultrasound, and a fine needle or core biopsy. Even though for the majority, the testing went rather smoothly others described unexpected events or had more painful memories of the tests.
Dense breasts have less fatty tissue and more non-fatty tissue compared to breasts that aren’t dense. Dense breasts can make it harder for mammograms to detect breast cancer and dense breasts have a higher risk to develop breast cancer. Iceni for example, described being told that she has dense breasts. She was surprised to hear that the lump was bigger then initially was expected. Julia and Margaret noticed a lump in their breasts but the mammogram and ultrasound did not show anything suspicious; only the biopsy showed invasive breast cancer. Malika suspected something in her left breast but in the end her cancer was found in the right breast.
Deann underwent testing for several years before the breast cancer was found.
Transcript
I had my first mammogram in 2009 and at time everything was ok. And then I also had the spot compression in 2009 and everything was okay. When I went back in 2010 and had the follow-up mammogram a year later I got recalled for spot compression again and when […]
Being diagnosed with breast cancer and finding out she was pregnant on the same day was difficult for Christa.
Transcript
And then so 2 weeks later they got the results back and they called me to say, “Okay we’ve got the results, come in for them,” and I’m like okay well I guess I’ll probably have to get a mammogram today too you know just to make sure everything’s okay. […]
The young women we interviewed did not have a mammogram but were tested with an ultrasound directly. Women who are premenopausal tend to have denser breast tissue and therefore mammograms are not as helpful for testing. These women will often undergo an ultrasound with or without a mammogram. Nalie experienced a delay because she initially thought she had to book an appointment for a mammogram first. Women also reported other kinds of delays. Laurie, for example, expected the ultrasound technician to provide her with an explanation of the results during the ultrasound. Hearing the results only later felt like a unnecessary delay to Laurie.
Shelley asked for another test when her test came back benign.
Transcript
So once that initial shock was over the next was the biopsy. The Breast Cancer Clinic phoned almost immediately to have the biopsy. During that biopsy, the doctor was having a hard time locating the lump it was so small. I believe once the autopsy (results) came in it was […]
Anticipating the results
Women described how they felt about waiting for the diagnosis and undergoing the tests. Some had a sort of gut feeling that something was wrong and anticipated the diagnosis of cancer. Others started worrying after a particular reaction from the technician during testing or after they were asked to come in for another test. For some, the diagnosis came as a big surprise as they hadn’t anticipated anything or because they had different expectations about how they would find out, from whom, and where. Some women were not worried at all during the testing nor for the results.
Debbra felt overwhelmed when she was told indirectly that it could be breast cancer.
Transcript
And then all the things lined up and so with the mammogram they’d seen something suspicious and then they sent me for an ultrasound. And I was just lucky that I had a senior ultrasound technician who realized that what she was seeing was just different than what she’s normally […]
Receiving the diagnosis
Women received their diagnosis is different ways. Some women for example heard during the testing that something looked suspicious, other were requested to come back to the physicians or oncologist’s office, and some heard the diagnosis through the phone. Isla was alarmed when the doctor called her asking to see her on the weekend.
It was difficult for Naoual to receive her diagnosis through the phone while she was working.
Transcript
I went to book an appointment, however it took me a while, I think a month or a month and half to have a biopsy and, following the biopsy, it took a while again to know the result. They told me: “If it’s serious, if it’s severe the doctor will […]
Some women, however, did not feel upset and felt they were able to accept the diagnosis immediately or even felt relieved that they finally knew what was happening.
Review date: 2018-04