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.
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.
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.
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.
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.
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.
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.
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.
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.