TO THE EDITOR: I appreciate that the author of the February 2022 article titled “How My One 'No' Might Have Saved My Life” shared her breast cancer journey, hoping that her experience would help other women and men, but I believe some of her recommendations are misleading and inaccurate.
Saying “No” to having a titanium or non-metal marker clip inserted during a biopsy is certainly an option that patients can pursue, but it is necessary to note that this is an important part of a biopsy, which helps to locate the area that was biopsied.
In addition to identifying a malignant area, the marker also allows a benign area to be monitored over subsequent years, to ensure that it remains stable. Such a clip does not interfere with any future MRI or other radiology exams and does not set off metal detectors. This technique has been tested and proved to be safe and effective for more than a decade. Such markers are the size of a sesame seed, and they do not interfere with imaging the surrounding areas of the breast.
Ms. Shaw’s statement regarding a previous biopsy when she refused a clip placement and a subsequent positive pathology finding states that, “If I had the clip, I would have never been called back, and my diagnosis would have been delayed, allowing the cancer to progress. This result was all because I said “no.’” This statement, I believe, is inaccurate and misleading.
I am concerned that CONQUER magazine readers will take this article as “gospel” and feel that they should refuse to have a clip placed during a breast biopsy. If the pathology comes back positive, the radiology team will need to go back and put a clip in place, so the surgeon could find the malignant spot, which can be difficult.
I would also like to offer the following comments regarding the list of “5 things to remember” in the article:
1. “Early detection is key.” This is certainly important.
2. “Mammograms are not enough....” This does not tell the whole story. Mammography (especially tomosyntheses) is the gold standard for breast screening, supplemented by ultrasound and MRI, as appropriate.
3. “Being your own best advocate.” This is always sound advice.
Numbers 4 and 5 are confusing:
4. “It’s okay to say ‘no.’”—To what?
5. “Help somebody else to say ‘no.’”—Again, to what?
As a breast nurse navigator, I always encourage patients to be informed, to ask questions, and to know why certain procedures are in place, and to do more than a “Google” search online (as Ms. Shaw advocates).
I’m sure that Ms. Shaw’s desire to help other women and men comes from the right place, but this article leaves out important information that may mislead and misinform patients who are facing a breast biopsy.
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