Breast biopsy - what to tell the kids?

December 1, 2007 8:11 AM

Breast biopsy. What should we tell the kids?

My SO needs to have an excisional biopsy performed. The results will take 3-4 days to return. The majority of breast lesions excised prove to be benign, and we are assuming that this will be the case with hers (albeit nervously)

We're trying to decide what to tell the children when she goes for the surgery. One in particular (13 yo) will worry herself sick, which could trigger a relapse in her Crohn's. We don't discuss everything with them, but what we do is always the truth. "Why is Mom going to the hospital?" will certainly have to be discussed.

Is some obfuscation or a "white lie" appropriate?

posted by anonymous to human relations (21 answers total)

From what you've said it's unclear whether the kids already know that she is going in for the procedure. Assuming that they don't know what's going on, I wouldn't say anything to them at all. I would simply say that she is going to get a massage or going to spend the day with Aunt Petunia. If they already know that she's going to the doctor, I would try to pass it off as nothing more than a check-up.

Your instincts seem to be that there is no need to make them worry about something that they may not be able to put into the proper perspective. I agree wholeheartedly.
posted by oddman at 8:32 AM on December 1, 2007

My mother had a breast biopsy when I was 9, and she told me the truth about it. As a kid whose dad had died of cancer and whose aunt had breast cancer...it was scary, but I think I would have been more frustrated if I'd been told a white lie. If I had to bend things, I'd go for a very simplified version of the truth rather than a lie.
posted by needs more cowbell at 8:35 AM on December 1, 2007

I don't know that there is anything you can say that will totally alleviate the worrying. No matter how it's phrased, hearing that a parent has to go to the hospital is scary for a kid. I agree with oddman that if they don't already know maybe they shouldn't. If you don't want to lie tell them she has a doctor's appointment but leave out that the appt. is at the hospital and not the doctor's office.

If you must tell them that she is going to the hospital, you could try to emphasize that this is just a test and compare it to tests that they have had. "You know how when you go to the doctors to get a checkup the doctor runs a few tests so he/she can make sure you're nice and healthy? Well there are some tests that they can only do in a hospital because they don't have the right equipment in a regular doctor's office. That's what mom is going there for."
posted by LeeJay at 8:41 AM on December 1, 2007 [1 favorite]

I would stick with leejays version of truth, but be straight up about the hospital visit just as the first step. It's hard to explain a mom not being home for X amount of time, but offering up "You know how when you go to the doctors to get a checkup the doctor runs a few tests so he/she can make sure you're nice and healthy? Well there are some tests that they can only do in a hospital because they don't have the right equipment in a regular doctor's office. That's what mom is going there for." should about cover it.
posted by headspace at 8:47 AM on December 1, 2007

don't lie to your children. tell them that mom's doctor found something that felt funny in her breast, and they are going to the hospital to find out what it is. tell them it's probably nothing bad, but they just want to make sure.

as for your daughter, if she regularly worries herself ill, you should probably set her up with a therapist to learn how to cope with her fears.
posted by thinkingwoman at 9:12 AM on December 1, 2007 [1 favorite]

Oh for god's sake, do not lie to them. Do not tell them she is going for a massage. They will know you are lying and they will worry far, far more than they would if you would just be honest with them. If you're lying, they will assume it's far worse than you're telling them. Not to mention the huge hit to your subsequent credibility. Don't do it. Just don't.

My mom had to have some fairly major surgery when I was about 15. We weren't told what was going on aside from vague worrisome statements and I ended up digging through all of her files when she wasn't home so I could find out what was going on. I *still* have issues from this and it's ten years later.

I would go with LeeJay's statement. Tell them she's going to the hospital, that the doctor needs to check something out, and that you'll tell them what happens. Make sure they know what to expect when Mom gets home, too. Let them help out. Just don't lie.

(On preview: +1 to the therapist for the kid. It sounds like she could use a safe space to talk about her fears.)
posted by fuzzbean at 9:21 AM on December 1, 2007

I agree with LeeJay and headspace, but in case your older child intuits what's going on, as older children are wont to do, I'd suggest you talk to her about the likeliness of the growth's being benign, as evidenced by previous history.
If it turns out that the growth is not benign, then I'd like to let you know,as someone who has spent a lot of time on this issue over the past couple of years, that there have been many significant advances in treatment even over the past five years. Even a stage four diagnosis is no longer necessarily a death sentence. It sounds likely that your wife's breasts have been closely monitored and anything that could be found would have been found at an early stage, which means her chances for a complete recovery are excellent.
My thoughts are with you and your family. Stay tough.
posted by Sara Anne at 9:26 AM on December 1, 2007

I'm a totally adult person and yet when my mom had to go through a whole series of biopsies and surgeries for cancer last year, I found her approach to be distinctly off-putting so I'd suggest you don't try it.

That is, she would always try to prepare me for the worst and let me know how bad it could be, I think the assumptions being 1) she was nervous and this is how her mind works 2) she did not want to be responsible for not giving us a bad enough view and feared we'd be mad at her if she downplayed it and then died unexpectedly 3) she's dramatic, I am not, she thinks I may not fully appreciate the gravity of most situations.

So I spent a lot of time thinking she was at death's door when she wasn't with the resultant lack of sleep and depression. In fact, an after the fact assessment indicates that while there were risks, the odds were in her favor. I live a ways from her so I didn't get much information that wasn't filtered through her agita.

So, that said I think a few things are important

1. tell the truth but don't start making a spreadhseets of what COULD happen. "We don't know, the doctor will tell us, for now we're not speculating" [where the white lie might be that you may be speculating but you'll do it in provate]
2. stress that you'l tell her what you know when you know to but that this sort of thing can drag on and so it's important to not jump to conclusions
3. you trust your doctor and that you, as a family, are going to stay on top of what is happening.

So, stick to facts and not hypotheses. Give her information about the hospital -- hospitals are good about making patient information things like this available in many cases that is very calm in tone -- and let her ask questions but don't engage her in a lot of "what if" scenarios. The less you and your SO seem not stressed about it, the more that will come across to the girl. Focus on what you can all do to make Mom comfy and happy in the meantime and don't make it seem like it's a big ledge you're all jumping off of.
posted by jessamyn at 9:59 AM on December 1, 2007

I was a lot older than 13 when my mom had to have a lumpectomy, but she still hesitated to tell me at the time because she knows I'm a worrier. (And when I stress it exacerbates my Lupus, so she doesn't want to make me sick on top of everything else, much like your daughter's situation.) Anyway, when Mom told us, she was so non-chalant about everything that I ended up feeling concerned but not overly worried. She told us the facts: the doctor had done an MRI and there was "something" in there but it was less than 2cm. Her unflagging confidence that everything would be OK was contagious, so that even when the biopsy came back malignant, I was able to focus on the good news - all her lymph nodes were clear, she didn't require chemo, just radiation. That was 1992, and today Mom is just fine and still going strong.

I'm sending good thoughts your way that your wife gets good news. In the meantime, I'd advise being truthful with your kids, telling them Mom's having a test done and the doctor is pretty sure it's nothing, but he wants to be sure. Be matter-of-fact, but not overboard falsely cheerful. If for some reason your wife has to undergo further treatment, then, it won't come as a harsh slap to them.
posted by Oriole Adams at 10:25 AM on December 1, 2007

i think oddman has the right idea. do the kids know she's going in for the procedure? it might be better to wait to tell them when you actually know what's going on. kids (especially teens) don't process information and anxieties the same way as adults. they can internalize it and never really let go, so they will always worry about it.

i say this as somebody with lots of cancer in the family. my mom waited till the biopsy came back as malignant to tell my brother and i (we were 14 and 17) that it was cancer. when i first felt the lump, i waited till the biopsy came back before i told people i had it and it was cancer.
posted by kendrak at 10:28 AM on December 1, 2007

Also, and I'm sorry to be filtering this so much through my own recent experience, the thing about cancer is it's often not like you get a diagnosis and from then on you are a Person with Cancer with a set path of treatment.

While I wish you and your SO the best and sincerely hope this turns out to be nothing (which is what happened with my sister in your SO's case, turns out her courier bag had created this weird lesion that was just that, a weird lesion, now removed) one of the things I was very unprepared for was the sheer amount of inconclusive tests that followed the first "hmm, there's something that merits further attention" test. I assumed that test would result in some sort of yes/no answer. You may want to let your SOs daughter know in some gentle way that bodies are weird and complicated (which I'm sure she knows due to her own medical issues) and that what your SOs doctor is doing is narrowing down a huge range of possbilities which is what will continue to happen.
posted by jessamyn at 11:19 AM on December 1, 2007

just a story....when my nephew was 4 or 5 his paternal grandmother died, no one ever told him....he was just packed off to the other grandparents while mom and dad went to NYC to deal with everything.

A couple of months later he comes home from school and gives mom a picture and says:

"send this to grandma"
"which one?"
"Well, not the dead one!"

So no matter what you say, the kid knows more about whats going on than you think...be up front.

When I was that (13-14) my mom almost died and dad and I spend a lot of time going between home and the hospital, but we also did stuff mom didn't like to do like have pizza for dinner so things went along pretty easy.
posted by legotech at 11:32 AM on December 1, 2007 [2 favorites]

I used to be a chronic worrier. I developed rheumatoid arthritis when I was 22 because of severe stress and worry. I'm 25 now, typically without pain but whenever I get stressed or worried, the pain comes back.

So I understand that you don't want to stress your 13-year old out because of what it could trigger.

But you know, she's going to have to learn how to deal with the stress and worry these types of situations create at some point in her life. You won't always be able to cover up stressful events.

I have had very little interaction with children throughout my life, so I feel a bit weird giving parenting advice. But I suggest you take this opportunity to perhaps explore alternative methods of mentally coping with circumstances like this with your daughter. I don't suggest you lie to her. You don't have to tell her every detail, but I would be as upfront about it as possible.

Recently, I've taken the approach to tackling my habit of worrying, instead of focusing on the arthritis. I'm pleased with my results so far. I recently finished reading this book. It may not be the greatest book but it's an interesting read and gives you a lot to think about in terms of how to handle yourself mentally during the tough things you face in life. I'm not suggesting you hand it over to your daughter necessarily, but perhaps you could read it first and if you like it, share some of it with her.

Either way, hope everything goes well.
posted by Squee at 12:07 PM on December 1, 2007

I don't know how old the others are, but maybe you need two separate conversations, one with all of them and a special one with the 13 year old. If she's half-way smart, she'll figure out things and worry about things, which she is likely to hide to shield *you* (which wouldn't be good for her problem). She is capable of handling a slightly more complex discussion than smaller kids, and entitled to better info by virtue of her age. There's no need to frighten her, but a more complex explanation is due her as a woman-child, and tacit reinforcement of her status as older than the others and closer to adulthood. Just taking her aside and mentioning that this needs more testing to rule out Bad Things should be sufficient, but you have to be the judge of how much to tell her based on her reaction. They are all different.
Disclaimer: I let the kids have wine coolers when they were close to adulthood, so they would not go nuts with liquor later, and I bought them a package of condoms and suggested they read the directions and ask if they had any questions. That's just so you know my vantage point, but my name should tell you all you need to know about that. Let your conscience be your guide.
posted by unrepentanthippie at 1:21 PM on December 1, 2007

I understand wanting to protect your children, but if you lie to them and the biopsy ends up detecting cancer how do you think your children will feel? Furthermore, how would they be able to trust you with future medical information?

As a person who dealt with more death and disease as a child than many people deal with in a lifetime, I agree with needs more cowbell's advice, keep the information simple, but honest.
posted by a22lamia at 4:02 PM on December 1, 2007

Chances are, you're not nearly as good of a liar as your kids allow you to believe that you are. No parent is. (Think about it: how many times as a kid did your parents tell you something that you instinctively knew was a load of bull, but you smiled and nodded because it was appropriate?)

A thirteen-year-old kid is not stupid; if you lie, she'll probably know or at least suspect that something bad is afoot, and if she's of as nervous a disposition as you indicate, I suspect that her imagination-fueled fears will be far worse than the truth.

There are times when it's appropriate to participate in the whole white-lying charade, where you lie and everyone knows you're lying but pretends not to notice and maintains a facade for one reason or another, but this doesn't strike me as one of them.
posted by Kadin2048 at 4:32 PM on December 1, 2007

No one has mentioned yet that it's a good idea for female children to be raised with an awareness of breast cancer, of the screening process and so forth. If one of your daughters ever finds a lump and has to have a biopsy, she will already know a little bit about what can happen from there.

And just make it very, very clear that biopsy != cancer. Both my mother and I have had biopsies; both of us freaked out; neither of us had cancer. Your daughters could need biopsies for any number of reasons later in life: lesions beneath the skin in places other than the breasts, unusual moles, etc. This could be a good way for them to learn a little bit about how the process works.

I very sincerely hope your wife's lump is benign, but I just want to echo the suggestion that your children would not be happy to learn you hid information from them if things turn out badly. Or even semi-badly: Your wife could need multiple biopsies, and then would there be multiple lies?

Best wishes.
posted by brina at 5:45 PM on December 1, 2007 [1 favorite]

13 year olds are old enough to hear the truth. I still remember what it's like to be 13, and it was so frustrating to have adults assume that we can't handle certain bits of information simply because we're too young. Tell them the truth, but be honest. Explain that it really IS just a test, and it doesn't necessarily mean that she's sick. It's just a check up to make sure that she is healthy.
posted by mittenedsex at 6:56 PM on December 1, 2007

Brina makes a good point, and I'm going to add to it. My mother found a lump in her breast at one point and had to go in for a biopsy. She actually had me feel the lump (at which point I went, "Seriously? That's what I'm looking for?") so I would know what they felt like.

This was a really good thing. You only get one body and it's damn hard to know what's "normal" and what's not when you've got no basis for comparison.
posted by fuzzbean at 8:36 PM on December 1, 2007

Nthing telling them the truth. My parents always wanted to spare us kids the worry by not telling us things (or waiting to tell us after exams/after our birthdays/after whatever), and as a result I have a near-constant background level of worry (especially around events that should be enjoyable involving family) that there's something dreadful that they're waiting to spring on me. Please don't do that to your kids, it's much better to tell them the truth and explain it as well as you can, even if it causes some worry, because I guarantee you that your older kid will know something's up and will invent something much worse to worry about if you don't.
posted by biscotti at 11:30 PM on December 1, 2007

You can put the infuriating self-absorption of children to excellent use here. Your kids need to know that THEY will be alright, almost as much as they need to know that you will be alright.

I went through this with my mother when I was 13 (lo these many years ago), and my memory of this now is that I was fairly oblivious as to the seriousness of the procedure, because my folks emphasized that mom would be OK, that my life would not be affected that much, and that they trusted my maturity and ability to cope.

They also gave my brother and me some fairly grown-up stuff to do so my mother could recover (basically we took over all the household management like cooking to cleaning).

My mother was really sick, but I remember this period of my life as being smooth and reasonably anxiety free, because we were treated as responsible members of the family.
posted by nax at 9:50 AM on December 2, 2007