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Question:
#2221
02/13/2003
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I had an excisional biopsy in June 2002 with the following results: "fibrous mastopathy with duct dilation, background fibrosis, papillomatosis and apocrine metaplasia. The aprocrine changes are rather extensive in some ducts and there is some degree of mild atypia. Patient should be followed."
I went back to see my surgeon 5 months after the surgery (in November) because of pain and the fact that right above the scar I had a raised swollen lump come up (the only thing I kind think to describe it as is similar to an insect bite but much larger). This area stayed this way for 2 days and then was gone. This has happened several times since November, except the last time I had 2 "lumps". My surgeon is checking me monthly but I'm getting nervous. He did a mammogram & ultrasound in November but he said nothing unusal showed up. He isn't sure what it could be and says the only thing he knows to do is go back in surgically. Have you ever heard of anything like this following surgery? I don't want any exploratory surgery unless I absolutely have to but I sure would like to know what is going on. Can you help me? |
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this is an unusual problem that is unique to your situation unfortunately. your doctor is doing hie s best in following your closely. it is true that the only way to definitively answer the question what is going on in there may be more surgery... or watch and wait as you have been. |
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Question:
#2222
02/13/2003
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Some of the preceding questions may have answered my question. I had a mammogram on January 2, 2003, which showed microcalcifications present. The location was left breast - lower underside near the chest wall. On Jan. 16, 2003, I had a stereotactic needle biopsy. My recovery from this procedure was a few days and the results were inconclusive. I went into the hospital on January 23, 2003, to have a needle biopsy. Long story short, I had back-to-back needle biopsies when my surgeon misinterpreted the radiologists instructions for the location of the calcifications. He was very candid with me about what happened and I totally understand how this could happen. They got all of the area - which had been diagonosed as intraductal carcinoma. I may have to follow this up with radiation. Today, it has been 3 weeks since the last 2 biopsies. The pain in my breast is very severe. The nipple area is too sensitive to touch. I have a very high pain tolerance and this has just about got the best of me. Should I be concerned that something is wrong. The bruising has healed nicely and I have no discharge. Does it sometimes take a long time for this to heal and is there a possilbility that I may have permanent nerve damamge? I will really appreciate your comments or suggestions on this matter. Thank You! |
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The breast contains many nerves, which is why it is a sex organ per se... when several biopsies are done at once the breast cancer be quite traumatized. This can take several weeks to heal and feel better. Your surgeon should be seeing you also to ensure that no presence of infection is there as a possible cause of the pain. In rare cases patients have complained of chronic breast pain after an excisional biopsy or lumpectomy but this is unusual. Continue seeing your surgeon and keep him informed of your condition. Assuming he got clear margins and you are now ready for radiation, discuss with the radiation oncologist your breast pain too before treatment starts as it may influence when they want to begin this. |
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Question:
#2223
02/11/2003
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Hello
I had a biopsy done and it showed a dilated and ruptured duct exhibiting intra and periductal inflammation. The lump was removed. Now I have another lump in the same location.
If it is a ruptured duct again how can it be treated?
Do I have to have the lump removed again?
Thank you
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not sure... too many factors to consider-- so see a breast surgeon who specializes in breast cancer and breast disease for an opinion about what next to do. |
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Question:
#2224
02/03/2003
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I am nervous as all get out. As a medical professional I am even more so on pins and needles. I am now 41 years of age. I have a history of fibroadenoma of the same right breast X 12 years ago. Have had one surgery to remove an ovarian cyst X 16 years ago (the approxiamte size of a tennis ball) and lost the right ovary due to hemorrhage. Began my menses at 12 years of age. Have negative hx of maternal nor paternal breast cancer. Have had 3 pregnancies and 3 live births. First child was had at 22 years, 2nd at 25 years, and my last one a 39 years of age. Breast fed all 3. It was 1 month after giving birth to my last child at almost 40 years, (08/01)I then discovered a breast lump at 1 o'clock position of right breast. Imeadiately alerted OB/GYN and has F/U U/S which was found to be benign. (Have also had related pain until now with upper inner quadrant of right breast upon palpation.)Was then reffered to breast care center and follwed-up. Have had repeated U/S X3 all found to be benign and 1 diagnostic mammogram of right breast. Again, found to be benign by first radiologist. Finished breast feeding 11/02. Then decided to continue follow up at another breast center due to excessive patient load at former breast center. They now are acting as though I may be misdiagnosed. After 1 1/2 years, of being followed up and being repeatedly reassured the mass looked and felt benign, could it be that I may have been misdiagnosed. The new Radiologist, at the 2nd breast care center stated that he had to ask for a second opinion on my U/s and films. They stated that is simply because because he is VERY thorough and it is standard not to make any rulings until all previous tests are examined. After 3 weeks have not yet received his letter. Now after getting his 2nd opinion I was called to schedule for pre surgical consult for excisional biopsy in 2 weeks and after make arragements for procedure. This radiologist did state he thought it may be fibroadenoma after performing his own ultrasound on me upon first visit, but needed to view all previous records. I have had excisional biopsy as stated earlier and had removal of fibroadenoma at 29 years of age. What does this all mean? I am scared and on pins and needles literally. I can't eat nor sleep well and am in tears and consumed by all of this. U/S has repeatedly stated both masses (which are possibly one are butted together) are echogenic with one being hyperechogenic and the other hypoechogenic. Please advise. Thank-you for your consideration in ths matter. Please respond asap if possible... |
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Fear of the unknown is the worst fear of all. absolutely. sounds like your new radiologist is trying to be thorough and you want that thoroughness- thoroughness is a good thing. Remember that most masses are benign. The key to evaluating mammograms is to compare them to previous films-- the doctor is looking for a change from what was seen earlier. This biopsy will give you the answers you need. Focus on the positive-- 80% biopsies are benign. There doesn't appear to be anything grossly evident on your films that you describe to make them think definitively that it is cancer either. this is also good. So take in a deep breath and focus on resolution in the positive. I hope they have you scheduled for this week so you don't have to lose any more sleep. if you need us here at Hopkins afterwards you know right where I am...just qa click away.. |
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Question:
#2225
02/03/2003
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Hi...I am a 30 year old woman with a history of breast lumps in myself and in my maternal grandmother. Most of the women on my maternal grandmother's side of the family have a history of some sort of cancer (overian, breast, cervical). I started my period when I was 10, and now have trouble having one at all. I missed my period for a year and a half, and then got it for a while, now it's been 3 months since my last one.
I have already had 5 lumps removed by the age of 27 and I have discovered 2 more. I have scars all over my breast and I hate it! It scares me to find these lumps. My grandmother had to have a double masectomy and she had a very hard time with it and with the implants. Now, years and years later one of her implants is leaking and she has more tumors growing in the remaining breast tissue.
During my last visit with the surgeon, he suggested that I might consider a prophylactic masectomy, and have all of my breast tissue removed (including nipples etc.). This was 2 1/2 years ago and I am scheduled to see him again 2 weeks following the ultrasound. I have no health insurence execpt for the Veteran's Administration (I am a Vet). I am confused and scared and don't know what to think. |
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these are scary times for you for sure... you need to get another opinion for sure. this action might be recommended since you've had a lot of biopsies and the scar tissue might be hard to see abnormalities clearly... but before pursuing bil mastectomy, talk with other surgical oncologists who specialize in breast cancer as well as a radiologist who specializes in breast imaging.... let them decide how hard or easy your breasts are to follow going forward. |
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Question:
#2226
02/03/2003
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What if the surgeon fails to tell the patient about the various options for breast biopsies and only suggests an open biopsy? How will the patient learn about these state of the art techniques. SHe may be so trusting of the physician that she questions nothing and is lead down the path of incision and scar and possible complications. Who protects the patient? |
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Today, until there are better national quality standards for this, women truly need to be their own advocates and protect their own rights... sad but true. So being an empowered patient and gathering information yourself is important to know what your options may be. it is always wise to ask the doctor "what other methods might be used to accomplish the same goal and how did you decide on this one that you are recommending?" |
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Question:
#2227
02/03/2003
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Hello, I am 34 years of age and during my yearly exam,my doctor found a nodule on my left breast. I then had a mammagram which was followed by an ultrasound.I was then told by the radiologist that it looked to be a benign fibroid tumor but couldn't positively say that it was benign. So he reccomended surgical removal or a core biopsey, core biopsey being his most suggested procedure.What kind of procedure is this? Is it painful and if so will they give me a local anesthetic before they do it.I'm scared that if it is cancer that this will make it spread.Would I be better off just going ahead and having it removed. |
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Core biopsy is the standard of care for determining what a mass in the breast. It involves the insertion of a large guage needle to obtain cells and a small amount of tissue of the mass itself. yes, local anesthetic is used and you can resume your usual activities afterwards except for no heavy lifting for a day or so. |
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Question:
#2228
01/31/2003
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I am a nurse and I have a question regarding sterotactic vs open biopsy done by a surgeon. In the community hospital where I used to work all sterotactic biopsies are done by surgeons and the equipment is suboptimal. The radiologists have been excluded from doing the sterotactic procedures. Thus a large percentage of biopsies are open biopsies. Is this state of the art? This hospital is one of the only hospitals in the metropolitan area in which radiologists are not in charge of performing the stereotactic procedures |
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There is stiff competition among radiologist and surgeons in some communities regarding who will be the one to do the biopsy. Biopsies have become bread and butter for many surgeons. The key is that stereotactic or core biopsies are achievable more than 90% of the time, making it the standard of care. the only time open surgical biopsies should be taking place is when a minimally invasive biopsy isn't medically possible. Biopsies done minimally invasive result in less scarring of the breast tissue, don't require anesthesia sedation, and provide an accurate answer pathologically. So it is certainly fine for surgeons to do the stereo procedures, but the wave across the country is that radiologists are the primary health care provider doing them. You mentioned equipment not being up to par... that is an issue unto itself-- without the right equipment, we are all subject to error. all the more reason why patients need to get lots of information about such things before embarking on procedures being done to them, no matter who is doing them and where they go. |
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Question:
#2229
01/29/2003
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Dx on digital mammogram was microcalcifications, stereotatic mammotome recommended asap., plus by the 8th time they took compression films, which became painful, i had some yellow discharge... barring the worst and hoping for the best case (benign), after reading some of these postings i'm not sure what to expect the biopsy - can i work out (cardioexertion, weightlifting)as i usually do? do you or you partner feel the wire through the skin if it's close to the top? can you have "rough sex" ever again (nothing wierd, just uninhibited and occasionally vigorous)? these are not meant to be selfish questions so i hope no one interprets them the wrong way. for a very active person, can you ever go back to feeling strong and free again or does everything change even if the results are benign? Thanks |
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Right now you are dealing with fear of the unknown which is the worst fear of all. so let's give you some information to allay those fears... If stereotactic biopsy is recommended you would be placed on a table laying on your chest and your breast will be dropping through a hole in the table. (sounds strange but try to picture it.) Your breast is numbed with local anesthetic and a needle (mammotome) is placed in the breast which also is the biopsy device. You feel pressure but if properly numbed shouldn't feel pain. If you do, speak up. No heavy lifting for 2 days, then resume all your routine including vigorous sex. Hopefully your results will be benign and your life will march on in its usual way...weight lifting is fine, cardiac workouts are fine- just give yourself a couple of days for the bruising to be gone. that's it! |
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Question:
#2230
01/29/2003
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A woman called me because she has a suspected intraductal papilloma. She had two needle biopsies, one came back as benign (liquid part), the other came back with questionable cells (solid part). She is now to have it surgically excised. It is just under the outside margins of the areola. She discoverd the lump while in labor. She is breastfeeding her 12 week old, and the surgeon told her she must wean, then after conferring with her OB-gyn,the surgeon agreed that she only had to wean off of the affected breast. She called me for advice about what to do, and for assistance with unilateral weaning, if it is necessary. She has read, as have I, that it is not necessary to wean before a biopsy. Her impression is that the surgeons (she has seen two) are very quick to tell her to wean without seeming to evaluate the possibility of continuing to breastfeed. When asked why she would have to wean, the surgeon did not answer. If the concern is because of the location, that can be dealt with, if need be with the use of a nipple shield. If there is another reason, so be it, she will deal with it, but she would like a valid, evidence based reason as to why she must wean now. Of course she realizes that the situation will be totally changed if the results show a malignancy, but if it is benign, she doesn't not want to have lost her milk on one breast. And of course it has been shown that that would increase her chances of getting breast cancer in that breast later on in life.
Also, can this surgery be done in a manner that will avoid as much damage to milk ductules and nervs as possible? What advances have been made in this regard? Please share any pertinent information and insights about this.
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Breast Surgeons do prefer that the breast be dry and no longer lactating because the risk of infection, fissure tracks and long term healing problems is extraordinarily high. This is a known risk with lactating breasts, especially if the biopsy is to be done as an open surgical excision. Regarding her increase risk of breast cancer due to having a biopsy, let me clarify this-- having had a biopsy is listed as a risk factor but not because it contributes to causing this disease. it is because if a woman warranted a biopsy then her breasts have a reputation for wanting to grow some type of abnormal cell. So it doesn't actually contribute to her risk literally-- just the fact that she needs a biopsy now signals an issue. So wean away... |
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Question:
#2231
01/24/2003
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Dear JH Staff,
I have been diagnosed with ADH after a core needle biopsy. The hospital now want to do a further wire localization biopsy.
If there are cancers cells within the ADH is it possible for them to have advanced or is this a sign of a more early cancer?
Many thanks for your help
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It is standard of practice to want to remove additional tissue for pathological evaluation when ADH has been found in a core biopsy specimen. Do not worry about cancer cells growing/advancing. And keep in mind that there is a good chance that only ADH will be found on further investigation. It is wise to follow up and have this additional "bigger" biopsy done... |
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Question:
#2232
01/22/2003
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My wife is 47 years old , on her last mammogram they found a spot and then had a second mammogram and sonogram done, this led to removing a tumor 1cm in size, she went for a second opinion at Robert Woods Johnson University Hospital Cancer Institute of New Jersey. They want to take more surrounding tissue and perform a Axcilliary Disection, my question is when they remove Lymph nodes do they have to take them all out or should a Sentinel Node removal be done first and check if cancer is present, in which case all the nodes will be removed. |
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It has become standard of care here and in many large cancer centers today to do sentinel node only rather than continuing to do axillary node dissections. I'm glad to hear that her tumor is small, which means that the risk of the disease having spread to other organs is quite low. All the more reason to pursue sentinel node biopsy alone without full axillary node dissection. |
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Question:
#2233
01/21/2003
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I am scheduled for a core needle biopsy of the left breast for a lesion at the 4 o'clock position located near the nipple area. I had a breast lift and implant put in on that breast last year along with breast reconstruction on my right breast. My question is what are the chances of the implant rupturing during this procedure? Would a surgical biopsy be a better option to avoid rupturing the implant? The ultasound done on that breast indicated that the small leison looked like a cyst, but that it also had a solid part to it. The small lump feels very smooth and quite different to the cancerous lump I found on my right breast four years ago. |
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As long as you are in the hands of a skillful experienced radiologist who specializes in breast imaging and biopsies you should do fine. He/she will be using mammography or ultrasound to guide him with the goal to reach the abnormality and leave the implant unharmed. |
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Question:
#2234
01/21/2003
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I have been diagnosed with multifocal dcis, grade 2, in my right breast. I have elected to have a bilateral mastecomy with immediate reconstruction with tissue expanders and later, silicone implants. I have had several consultations with surgeons who differ on whether or not to perform a sentinel node biopsy. What is your opinion? |
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Multifocal dcis would imply that it is extensive and in such circumstances sentinel node biopsy would be done here more than likely. No sentinel node biopsy though on the prophylactic side as there is no evidence of cancer in it. |
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Question:
#2235
01/21/2003
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I recently had a mammogram show a 2.8 cm nodule. They scheduled an ultrasound for 4 weeks later. They said because my tissue is dense they could not locate the area and that I should follow up in 6 months. Im 39 and although there is no family history of cancer, I have several factors that put me at a higher risk. I felt uneasy because they could not determine if it was a cysts, so I made an appt. with a breast surgeon but could not get in for 6 wks.At first she did not seem concerned until she saw my film and realized they did not have a prior mammogram with the same view, so there was no way to tell if it was there before, and because of the size she felt they should have been able to locate it. It did look benign but she sent me for spot mam. and ultrasound.Once again found on mam. but not ultrasound so they did a ge 700 ultrasound and finally located it. They said it was not a cysts, probably a fibroadenoma. The doctor said I should either have it removed or wait and do a followup in 4-6 months. She did not act like it was vital it be removed, she just said there was no way to tell for sureand that usually if they are over 1 cm. they want to remove them. She said it would be day surgery and I would have a local, What does that mean?, and is there a type of biopsy that would show whether it was cancer. I know it is oval shaped and smooth edged but is very deep and hard to locate. I know I shouldn't worry about the money but my deductible is 2,500 and I wonder if a biopsy would be less expensive and yield the same results. Thank you for any information you may be able to provide. |
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The shape is a good sign-- oval and smooth. It is true that the only definitive way to know is removing it. A needle biopsy may confirm what it is-- benign vs malignant. You have received 2 opinions thus far pointing toward it being benign which is good news for you. "local" means that you will be given local anesthetic in the breast and not be given general anesthesia. Sometimes biopsy is close to the same expense as removal of the mass so ask the doctor for a price quote. |
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Question:
#2236
01/21/2003
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how is the surgery done after then needle is inserted in the breast |
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The patient is then taken to surgery after the wire is placed in mammography marking the center of the abnormal area to be removed. In some cases a doctor may also use blue dye to further mark the spot. The wire serves as aa guide for the surgeon, along with the mammograms that were taken after the wire was placed. The surgeon cuts the tissue down to where the base of the wire is located and excises the area in question. |
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Question:
#2237
01/16/2003
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I have to have a biopsy of the axilla or something in the axilla tomorrow. I didn't know you weren't supposed to feel it or put hot packs on it or press it with your finger. I have done all of the above, today my doctor don't me I shouldn't have done that, but he didn't tell me why. Anyway the gland is much smaller and I'm scared I may have sent something horrible through my body by messing with it. PLEASE tell me if this is possible or what I may have done. I'm sorry to bother you but I am so scared. Thank you. |
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Since I'm not sure what he suspects the findings to be on biopsy it is hard to give an opinion about this issue. So ask your doctor if he feels any harm has been done. The answer is probably that it is okay, but go back to your surgeon to confirm.Also ask for written instructions going forward so that you know what is and isn't okay to do. |
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#2238
01/14/2003
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My doctor wants me to have a wire localization in radiology to pinpoint the calcification that was detected on my mammogram. Then I would be moved from radiology to the operating room for the biopsy surgery. My question is - isn't there another way of finding the location of the calcification while in the operating room, maybe by ultrasound, etc. Thank you for taking the time to answer my question.
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Actually there isn't any other way other than mammography to find calcifications and doing a needle localizatin procedure is the correct standard of care for this type of biopsy. Sounds like you may be worried about what you will experience in mammography? the doctors usually give local anesthetic before inserting the wire which is the diameter of a strand of hair. Don't fret over it. This method provides the accuracy you need so the surgeon can go right to the spot that warrants removal and pathological evaluation. |
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Question:
#2239
01/13/2003
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I had endometrial cancer two years ago - now after having a rodeo mri - they are saying biopsy for infiltrating cancer - and my Dr gave me one of these oh no here we go looks. what am I in for ? AM I likely to have cancer pop up everywhere. i am 51.
Thanks
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There is a relationship between some types of cancers--- hormonally driven cancers such as uterine, ovarian and breast... when you've had one there is a risk of developing one of the others, but most women don't. The rodeo MRI finds everything and anything going on in the breast, including artifact that can look like trouble but actually be no trouble at all. so take this a step at a time right now.. get the biopsy under your belt and then let us know if you need our help further. we will hope for benign results for you |
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Question:
#2240
01/13/2003
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My right axilla was swollen and under my arm I was very "sweaty." After a couple of weeks when it only decreased slightly in size, I went to the doctor. They said it could be swollen for a number of reasons, but I should have an ultra sound. I had a mammogram and ultra sound and it showed a dark circle that the radiologist said looked like fluid. The mammogram showed a "cyst" and said I should repeat the mammogram in six months. I went back for the mammogram and it was fine, they also did an ultra sound, while I was there with the radiologist I asked him to take another look at the swollen gland. He did the ultra sound and asked me how long I had, had it? I told him that's why I was there to start with months ago. He called when I got home, said the gland looked different and bigger and said I had to have a biopsy. He said it was black and there was no fat in it. I'm scared silly, I will get the ulta sound, but what does this mean. Do I have cancer or what? Please answer quickly I'm so scared. |
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there isn't a way for them to tell at this point---so that is the reason for recommending a biopsy. Don't panic. You are in limbo right now without defined answers but soon will have them. Fear of the unknown is far worse than knowing , even if the news isn't favorable. The deion isn't particularly worrisome so think positive and let us know if you need our help further post biopsy. |
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Question:
#2241
01/13/2003
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I recently had a stereotatic core biopsy performed on one of my breasts due to calcifications and the diagnosis was: fibrocystic changes and ductal hyperplasia with microcalcifications. I went for a follow-up visit with the doctor to go over the results, but I'm not sure I understood exactly what this means in a manner in which I can understand. I need some assistance on this please. I am also to return for a mammogram in six months. All of the calcifications were not removed and they inserted the clip for future mammograms to pin-point the exact area of calcification cluster. The doctor said these calcifications could still turn cancerous someday. Could you please clarify this as well? She said they didn't remove all of the calcifications since they were benign, but I don't understand why they wouldn't remove them all if they could one day turn into cancer? Please help and thank you in advance for your assistance! |
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the results were benign which is the good news! there was no mention of "atypical" cells in your post which is also good news. It isn't clear why they mentioned that the calcs could "turn into cancer" though--- if benign now they will be benign later. This doesn't mean to say that you can't develop new abnormalities including a new cluster of calcs that may be suspicious for cancer. hope that is helpful. rest easy.. |
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Question:
#2242
01/13/2003
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My 18 yr old daughter had a 4cm tumor excised which is determined to be malignant phyllodes. We live in Vermont, but my daughter attends college near Rochester NY.
Would you recommend large margin excision or mastectomy? and would you recommend one breast clinic over another? I know Dartmouth is doing a study on the adjunct of radiation therapy - what do you think about this treatment approach? and do you have an opinion on the clinic options? Any and all help is greatly appreciated!!!
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We're sorry but it's not possible to give a medical recommendation via the internet.She would need to have a formal consultation with a surgical oncologist, have the pathology re-reviewed, be clinically examined as well as look at her mammograms, ultrasounds and other scans done to evaluate her condition/prognosis. Usually in very young women mastectomy is more often done but not always. It will be of value for her to be treated at a large cancer center where they have experience with young women having also been diagnosed. So ask about their experience and volume of patients...As you know 18 is very young to be diagnosed with breast cancer. She will probably be advised to do aggressive treatment as a result. Additionally if you would like support contact "Mothers Supporting Daughters with Breast Cancer" at www.mothersdaughters.org |
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Question:
#2243
01/13/2003
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Two weeks ago I wrote you about an ultrasound that said hetereogenous hypoechoic lobular focus. I was scheduled for a FNA this morning. The technician and the radiologist could no longer find what they had planned on doing the biopsy on. She suggested that it could have gone away. How is that possible in on only three weeks. Also since my report said possible cluster of cysts could they all have gone away like that without a trace. As I had stated in my previous e=mail, I am one year post treatment for invasive ductal carcinoma for my other breast and the breast I had the new ultrasound on I was diagnosed with LCIS five years ago. At the radiologist this morning, she told me to come back in six months and they will follow up. Is it possible that the cysts could be hiding behind tissue and they just could not see it. Since I already had cancer, it goes without saying that I am extremely stressed about this and keep thinking that maybe something is there and they just can't see it now for some reason. Does any of this make sense to an expert like you and if so how does something appear to be possibly solid one week and then three weeks later disappear? Of course had they done the biopsy at the time of the original ultrasound three weeks ago i wouldn't have been put through this incredible strain i feel. Thank you so much!!!!! |
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sorry you are having to worry with this for a longer period of time... masses and cysts can "go away" but when they are clustered together it is unusual for all of them to be gone at once. Cysts can spontaneously rupture on their own sometimes. Consider having your films re-read by another mammographer to give you more confidence that its okay to wait 6 months. |
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Question:
#2244
01/13/2003
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I recently had a spot mamogram and an ultrasound. This is the result:
History: Abnormal finding on recent mammogram with increasing nodular focus between 4 and 6 0'clock.
Technique: Left diagnostic mammogram followed by a left breast ultrasound.
Spot compression views of the left lower central breast confirms the presence of a small ovoid nodular focus centered at approximately 6 o'clock which appears to be slightly larger than one year ago. The surrounding parenchyma is otherwise unremarkable.
This was followed by a left breast ultrasound where 6 o'clock area is normal in appearance. There is a small nonspecific hypoechoic shadowing focus (what does this mean, a nonspecific hypoechoic shadowing focus?) between 3 and 4 o'clock, without a correspoinding mammographic abnormality. This is perhaps related to some scarring in this patient who has undergone reduction surgery (it was not reduction surgery - it was a breast lift 20 years ago). A small 5x3 mm cyst is incidentally noted at 9:00 medially. This finding is also not identified by mammography.
IMpression: 1. Slight increase in size of a small benign appearing nodular focus at 6:00 on the left by mammography, not visualized by sonography. Consider Mammotest biopsy (what is a mammotest biopsy?) of this mammographic focus. 2. Additionally, a nonspecific small shadowing focus at 3:00 in the left lateral breast should be redhecked in six months with repeat left breast sonography assuming that the stereotactic biopsy (what is a stereotactic biopsy?) of the 6:00 focus is benign.
A negative mammogram report should not be interpreted so as to delay biopsy of a clinically suspicious palpable mass.
Normal and callback notification letters are sent to the patient. Notification regarding need for breast biopsy or surgical consultation is directed to the ordering physician and patient.
ACR: 4 Suspicious Abnormality - Biopsy Should be Considered.
So, after talking with my doctor, she suggested the biopsy. Should I consider an MRI as well? The way I read this report is that a biopsy should be considered because they really can't identify anything specific or are they going to biopsy the "6:00 benign appearing nodular focus". Am I reading this right? |
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you are reading it right-- they can't definitively determine what it is without a biopsy. Stereotactic biopsy involves the use of a device that connected to a computer and helps pin point the exact spot that needs to be biopsied. It can even remove a single calcification with considerable precision. The "hypoechoic" relates to the amount of light that shines through the mass/abnormality. Scarring after breast reduction can cause changes in the breast tissue that look abnormal on a mammogram/ultrasound so don't assume things are cancer yet. Follow up with the doctor for biopsy and take things from there. we hope you get a good report. |
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#2245
01/09/2003
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A recent stereotactic biopsy for calcification revealed DCIS. Is it common to do a lumpectomy with sentinel lymph node removal for DCIS? Is there a reasonble chance the DCIS has spread to the node? |
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DCIS by nature of what it is, NONinvasive breast cancer, cannot spread to any node. If a patient has extensive DCIS, which usually warrants mastectomy surgery, then it is reasonable and prudent to do a sentinel node biopsy as there may be hidden in the DCIS a tiny foci of invasive disease. The value of mammography is catching breast cancer at its very earliest stage-- DCIS. stage 0 disease. The stage we can actually use the word "cured" when talking about treatment. |
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#2246
01/09/2003
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what is the difference between a stereotactic core biopsy and a mammotome? |
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mammotome is the name of one of the instruments used for performing a stereotactic core biopsy. |
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Question:
#2247
01/07/2003
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Is it true that most biopsies lead to surgery to remove the mass? If so, why not just go in initially and remove the mass rather than have a biopsy and then the surgery? Thanks. |
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its important to know what is being removed before it gets removed... taking out something that is cancer is done differently than something that is benign. that's why |
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Question:
#2248
01/07/2003
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I am schedualed for biopsy and removal of three ducts due to brown discharge from these (positive for blood). How does the surgeon know if the ducts alone are to biopsied or if the connecting lobes are also possible cause for the symptoms?I had no changes on my recent mammogram- when compared to one 18 months ago- when I had biopsy for a "suspicious area" -that turned out benign. I was having the same symptoms of discharge then. Also, my ducts with the discharge are on opposite side of the areola- will this cause any unusual cosmetic concerns as to the final appearance?How deep do they go to remove the ducts? Thank you for this tremendous website! |
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Having a surgeon who is experienced in doing ductal surgery is key. Plus a ductogram helps to guide the surgeon as to which ducts are involved and to what extent he needs to go. The cosmetic outcome needs to be discussed with the surgeon as it is dependent on the size of the breast, location of the ducts, size of the ducts and such. take care |
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Question:
#2249
01/07/2003
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I recently had a stereotactic biopsy for calcifications in my right breast. The calcs were removed and determined to be precancer. The surgeon wants to do a lumpectomy. How fast does this precancer grow? What are chances that it will grow back in this area? Should I get a second opinion on this procedure? |
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rest easy. precancer is exactly that-- cells that aren't cancer yet and usually grow very slowly... sometimes never becoming cancer at all. it may be helpful to get a second opinion on re-reviewing the pathology too. Precancer usually is Atypical ductal hyperplasia. noninvasive cancer is ductal carcinoma insitu. ADH warrants a bigger biopsy to ensure there is only ADH there and nothing else. DCIS warrants resection (lumpectomy ) and depending on the amount of DCIS then possibly radiation. |
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Question:
#2250
01/01/2003
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I had a biopsy on Nov. 22nd. Had 2 lumps removed one from each side. The right side is healed very well. I thought the left side was too. But it is still tender and swolen, 2 days ago after I got out of the shower the incision busted open and i have a yellow discharge with blood mixed in with it. I went to the ER and they said It was ok but they left it open. Does this sound right to you. |
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well, it's not okay if that's what you mean... you need to return to the doctor who did the procedure and be seen by him/her and probably get on some antibiotics and possibly have the area more carefully evaluated and possibly drained. Sounds like a pocket of fluid formed post op that became infected. So see your surgeon so you can get this resolved. He will probably recommend packing it and having it slowly close from the inside out. |
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