Bi-rads 4 mad at surgeon

pattimay

Just picked up my MRI report.  Surgeon is on vacation and forgot to ask him for it last week when I saw him.  NOw I just had surgery for the ADH and papillomas in December.  NOw MRI read:  1.7 x 1.2 cm irregular heterogeneous clumped enchancement posterior and slightly superior to the biopsy cavity in the left uper outer quadrant.  Suspicious for carcinoma. But not only that.  My surgeon last week said only in my left breast in the area I had the ADH he took out three months ago.  Report says heterogeneously enchaning nodule the right breast also.  Probably just focal fibrocystic change.  However given history of atypia MRI guided biopsy of right breast recommendated.  So how is this all possible that in three months I'm starting all over again???? If MRI with the contrast is so much more sensitive then why right before my surgery didn't I have one so this could have all been taken care of then?  Why after the first stereo-tactic biopsy showed the atypical cells did my surgeon not say to get an MRI to see if anything else was going on?  I'm confused and scared and depressed.

mawhinney

What type of surgeon are you seeing? You want to work with an experienced surgeon that has a special interest in breast care.

Why don't you seek a 2nd opinion.  Gather your records and questions and meet with  your current surgeon. Discuss your concerns and what treatments are recommended. Then meet with another BS to see what he/she would recommend for your situation.  Having a list of the questions I want to ask helps me stay on tract and get answers for all my concerns.  I also take someone with me to jot down answers & to remind me if I have forgotten to ask anything.

pattimay

He is a respected breast surgeon.  I like him very much because he spends time explaining and is compassionate.  I saw him the day he was leaving on vacation to Disney with his family and I'm wondering if his mind was elsewhere .  I went in with my mom and she too remembers him saying my right breast was clear.  He also said that he would wait a few months in regard to the finding in my left breast if not for the ADH that I had.  So I relaxed a little. I forgot to ask for a copy of the MRI but picked it up today.  I'm shocked to read that the impression is suspicious for carcinoma and Guided biopsy recommended with BI-rads 4.  The right breast does show something that likely represents focal fibrocystic change.  I'm thinking that he was reading the impression of my right breast instead of the irregular heterogeneous clumped enhancement they found in my left.  He said my right breast was all clear.  NOw I'm not trusting him making a mistake like this.  I can't even speak with him because he's on the vacation.  He said my odds in my favor and that he gives only a 10% odds I'd need surgery .  REading my MrI report tells me a different story.  I'm so scared that this is cancer by the wording. It says mixed enchancement pattern with areas of suspicious washout kenetics present.  Can this ever be a benign finding???

Anonymous

patti---MRIs are very good at picking up bc, but unfortunately they also pick up a lot of stuff that is benign, so chances are very good that these enhanced areas are benign findings.  I'm so sorry you are having to go thru this all again.  MRIs are not yet the standard of care, probably due to the high rate of false positives and that they are very expensive. I have LCIS and family history of ILC, and even with a much higher risk than you, it took me nearly 3 years to get my oncologist on board with MRIs (he felt they often lead to unecessary biopsies and anxiety). I have seen things start to change in the years since I was diagnosed (over 6.5 years now)---now they often do recommend MRIs for high risk, but it often depends on your doctor and of course on your specific individual risk.  Praying yours is just  post op changes from your excisional (perhaps you could ask the doctor if waiting a few months for the area to fully heal would be a safe option and then rescan to see if it is resolved?)

Anne

pattimay

Thank you Anne.  You've calmed me down so I can sleep tonight.  Guess I will feel better after the Core biopsy is over with.  It's always the waiting that's gets you.