UPDATE: can i request a biopsy?

Sunshine9504

its been a little over 5 months and i got my letter telling me i needed to call and schedule an appointment and this time they only wat to do a bilateral ultrasound. so i made my appointment and i was on Wed December 28 and she said i could call and check on my reports in 48 hours, well my doctors office called me yeasterday to tell me he wanted me to come in and go over the report. I just returned from that appt and he is sending me back to the surgeon. Back in July when they sent me to him he did a ultrasound but felt the biopsy wasnt needed at that time. Is there anyway i can request one be done? this is very nerve racking plus expensive just to be told ah its ok we'll wait and see next time. ( i'm scared next time might be too late) when i was at doctors i got a copy of the US report and it looks like one area has gotten bigger, im not sure i just know this really scares me!!!!! any suggestions?

marie5890

Hello Sunshine.

Absolutely. Be clear with the surgeon

"Dr can we just biopsy this and know definitviely? The anxiety has been interfering with my life and I just want to know one way or the other" 

37antiques

Sunshine, Did you get to see a copy of the report?  Did that say they see anything?

Always remember your doctors work for you, that's what you're paying them for, so you can ask anything you like and expect to have answers clearly explained to you.  You can at the very least call them and ask why they feel the referral to the BS was necessary.  If they aren't explaining it to you, how can you make an informed decision about anything?

Hang in there!

cycle-path

I'm a big believer in communication. If the doc doesn't like the idea of a biopsy, ask him/her to explain his/her reasoning. You may not succeed at "demanding" a biopsy, but you DO have the right to demand that the doc explain his/her thought processes in a way that makes sense to you. 

Sometimes a comprehensive explanation will change the patient's mind. And sometimes, when forced to explain his/her reasoning, the doc will realize his or her reasons really aren't that good and will end up making a different decision. So, whatever else you get, get that in-depth explanation!

Kaara

If there was a lump or a suspicious area that was being "watched" and I wanted a biopsy, if the doctor didn't agree, I would ask for all my reports and get a second opinion.  You have a right to have the care that you are comfortable with, and if an area bears watching, a biopsy should be an option as well.

Sunshine9504

thank you all for your replies. i have seen a copy of this latest ultrasound they did it states:

reason for study : bilateral breast mass

 this is a 6 month follow up

imaging directed anteriorly both breasts where on the right there is a persistent stable 1.0 x 0.7 x 0.8 cm hypoechoic or solid nodule with echogenic center that is suggestive of a an intramammary node. Other small benign-appearing nodules again noted in the periareolar regions.

the last ultrasound that i had i need to find it but i know this new size is bigger than the last time. can anyone explain this to me, or give me any suggestions as to whether i should have the surg. do a biopsy? it just gets expensive to go and him to just say oh we will wait and check it again next 6 mths

beepbeep

Sunshine, I know how you feel. If possible, always try to do at least a needle biopsy on any breast lump. Especially if you are worried. It's easy to say and very hard to do, I know. I never imagined myself getting a biopsy but I did it. It's really not that bad. It hurt very briefly, like getting ears pierced. I'd do it again if I had to and I probably wouldn't dread it nearly as much. I had a sweet nurse talking me through it. I think mine hurt a little more than it was supposed to because I didn't speak up. I'm sure they would have given me more local if I wanted. I think the biopsy will bring you closer to peace than an ultrasound can. It probably is benign but this will help you know for sure. By all means ask for it if they don't offer it. These days it's a bit unprofessional for a doctor to be passive about any breast lump. Find another doctor if this one gives you any trouble, Good luck!!

I wonder what hypoechoic with echogenic center means. I have a report that says those things too. Does it mean anything when it's hypoechoic and echogenic? Just curious.

Sunshine9504

thank you and im not sure what it means either

Momine

I looked it up and "hypoechoic" means that the tissue reflects too few of the ultrasound waves.

Sunshine9504

is that a good thing? or bad? and why would he send me to a surgeon again? he sent me on my last 6 month check up as well

marie5890

I think they are sending you because it grew.....Im guessing that is why you were on 6mon follow up...to see if it grew....

Sunshine9504

well on my first report 6 months ago they had it at 11 x 6 mm now it has 1.0 x 0.7 x 0.8 cm so i guess it did. they dont tell me a whole lot and my doctor is sometimes very hard to understand 

cycle-path

Sunshine, it doesn't sound to me as though it's grown. 11 mm is the same as 1.1 cm, and 6 mm is the same as .6 cm. So:

Six months ago it was 1.0 cm x .7 cm

Now it's 1.1 cm x .6 cm.

Basically that's the same size. While it's in the breast it can't be measured precisely, and something that's measured as 1.0 cm by one person could easily be measured as 1.1 or 1.2 cm by a different person. 

Sunshine9504

then i wonder why he is insisting on me seeing the surgeon again? thats an automatic $100  and i just cant afford to just had that money over for him to tell me the same thing he said 5 months ago. i dont mind paying it if he is gonna do test but for him to just talk isnt telling me anything.

A_FIGHTER

Hi Sunshine9504...

Just to give you some background and be your own advocate: I felt a lump three days before my mammo. I didn't say anything the day of the mammo because a part of me wanted to see if the mammo would pick it up. The mammo didn't pick it up (which is not out of the ordinary). I then saw my Obgyn and he said let's schedule an ultrasound to be sure. I had the ultrasound and the technician did indicate to me it was not a cyst. The results came back and I was told to come back in 6 months. My mother works in my Obgyn office. The mammo tech, my Obgyn, and a very reputable Breast suregeon all agreed everything was fine and to wait 6 months. I was not at all happy with this. Now mind you, my past mammos (I have very dense breast) I've had follow-ups in 6 months and then when it was switched to a year I still requested 6 months and I was fine with that. However, something told me different with this and I went with my gut. Now, perhaps seeing my friend go through all this (diagnosis, surgery, treatment) in the last few months influenced my push as well. I saw a Breast Cancer Specialist on my own. He did an ultrasound in his office. He then gave me options for the next step which I chose a biopsy. The biopsy came back positive with DCIS/DCI.  This was Oct. 31st. I am now home recovering from a bi-lateral masectomy with reconstruction. My final pathology came back yesterday. I have now found out it is Grade 2, w/ 1 lymph-node involvement - micrometastatic carcinoma (we thought going in I was clear), Nuclear Grade II-III - necrosis present, central expansible comedo necrosis, margins uninvolved. Now, the right breast (I only had cancer in left breast) came back with - focal atypical ductal hyperplasia in lower inner quadrant - basically the Dr. told me I would have seen him down the road with cancer in my right breast and we made a good choice in a double masectomy.    

With all this being said, I can't imagine what the circumstance would have been had I waited six months like I was told.

Go with your heart/gut, whatever you feel...You are your own advocate!!!

Sunshine9504

thank you! i wish you luck and im sending you many huggs

Shawna

cycle-path

"then i wonder why he is insisting on me seeing the surgeon again?"

I think you should call the office and ask this. 

Tenmom

A fighter... Necrosis found? I was diagnosed with fat necrosis. Is necrosis part of cancer ?

Sunshine9504

well i got my appt letter scheduled to go to surg. on the 10 th like last time this will be a consult then he will schedule me to come back for the procedure then i'll go back and he will say i think we should just wait and see. But instead im gonna open my mouth and ask questions and see if he can do the procedure or if its a wait and see then im gonna do a follow up in 6 months, my doctor isnt telling me anything other than he wants the surg to look at it and use his judgement. my doctor doesnt return my calls. I think after this appt i'm gonna look for a new doctor 

marie5890

Tenmom, 

Relax. (big smile) "necrosis" just means "dead". Have you ever heard of the term "necrotic"? as in necrotic skin from a wound or a burn or something?

Your biopsy showed dead fat cells. A-Fighter's pathology showed dead cells.

All cells, cancers or otherwise, end up "necrotic"...We all end up necrotic sometime... 

A_FIGHTER

Hi Tenmom & marie 5890,

Thank you marie5890 for answering Tenmom  

Sunshine9504

hi everyone, well i'm gonna take (all) your advice and i'm gonna question the doctor today as to why the need to return to him (the surgeon) and ask lots of questions (gonna try at least) i get nervous and kinda shut down, but i'm gonna do all i can to go in there with my head up and my mouth open.  thank you all for your advice and all the information.

 i got 2 1/2 before my appt 

Layla2525

So right Kaara...sometimes you have to get a second opinion or fire your dr and get a new one.  I had gotten a new surgeon and I think she is not gonna have anything left to remove during the surgery as she is biopsying me to pieces..lol...but seriously my fiance needed a stent and had to go to 5 drs before he got one put in.  He really has a problem with blood flow and hearts and cholesterol inherited and I got the breast cancer probably inherited. awaiting the genetic testing altho I hear only a small percentage of breast cancer is inherited. If you dont feel you can push for the biopsy on your own...see if you can take a pushy friend with you.  Crazy as it sounds, sometimes that helps.

Leah_S

Sunshine, it might help if you write down your questions and bring the list with you. It will help you to focus, and it will also make you less nervous.

Best of luck.

Leah

marie5890

Sending good thoughts your way Sunshine. 

Sunshine9504

Well the surg didn't know why the doctor sent me back to him because I'm not due for a followup until feb. 2012. He had 2 students in the room which I was not comfortable with at all. The dr proceded in a breast exam but thos time he was a little for thorough. He felt a new area and it was very very tender. It was right down by the side of my left breast close to the arm area. So now he is sending me back for another mammo and then he wants to do another US immediatly after I have the mammo done. He is gonna investigate the new area and make sure nothing got overlooked...... Is pain/ tenderness common?

Sunshine9504

Ty Marie5890 thank you everyone. HugGgs to you all!!

Sunshine9504

UPDATE:

well i went in for the mammogram that my surgeon requsted since they didnt do one at the december visit and they only did the right side. and as i was waiting like they ask they came and said they want to do an ultrasound and i informed them that my surg dr wanted to do that himself this friday but they said they still want to do one so they will know. While they were doin this one i notice several things were different, one of the areas they were measuring was real fuzzy ( grainy ) looking. most of the other areas were almost clear inside were they measured and she also did some kinda of color enhancer and she took pics of that. then she made me wait while she went out of room so she could make sure she got what she needed ( never did that before ) then about 5 min later came back and said ok we done. your doc will get results....for a whole week i tried not to even worry about this and then it went out the window with that visit......... is there reason for concern in this new order she did things?

I know i'm a bother to some of you and i'm really sorry i know yall are just as scared as i am.

 huggss to you all

cycle-path

That all sounds entirely normal to me. Did they tell you when your doctor would get your results?

Sunshine9504

48 hours but i go back to the surg this Friday, this whole thing is very stressfull and i sure hope that its not cancer but if it was wouldnt someone have already told me by now??? i mean all this back and forth doctor to doctor test to test with no real answers is leavin my mind running wild with the what ifs

kimmy43

I no exactly how u feel.its so stressful the back and forth test after test.I have microcalifications and i keep getting them.have had this problem since 07.They all have been benign but these are clustered  together so i have my six month followup feb 11,three days after my b-day.  I am  so worried i dont no what to do.i havnt had any changes sice 2010 but i dont no why he wants to see me back. I usually go back to annually but he says because of my age.That  really scares me but i am only 43.Cant wait to that day comes and goes for the test so i can celebrate my b-day without having to worry.Take care.