Risks of removing benign growths

Janeway69

Hi,

I am waiting for MRI results after a diagnostic mammo and sono. Sono found cysts, but mammo found something the radiologist said has no explanation, but he does not think it's another cyst or perhaps even related. I guess because of my age, he ordered an MRI rather than a biopsy directly. I hope that's a sign of non anxiety on his part BUT.......

I asked about simply removing the area of concern with wide margins regardless and he said it was medically unadviseable. "Do you want to risk scarring and infections?"

Okay, infections can be bad for sure, but I would think it's a center's job to minimize that risk. And scarring? I thought he meant outside in which case I thought, compared to cancer, who cares??!!

But now I am learning from reading that there can be internal scarring that can make future screenings more complicated? Okay fine, but is that a reason to not do it?

All my GYN said was "That comes with risks too" but we did not go into it for now.

So,why all the hesitancy on the part of the doctors? Okay they don't know what it is yet but why leave ANYTHING there?

ballet12

Hi Janeway,

It sounds like you have done a great deal of reading.  It is true that they just don't biopsy unless there is a reasonable degree of suspicion that it is cancer.  It's likely that they are pursuing the MRI, in your case, to see if the same area is seen on the MRI (it might not be--different imaging can show different things) and if it is suspicious looking on the MRI. As I'm sure you have read by know, they "grade" the findings on imaging on a BI-RADS system, and they usually only biopsy areas that are rated either "4" or "5".  You can read further on this website about that rating system.  That means that there is greater than a 3 percent chance of being cancer.  For BI-RADS  4, only about 20 percent of biopsies are found to have cancer.  For BI-RADS 5, there is a much higher degree of certainty of cancer.  They are about 95 percent certain.  So, they usually don't biopsy areas where they don't see characteristics in the imaging which make it at least possible to be cancer.  About the "internal" scarring, well that is actually a big deal. If they biopsied every oddity that they saw on imaging, most women would be having biopsies after every mammo/sono.   Also, when they biopsy, if they don't have a diagnosis of any kind, they don't do "wide margins".  That is only when there is known cancer.  Try to take this one day at a time.  Best of luck, I know that the process can be terrifying.

Janeway69

Actually the BI RADS ratings are the one thing I have not completely learned about yet. Well, okay not the ONE thing but...

So if someone had a 3% chance or less of having cancer, why would anyone NOT biopsy? 3% is still a considerable chance in my mind, when it comes to cancer. I don't think you'd want to chance someone being let go and being in that 3% would you?

I'm also not clear about the explanation on scarring. Are you saying it can cause odd things to come up on future mammograms/sonograms which will MAKE them do more biopsies?

I'm just trying to figure it out. The way you wrote "About the "internal" scarring, well that is actually a big deal. If they biopsied every oddity that they saw on imaging, most women would be having biopsies after every mammo/sono", those look like two separate sentences to me that are not necessarily connected or talking about the same thing. It looks like you could simply be saying internal scarring is a big deal, and then changing the subject, because "If they biopsied every oddity..." is something that could be considered generally true I suppose.

BTW, that third paragraph may indicate anxiety to a lot of you, but this is how i converse with people more than half the time normally. LOL!

Not that I am not nervous. I am!

Thanks!

Fakeboobs123

I have had two cosmetic surgeries on my breasts, first implants, then a mastopexy/uplift with implants, they were ten years apart or there about. Now I had an MRI recently, because you have to, to see under implants. They found a "nodule.. Suspicious abnormality", it was BIRADS 4 and they did the biopsy and it came back as normal Breast tissue, the radiologist concurred and the Breast surgeon said surgeries can cause changes in Breast tissues that will be picked up on screenings. Also statistically your chances of getting Breast cancer is raised after having breast surgery. However, the basis of that statistic may come from women having excisional biopsies..and risks for Breast cancer is also greater in those who have had previous biopsies. This may not be due to the surgery itself but due to simply being prone to abnormalities. I do not think the link between previous Breast surgery and cancer is significant by the way

bellajenn

Hi Janeway - I completely understand your worries. This community is a great place to get some good information. I would caution you on just Googling things because you will find either conflicting information or may end up scaring yourself more. In terms of whether or not it is advisable for your doctors to just take everything out, including a wide margin, there are reasons they are being cautious - and hopefully they will communicate clearly with you their plans.

I asked the same question when they found a 2cm lesion in my right breast - why don't they just take the whole thing out? You can see it on the mammogram and sonogram - if I can see it, shouldn't it come out? The resounding answer was that doing a biopsy first to get a handle on what the lesion could be was a less invasive way to deal with it. If they just cut in there and excised it without knowing, they might not take the margins they need to later on if it ended up being something worse than a benign lesion like my complex sclerosing lesion. The ultrasound core biopsy allowed them to take samples to test it first. It didn't hurt me that much, and I healed fast.

Now that they have an idea of what they're dealing with due to the core biopsy, there can be a clearer plan made. When I go in to have the lesion excised, they may take some margins as well since it can hide cancerous cells. I understand now that precision of dealing with my situation means taking steps, even cautious ones. But I completely get what you're feeling.

Hang in there!!!

ballet12

Hi Janeway, you are accurate that I wrote two sentences that were not really meant to be connected with each other (about the internal scarring and the biopsies of oddities).  I was sleep-deprived (moving offices/lots of paperwork and other stuff).  It should have been two separate paragraphs.  My apologies, although (about the second issue) I do believe that they shouldn't remove everything that appears to be odd or different on imaging, and should biopsy when there is a reasonable degree of suspicion about malignancy.

Again, my apologies.