More biopsies scheduled, MRI denied.

VanillaPudding

I have extremely dense fibrocystic breasts and am almost 44 years old.  I have innumeral cysts (30 on left and 25 on right as of US last week) and have had 3 confirmed Fibroadenomas found on previous biopsies.  I just had another 6 month follow up, never have gone more than 6 months in 4 years, Mammo and US last week.  I now need 3 new areas biopsied, all new findings since Mammo/US and biopsy in November.  I was given the option by the Radiologist of getting an MRI or going with the biopsies.  I choose MRI since my last one was 18 months ago.  I have had 3 biopsies in the past.  Insurance denied the MRI and now I HAVE to get the biopsies.  I was really hoping to just get the Mri and get a complete picture of what is going on before I am subjected to biopsies again. 

I have been having a lot of issues in the right breast in the upper quadrant.  The 3 lesions are in the right breast at 7, 10 and 11 o'clock.  I also have an enlarged lymph node in my right axilla.  I am pretty sure these are just Fibroadenomas again.  My previous Fibroadenomas have all come back as complex.  At what point should I have one, or more, excised and tested?  I have only had core biopsies before?

I know the whole "remove or not remove" a Fibroadenoma issue has been discussed before.  Given my age, and history of Complex" pathologies I think I might push for excision.  I am not really sure what I want to do.  This stress every 6 months is getting to me.

Waiting for date of biopsies............

Cowgirl13

I can understand why you would push for a biopsy. A biopsy could tell you what you are dealing with. Good luck!

Gina72

It's insane that insurance companies would rather pay for multiple biopsies at once and not approve the mri. I am right there with you. I am 43, lots of cysts where they don't even count the simple ones anymore just the complex ones. Three biopsies, 3 fna's of complex cysts, and many simple cyst aspirations because some keep growing over 5cm. Just had birad 5 biopsy in April that came back as another complex fibroadenoma, doc had said she has never seen a fibroadenoma with so many malignant features. My first one came about in 2013. Breast surgeon says she prefers to leave them alone as long as they stay stable, will follow up in a few months for another US. Biopsies have shown moderate ductal hyperplasia and apocrine metaplasia and part of me says get them out as things keep progressing but I want to trust my surgeon as long as they stay stable and be thankful they are benign. I am pondering a second opinion. So many here say to remove because cancer can hide and be missed.

Do you see a breast surgeon? How old were you when your first fibroadenoma appeared? Are you previous ones in the right breast too or bilateral? Just curious as I have never found anyone my age with multiple complex fibro's.

Hope your biopsies are soon and benign. I know it stinks to have such have busy, rare breasts!

VanillaPudding

Gina,

Exact same scenario.  Mostly complex cysts and all Fibroadenomas have been complex. I do not officially see a breast surgeon.  I work with one, and have had many "hallway consultations" with her.  She is a wonderful surgical oncologist, yet tends to be very conservative with the watch and wait approach.   My PCP is not very knowledgeable about breast issues.  My Gyn Dr. does not deal with breast issues.  I am being my own navigator.  I am waiting for biopsy dates from Radiology office.

Here is some of the pathology from my Fibroadenomas:

Apocrine Metaplasia, Moderate Usual Ductal Hyperplasia, Sclerosing Adenosis, all making them Complex.

I also have:

Extrememly Dense breasts < than 90%!!!, Diffusely prominent Ductal pattern, Segmentally dialated ducts, simple cysts, complicated debris filled cysts, septated, clustered, and bilobed and complicated multiloculated septated cysts, nipple discharge and a constant changing nipple.  It is growing. 

So basically my breasts are very busy.  I currently have 30+ cysts and 4 Fibroadenomas on the right, and 25+ cysts and 2 Fibroadenomas on the left.  3 of the (suspected) Fibroadenomas are new since November.  My twin sister just had a Mastectomy in January due to all kinds of atypia, ADH, ALH, FEA, and PASH.  Everything I have is benign.  I just happen to have every single benign issue it seems.  Clearly I am progressing downhill, just not sure how to stop it.  I think my next step should be 1.) Biopsies x 3      then 2.) after final pathology, regardless what is says schedule at least 1 excisional biopsy.  I just want complete pathology,  not just a sample.

 

VanillaPudding

Home from biopsies.  Lots of Lidocaine so not really hurting.  Had a great conversation with Radiologist as she was doing biopsies.  She took 16 samples from 3 areas so that was good.  She recommended the same surgeon I was thinking of talking to, and the Radiologist also agreed  that excising at least one Fibroadenoma would be a god idea for complete pathology.  She even told me which one to take out.

So other than waiting for pathology on these samples, it was a good day.   And now I wait.............

Gina72

So glad you didn't have to wait long for biopsies. Will be waiting to hear your results. Yes, sounds like a good idea to get at least one out and get another opinion.

carrol

i had a breast biopsy and they put a titanium pin marker. My biopsy came back benign but pin caused breast infections. Went to a surgeon to try and have pin removed so many infections tokk antibiotics . surgeon said be to difficult to remove it. Now staph in breast I fear has set off cancer u have cancer genes and I am hyperallergetic. My body was trying to reject pin marker for 2 years breast trying to reject it .was like a sliver in there . now I am afraid of what staph in there has set off. Cancer follows infections. Concerned . I have been sent to a surgeon because xray shows a ma's now around pin marker.

VanillaPudding

Great news!  Benign, all three!!!!!  Excited but confused.  I was told by my Dr's office it was good news not great news.  The initial pathology report says "areas of columnar cyst formation and surrounding fibrosis", and another says "columnar cysts formation and fibrosis".  I have heard of columnar cell change but not cyst formation.  This is from an Ultrasound guided core needle biopsy.   Yes I did a quick search here and google, not coming up with much.  Any help?  I know the fibrosis is nothing to worry about, all three results said it.  The cyst part is confusing me as all these were solid masses.

Fakeboobs123

My pathology report read negative for Cancer/malignancy before it got into nitty gritty of what tissue actually was, does the report say that, all the language you describe sounds good. I had the physicians assistant at the Breast clinic call and explain the results before I saw it in writing, Those bloody insurance companies I was told my MRI was preauthorized and now I'm paying over50% of the costs of it. For what its worth the area of concern was also found on a diagnostic ultrasound though I will admit they used the MRI as a reference point.

VanillaPudding

Fakeboobs12, that is my confusion.  All of my previous biopsies stated in final pathology what the mass was, and what it consisted of, ie: complex fibroadenoma with apocrine metaplasia, moderate usual ductal hyperplasia, sclerosing adenosis and microcalcifications.  This report just says "Benign breast tissue with nonproliferative fibrocystic changes with columnar cyst formation and fibrosis."  So, were they all cysts or FA's?  Regardless, it is benign so I am happy, just confused.