Spiculated mass on screening mammogram

dew206

I don't know if I should even be posting here yet as I know so little. I had a screening mammogram at the end of January and the radiologist requested prior films which I had already signed for and they already had, but didn't realize until I called. This week I got a call from my doctor that they wanted spot compression views and possible ultrasound. When I saw the radiologist report it noted a new spiculated mass. Also that I have breast density value of D which I was previously unaware of. It had been 4 years since my last mammogram. My only excuse is that we moved and it took me a long time to get settled and find a new doctor. I have mashed and smushed and cannot find anything unusual by feel. I have always had lumpy breasts though. I was told more than 30 years ago that I had fibrocystic breasts. I am currently 53 years old and had taken continuous birth control pills for most of my adult life to alleviate severe headaches. Just came off them a week before the mammogram to see if I am post menopausal. Now I'm terrified that I have given myself cancer by taking them for so long and also given it time to get really bad by going so long without a mammogram. From what I'm reading a spiculated mass is almost certainly invasive cancer. There is no history of breast cancer in my family and in fact no history of any cancer other than my grandfather's lung cancer, but he was a lifelong smoker. All of my other grandparents lived into their 90s. My parents are in their late 70s and healthy, so I can't blame bad genes. My biggest question though is why, if it's almost certainly cancer am I being sent for spot compression and ultrasound. Why not biopsy? Is there anything they could possibly see with these additional tests that could make biopsy unnecessary? I just want to hurry up and find out what I'm dealing with and this just seems to be a delay. I'm a basket case right now and trying to maintain a normal demeanor with everyone around me is exhausting. Only my husband knows and I want to keep it that way for as long as possible.

marie5890

Hi Dew and welcome. Sorry to hear that you have a reason to be concerned.

Spot compression mammo's give them a closer and better look, especially since you have very dense tissue. It's often just part of the process. I would recommend getting copies of all the radiologist's reports, i.e. the screening mammo, the diagnostic ones and U/S if you end up having one. Based on what you said, expect to have a biopsy done.

Now to address some of your concerns.

1st) A spiculated mass is concerning, however there are a few things that can have that look and still be B9. One is known as a radial scar.

2) If it is cancer, you didn't give yourself cancer. The fact that you are a woman and are getting older are THE two BIGGEST risk factors. Things like family history, having had children, nursing children, etc., may have something of impact, but not to the degree you think. Most of the women here on BCO have no family history, are mothers and grandmothers and nursed their kids. And they still have BC

3)It having been a few years since you last mammo: with the density of your breasts being such that it is, and *if* it is indeed cancer, chances are you have had it for several years, but the density obscured it or would have obscured it anyways.

4)not being able to palpate it (feel it). Many women don't detect their lumps. Most are found thru imagining.

So, please, don't put yourself on any guilt trip. It would be wasted energy.

In the meantime, get those tests done, stay off of google. If you have questions, ask them here.

In the end, only a biopsy can give you a the actual diagnosis one way or the other. The radiologist's reports can shed some light, however.

Hang in there. The waiting is brutal.

dew206

Thank you for replying. Number 3 in your reply is what really, really scares me. That it has probably been there for years. Wouldn't that mean it has more than likely spread and would have a much lower chance of survival? I know a number of women who have caught their cancers in the early stage and have done very well, but this wouldn't be early stage would it? I can't find any info on how long it takes to get to an advanced stage. My doctor gave me xanax but it's not helping. I can't think of anything else and have no appetite even though I get hungry. There's just nothing I feel like eating. How do people stay positive? I haven't even got a diagnosis yet and I'm just so depressed and mad at myself. I wish I hadn't seen the report. I had never even heard the term spiculated until this week

Numb

Hi Dew, there is nothing to say at the moment that just because you haven't had a mammogram for 4 years that your mass has been growing for the last 4 years. I had a mass this time last year but was told that it hadn't been there for long and my previous mammogram had also been 4 years before that. You are having an ultrasound to check things out further and this will probably give a good indication of what is there. You are probably still early stage because you had no symptoms of cancer and it is just your recent mammogram that caused suspicion. So don't panic.

MinusTwo

dew - stop guilting yourself. There is likely NOTHING you could have done. I had a mammos regularly since my 30s when they came out as blue line Xerox drawings. Every time I had dense breasts. Every year they found nothing. Then when I was 60, they started seeing new things or changes. I think it was the technology of the machines as much as anything. Mind you, there was still no 3D available, so I got the mammo every year and was called back every year for a 2nd screening and an ultrasound. Nothing was definitive or even recommended for biopsy until I was 65. So - had the cancer been growing for 30 years? Who knows. And in the end it just doesn't matter.

Ultrasound is the next step. You may discover it is not cancer after that. Biopsy is the step after that, and you still may discover your results are B-9. "Catching it early" is a 'catch phrase'. If it is cancer, there are many different kinds and characteristics. Some are growing so slowly that women (& men) might easily have lived to 85 and died of something else altogether.

Marie is right. 'dr google' has a lot of mis-information & outdated facts. If you want to research, do it here at BCO. We know it's a nightmare, but try not to put the cart before the horse.

dew206

Now I know that temporary hope is the worst. I had my spot compression mammo this morning and the technician was very pleased and positive. The mass seemed to disappear so for about 20 minutes while I waited for the ultrasound, I was feeling very good. Then I could tell from the ultrasound techs faces and murmurs that it was bad. One said "more like 3" and I asked what she meant and she said "I can't tell you". Shortly after I got home my doctor called and said I have to have an excisional biopsy now. I feel worse than ever now. This can't be good.

marie5890

Dew,

How can we help? Do you have some questions that we may be able to help (rather than turing to Dr Google)?

dew206

I don't know what anyone can do to help. I guess I just felt like telling someone, but I can't tell my family other than my husband. I've never been so depressed in my life. I just don't understand why something that looked so small on the original mammo and then disappeared on the next one could turn out so bad. And now more waiting for the next bad news

Icietla

I am so sorry you are going through this. All the wondering and waiting between procedures will feel like very long times.

It is fine not to tell others who do not need to know. Nobody else from my family of origin knows about mine. My husband, four other trusted friends, and my health care providers know about mine -- nobody else. If news of mine were generally known, there would be a steady stream of single women bringing cookies and casseroles for my husband.

dew206

I know that I will have to tell them eventually. My daughter is in her most stressful semester of college yet and I don't want to stress her even more and cause her to fail classes or drop out.And I could write a book about why I dread telling my parents and it's not just because it will make them sad.

marie5890

Dew,

If I were in your situation, I would hold off until you have a definite diagnosis before telling others. They may starting asking all kinds of questions that may

1)increase your already heightened anxiety

2) you simply won't have answers until you have answers.

That is me, however, so do what it best for you

dew206

Oh believe me I have no plans to tell them until I absolutely have to. I'm on such a roller coaster ride right now. Just got my biopsy appt scheduled for Monday and the nurse said that looking at my ultrasound she didn't know why they would have recommended an excisional biopsy. She thought I would only need a needle. But that will be for the doctor to decide I guess. She just seemed to think what the radiologist wrote was overkill and said most of these are benign. I have no idea what I'm in for at this appointment. I do hate to get my hopes up again

Icietla

Yes, most breast tissue biopsies turn out to be of benign conditions. We hope that yours will not be anything serious.

Is your next appointment with a Surgeon? Or with a Hospital or surgery center?

marie5890

Dew, the nurse was out of line by saying that she thought what the radiologist (who is a doctor) was overkill.

The radiologist is the expert in reading radiological images, not her.

The radiologist reported a spiculated mass if I recall correctly. That is something is typical removed, even when it's something B9 like a radial scar.

dew206

She didn't *say* it was overkill, just that she didn't see why he said excisional rather than needle. It was just my impression that she thought that. The breast surgeon will have her own opinion I'm sure. I see her on Monday. Also the mass that the radiologist circled on the mammogram as spiculated, disappeared on the spot compression entirely. I saw it myself. And honestly it didn't look anything like the pictures online of spiculated masses to begin with to me. Didn't look any different than the rest of the tissue that I could tell. Obviously I'm not a radiologist either, but I'm just saying it didn't look as obvious as I thought it would. At this point I have no idea what was seen on the ultrasound. They wouldn't allow me to look at it. Which was pretty scary. I'll never go back there for an ultrasound. The techs had no compassion at all in my opinion. I understand they couldn't give a diagnosis and I didn't ask them for one, but their whispering to each other upset me and when I couldn't hold back the tears any longer they just seemed mad.

Don't worry, I'm still scared out of my mind and overwhelmingly depressed.

marie5890

It's really hard not to try and read things into what the techs and nurses say, we know. We are looking for any sort of information.

Stay focused on the doctors, though, and what they say. It will keep what may seem like mixed messages down. Otherwise you will go crazy.

So what you know right now is that the radiologist, after the mammos and US, is recommending an excisional biopsy.

Don't listen to what techs, or nurses, say or try to read into any facial expressions. It will help keep you focused.

It's really really hard, we know. Because we are desperate to know.

Remember, doctors and doctors only. Those are who you want to listen to. They are the ones with the MD's in their area of specialty.

(((HUGS)))))

(Edit to add)

I went back to your original OP. Remember you have very dense breasts. That makes imaging more challenging, which would mean it would make a core needle biopsy also more challenging.

Hang in there.

dew206

So, I had my biopsy yesterday. The surgeon echoed her nurse's questioning of why an excisional biopsy was recommended. She saw no reason not to do a core needle, which is what she did. This time I was allowed to watch everything on the ultrasound screen and it was such a different experience. Since I was last on here I received a disk with still pictures of my original diagnostic ultrasound and it looks like they only took stills when the "mass" looked the worst. And the pictures were so much fuzzier than looking at it live. What it actually was, was a cluster of very tiny cysts. Depending on exactly how the wand was positioned, it looked like an irregular mass or a group of separate little black ovals. The surgeon said immediately that she was fairly certain it was benign and that's what the pathologist report came back as. I'm so relieved. I don't know if the ultrasound techs at the small town hospital I originally went to weren't very experienced, if the machine was bad, or if the stars just weren't lined up right for them to get a clear picture, but I feel like at the very least I would have had a lot less anxiety if I had seen the same thing on the ultrasound screen then as I saw yesterday. I also asked the surgeon about the "spiculated" wording and she said that was just because it had irregular margins on the mammogram. Like I had said before, it didn't look anything like the pictures on the internet of spiculated masses to me. I just wanted to report back in case it helps someone in the future not to panic. Even as bad as it sounded for me at first, it turned out OK. Oh, and the biopsy was no big deal! They told me the numbing shot would be the worst and feel like a bee sting. I tensed up waiting for it to hurt like a bee sting and it never did! Barely even felt it. The worst part of the biopsy was when the tech put pressure on it at the end to stop the bleeding. I was a little sore last night and less so today, but nothing horrible. The absolute worst thing was the anxiety in between.

MinusTwo

Good news. Thanks for reporting back.

marie5890

DEW so happy for you!!!

Thanks for coming back and letting us know.

Anxiety is really an awful thing, and I have no doubt it's one of the reasons that they want to change the recommendation of women having annual mammo's every year after 40 to after 50. Most issues are B9, but the pink washing we are exposed to sends women into a pool of anxiety.

That said, Ive seen enough women Dx-ed in their 40's that I am of the opinion that annual after 40 is prudent.

We just need to educate the public better. Many things happen to our breasts, and most have nothing to do with BC.

Enjoy your spring!

Kaso

My spiculated mass on the mammo was spiculated on the ultrasound as well. At my biopsy this morning I was told the 12:00 mass is 8mm, tiny and likely new. I did not have a mammo last year, and never had a fright with past mammograms. I find sites like this most helful and am in search of someone assuring me that I can beat this if it is in fact malignant. I wish I could get a call from the radiologist with the first findings (not the hormone receptors), but I will wait for my internist to relay in a likely manner-of-fact and few words, the findings. If you did have a spiculated mass of similar size can you share how your "journey" went.

MTwoman

Kaso, while "spiculated" is a concerning characteristic, I've read threads from women with BIRADS 5 spiculated masses that weren't breast cancer. Try your best not to go too far down the "what if" road. But if your mass is bc, then you'll find many women here to connect with and discuss options with and find support with. You are far from alone in your journey if you (sadly) find yourself a member of our club! Once you have details, post what you know and we will be able to direct you to threads that may be pertinent. So sorry you are worried and waiting for information, that is one of the worst places to be! ((hugs))