Should I ask for biopsy? not confident

Amy988

i just went for an ultrasound on a lump I found in the breast, which to me feels attached to other thicker breast tissue. Yet they still diagnosed me with a fibroadenoma.

The first woman checked with the ultrasound and she wasnt to sure on whether to biopsy or not because Im 20 and dont like to do biopsies unless they are fairly certain, so she went to get the consultant to then check and she confirmed that I dont need a biopsy. I asked why the other lady needed the second opinion and she said it was because one side looks like breast tissue and the other part she could see a lump but it didnt look suspicious so im some what confused .

Should I be confident in a sense that even the consultant said that all is fine ?

MelissaDallas

I think you already had a lot of answers to this on your other thread.

Amy988

I have just seen alot of people who got misdiagnosed because of their age etc, so I was unsure whether I should be asking for a biopsy or just ignore it . From the thread before I hadnt had any imaging tests

Beesie

You have had multiple doctors tell you that your masses feel benign and feel like fibroadenomas. You've now had an ultrasound that has confirmed that your masses appear, on imaging, to be fibroadenomas. Ultrasounds are very good at identifying the unique characteristics of fibroadenomas. The "consultant" that the first woman checked with about your imaging was most likely a Radiologist - a doctor who has at least an additional 4 years (beyond their medical degree) of training in how to read imaging such as ultrasounds. Why do you persist in believing that you know what a fibroadenoma should feel like, and all your doctors don't? And why do you think that the Radiologist can't properly read the imaging for something as common as a fibroadenoma?

I've been hanging around here for more than 11 years and I have never seen a 20 year old misdiagnosed because of her age. Fibroadenomas are common in 20 year olds; the risk of breast cancer for a 20 year old is less than 0.0005% (seriously!).

For others reading, here are the answers in Amy's other threads. The info provided by Amy and the answers given in these threads are very relevant since the imaging she's now had in fact confirmed what a number of doctors told her:

Topic: 20 year old, hard lump, feels attached to breast tissue:(

Topic: Confused, need some advice

BarredOwl

Hi Amy988:

If you are interested in better understanding what was seen by the Radiologist on the ultrasound images, and his/her formal assessment of the likelihood of malignancy, you can request a copy of the Radiologist's written report (not some form letter and not some top-line summary in a patient portal). The Radiologist's report will include a description of what was observed, impressions or conclusions, and recommendations (e.g., further imaging needed at this time; return to routine screening; short-interval follow-up; tissue biopsy).

In the USA, the Radiologist's report typically includes a BI-RADS category rating, which is a rough assessment of the likelihood of malignancy according to American College of Radiology ("ACR") criteria. For more information about BI-RADS categories and management according by category, below please find a link to some information about the ACR BI-RADs reporting system used in the USA for Ultrasound (see Table 5):

ACR BI-RADs reporting system for Ultrasound: https://www.acr.org/~/media/ACR/Documents/PDF/QualitySafety/Resources/BIRADS/02%20Ultrasound/05%20%20BIRADS%20US%20Reporting.pdf

For example, a BI-RADS Category 2 rating, considered "Benign", is considered to have "Essentially 0% likelihood of malignancy." The accompanying recommendation would typically be a return to your routine screening regimen.

Be sure to note any recommendations, and do not hesitate to discuss the report with your primary care physician or general practitioner.

BarredOwl

dAd

Where did you see "a lot of people who have been misdiagnosed" and why are so sure you have Breast cancer? As was previously pointed out, you have been examined by a number of doctors who surely have expertise that you don't so why do you think you know more than they do

Amy988

I have seen a couple of young girls who have written their stories online saying they got diagnosed with fibroadenoma but she pushed for a biopsy, got it and found out it was actually breast cancer. So I have a worry that if I leave it , it could cause trouble

BarredOwl

Hi Amy988:

Often the person conducting the ultrasound examination is a "tech", and is not a trained Radiologist. Do you know the professional qualifications of the women who did your ultrasound? If she was a "tech", then the fact that she called in the Radiologist should not be any cause for concern.

Secondly, you cannot make informed medical decisions by focusing on the anecdotal experience of a handful of other women representing an infinitesimal fraction of those undergoing radiological examination, and whose situations may have differed from yours in material ways (e.g., more suspicious lesion, higher BI-RADS score, on-going monitoring, significant family history).

Today, please request a copy of the Radiologist's written report, so that you can see for yourself if you are dealing with a no-brainer (e.g., clearly benign). I suggest that you work with a medical professional, such as your primary care physician ("PCP"), to help you understand YOUR results and obtain his view of whether you can feel comfortable relying on the professional medical assessment of the Radiologist.

BarredOwl

dAd

Amy988, BarredOwl has given you excellent advice

mustlovepoodles

Amy, I know you're upset, but at age 20 you have more risk of being head-butted by a flying purple crocodile, than having breast cancer.

Amy988

on youtube and in the news I have seen young girls get misdiagnosed because they tend to assume it cant be anything serious because of age.

I understand that it is very uncommon but it is still possible. It says on google that fibroadenomas have clearly defined edges, but mine doesnt. It feels like a circular lump attached to some thick breast tissue on either side , hence why im concerned and think they may have got it wrong

MTwoman

Okay Amy, you have to STOP using sites like youtube or things you've found on Google to support this anxiety. You are feeding it only what supports it's growth, instead of looking at balanced or scientific information. How many 20 year olds do you know? How many of them have had bc? Most likely, the answers are hundreds/thousands and none; in that order. Has it ever happened? yes. But you've now seen multiple doctors and you are discounting their medical opinion because you saw something on youtube and now know more than they do?

Did you do what BarredOwl suggested " Today, please request a copy of the Radiologist's written report, so that you can see for yourself if you are dealing with a no-brainer (e.g., clearly benign). I suggest that you work with a medical professional, such as your primary care physician ("PCP"), to help you understand YOUR results and obtain his view of whether you can feel comfortable relying on the professional medical assessment of the Radiologist."? If not, why not? It was a very reasonable approach to actually getting a medical opinion on what is going on, instead of conjecture based on googling.

Please please, for your own sake, and the sake of the amazing women on these forums, who take time to support those going through diagnosis and treatment, stop feeding your anxiety about having bc. Stop googling bc, stop looking for it on youtube. This has clearly migrated from an issue of your breast health to an issue of your mental health. Anxiety is pernicious and debilitating.

BarredOwl

Hi Amy988:

If it was possible to determine the need for tissue biopsy from palpation (feeling) of a breast lump (i.e., clinical examination by a trained professional), then ultrasound, mammography and MRI would not be needed. In clinical practice, which is evidence-based, recommendations for tissue biopsy are based on the results of imaging assessment(s) used to determine the likelihood that a mass is malignant, and hence the need (if any) for short-interval monitoring or biopsy.

Radiologists do not in practice "assume" that a mass is benign on the basis of patient age. Radiologists use information regarding the appearance of the mass on ultrasound (or other imaging modalities) to assess the likelihood that it is malignant according to BI-RADS criteria that are age-independent.

Did you obtain a copy of the Radiologist's report and BIRADs score yet? What is the follow-up recommendation? Return to normal screening? Short-interval follow-up? (e.g., further imaging in six-months) Referral to a breast surgeon? Other?

The Radiologist's written report is the most important and informative data available to you at this time. Without that information, this discussion is essentially fact-free.

BarredOwl

mustlovepoodles

Oh, Amy, Amy Amy. Youtube? Seriously? I am 60 yrs old and been a RN 40 years. I have NEVER seen, nor heard of a 20 yr old having breast cancer.