Why core needle biopsy?

Henbane

I was referred for breast pain. Started 6 months ago and worsening. GP thought she could feel "something" (her words) in painful area.

I went to a breast clinic and had my first ever mammogram followed by ultrasound.

The outcome was that the painful area is apparently 100% normal but there are tiny areas in both breasts that might be suspicious. The doc said she is almost completely certain this is just menopause related breast tissue change and nothing to worry about but in order to "dot the i's and cross the t's" I might want to have a biopsy.

I decided to have this done same day and she did a bl-lateral u/s guided core biopsy, which was not the worst or the nicest thing I've ever had done!

I'm playing the waiting game for results now. But whereas I was convinced I had advanced BC before the tests and was feeling fairly confident I don't after hearing the doc, my hubby is much less confident and he's making me feel scared.

Is it usual to do a core biopsy on tissue that's suspected to be benign? My hubby said he could see the patches she biopsied on the u/s and that they were about the same diameter as the needle. i.e. tiny.

I don't know what to think or feel now. I have about a week to wait and I'm getting more scared each day. I'm 51. No history or family history of BC.

Mooshi

Hi Henbane,

I myself am currently waiting on my biopsy results, so I totally understand your anxiety. To answer your question, yes, it is possible to do a biopsy on something that is suspected to be benign. There is a bit of a grey area in radiology where it can state that something is "probably benign." The statistical chances of biopsies coming back positive for cancer in this category are very small. Perhaps in your case, it was your doctor's call to go with a biopsy "just in case." Personally, if I knew that my report came back "probably benign," I would push for a biopsy anyways. I know of a few people who were the victims of false negatives, so I would rather have the peace of mind.

I hope that helps. Please do keep us posted.

Henbane

Ah thank you Mooshi, yes that helps. I was wondering if the decision to do a biopsy meant things weren't looking as benign as she was making out, but hopefully it's just belt n braces. When are your results due? I think mine will be end of this week/beginning of next. Best of luck to you too. Fingers crossed for you!

Mooshi

I'm scheduled to get my results this Wednesday, April 5. I had the biopsy this past week Tuesday. I have a copy of the original radiologist's report, and given my personality, researched every word on it haha. The findings on the report are pretty ominous, plus I got a rating called BI-RADS 5. About 90-95% of tumours with this rating come back positive for breast cancer. So, although nothing is yet 100%, I am prepared for just about anything. If there is a light at the end of the tunnel, my lymph nodes looked totally normal on the ultrasound, so if it is cancer, I have some hope that I caught it in the early stages. We'll just have to wait and see. Stay strong.

Henbane

You too Mooshi.

Beesie

"Is it usual to do a core biopsy on tissue that's suspected to be benign?"

Absolutely. Any finding that the Radiologist assesses to have a 2% or greater risk of cancer will usually warrant a biopsy.

What is a BI-RADS score?

• Imaging that the radiologist assesses to have less than a 2% risk or less of being cancer (or alternately, a greater than 98% chance of being benign) is rated a BIRADs 3, and a short term follow-up (usually repeat imaging in 6 months) is recommended.
• The next category, BIRADs 4, includes all imaging that the Radiologist assesses to have a 2% or greater risk of being cancer, up to a 95% risk. Generally, a biopsy is recommended for BIRADs 4 imaging. On average, 80% of BIRADs 4 biopsies end up with a benign finding, while 20% end up with a diagnosis of cancer.

.

Hope you get a benign result!

Henbane

Thank you Beesie,

I wasn't told my BI-RAD score and feel too scared to go and ask for it. She used the figure 98%, I remember that because I thought it was oddly precise. I think she said she was 98% certain she was looking at something benign. But that doesn't stop me fretting.

Lots of love to everyone out there dealing with BC xx

Henbane

Actually Beesie, is it OK to ask you another question please?

How many cores need to be taken for a reliable result? I have read upwards of 5 but my doc took only 3 cores from left breast and 1 core from right breast. Is this OK do you think?

Beesie

Henbane, if you were told "98%", then it sounds as though the Radiologist rated your imaging to be a BIRADs 4a. That would warrant the biopsy (being a BIRADs 4) but represents the lowest risk level.

I don't know that there is specific number of cores that are necessary... I think it depends on how the suspicious area presents. If the area is widespread, then more cores will be necessary because it's possible that some of the suspicious area might be benign (or might be a high risk condition like ADH but not cancer) while another part of the suspicious area might have cancer cells. For someone found to have cancer, it's not unusual to have a bunch of different fibrocystic, high risk, pre-cancer and cancerous conditions all mixed together - so when there is a large area that appears concerning, the more cores that are taken, the more likely the result will be accurate and if cancer is present, the cancer will be found. On the other hand, you said that your areas of concern were very tiny - so in your case it's possible that just one core sample retrieved the entire suspicious lesion - in which case there is no need for any more samples to be taken.

Henbane

Thank you so much Beesie. I was absolutely refusing to look at any BC sites or info at all before my assessments so I'm not very knowledgeable. You've been really kind and thank you for taking the time to reply

Henbane

I had my results today and my lesions are benign. Thank you all so much for your support which has been like gold.

Beesie

Great news! Congrats

Mooshi

Henbane, I'm thrilled for you! Yay! Now go get that Critucal Illness insurance lol. X