Two small speculated masses is that worse than one big mass?

Catdreamer

I am trying to understand what is going on. I am very impatient. I have not told my family and friends about this. I am waiting for biopsy results. But, I am trying to understand what is happening to me.

So, here is my story.

A week ago went in for annual mammogram. They always do a preliminary review before sending me home (SOP for this place) . I picked them for that reason, since I have had some cysts in the last couple of years. They came back asking for more mammogram views of my left breast. Then said they wanted to do an ultrasound of my left breast. After the ultrasound the radiologist came in and told me they had found two suspicious masses in my left breast. Then he showed me the ultrasound and said the masses were both star shaped with poorly defined edges, and shadows. Finally, he said it was a better than 50% chance that it was cancer. When I said it back to him to make sure I understood, he said well over 50% chance, more like 50 to 95%. Which seemed pretty definite for an ultrasound.

I have now had an ultrasound guided core biopsy of both masses. They took three samples from each mass. Now I have to wait until Monday for a meeting with my ob/gyn for the results. I did not find the masses myself. And I could not find them after the mammogram found them. According to the first radiologist the larger mass was .9mm on its largest side and the smaller mass was 4.7mm (I think). The second radiologist for biopsy said the larger mass was 1 cm.

All the information I can find is about single masses and larger masses. Are multiple small masses worse than one larger mass or vice versa? Are these even considered to be smaller masses?

Any information or suggestions to get me through until Monday would be welcome.

Thank you

muska

Hi Catdreamer,

I am sorry you are here and waiting for biopsy results. First, your odds are still 50/50 which is good, let's hope it is not. If both lesions turned out to be cancerous they call it multi-focal cancer and it is quite common. I had two small cancers and the treatment is not significantly different.

I hope it turns out to be benign

Mucki1991

hi I'm sorry you find yourself here. Size does matter sometimes.. but what really matters is the specifics of the tumor. So right now you don't know what it is. Most biopsies come back B9. Did they give you a birads score before your biopsy was sched?

Catdreamer

thank you for the response. no birads score. Would not even have known to ask. Should I? How does it help?

MTwoman

Catdreamer, I am also sorry you find yourself here worried about your breast health. the BIRADS system of scoring basically categorizes findings based on characteristics and the likelihood that they are malignant. Read more about that if you'd like here: http://breast-cancer.ca/bi-rads/

Knowing your score would only help us give you more specific information about the % risk of your lumps being bc. I am very glad that your imaging center is so well organized and you're getting actual pathology results on Monday. Having to schedule various additional procedures, wait for them and then wait again for results can be really difficult for many women. Try your best to stay busy this weekend, distract yourself with deep cleaning, home projects or fun things. On Monday, take a level headed friend/spouse/family member with you so that they can take notes and help you ask questions. It is really hard to take in a process information when we're overwhelmed. That goes for hearing bad news as well as not bad news (i.e. we don't think it's bc, so we're going to schedule a follow up in 3 or 6 months to check it again, which happens to a good percentage of women). Let us know how we can help and good luck for b9 results!

sunnyjay

I had a similar situation as you. The mammogram and ultrasound showed one mass but so I had to do an ultraound guided biopsy. The machine was positioned in a way that I could watch the screen, so the radiologist showed me the mass she was concerned with. I also had a cyst that was in front of all this so she showed me the round edges of the cyst compared to the jagged edges of the mass. She also looked at my lymph nodes and saw something suspicious so she biopsied that also. When I got the path report, the mass was positive for IDC cancer <2 cm but the lymph node was benign.

My breast surgeon was all set to do a lumpectomy but he ordered an MRI and chest xray to rule out anything else. The MRI showed a deeper mass of DCIS <2cm.

It seemed like the size together is what he considered. So we were working with a close to 4 cm mass. He also examined my breast and said I didn't have enough tissue to just do the lumpectomy so he recommended a mastectomy.

Not sure If I answered your question. Let me know if you need clarification. Good luck to you. Praying for good results.

Msjackiefan

Hi, Catdreamer,

So sorry you have to go thru this process. As stated, most are benign and speculated can also be scar tissue or fibroid. They do masquerade sometimes. Either way, the growths are small-that in itself means you and your medical team have done a good job of monitoring. It's so hard to wait, but just know we are here for you. One of the best soothers is routine and familiarity...Try not to go too far out of your routine this weekend. Worry is natural, but so far, you have a lot of reason to hope all will turn out well. We are here for you.

Rrobin0200

was it microcalcufications? My radiologist also gave me those exact percentages, and my mass, which was not palpable, was a cluster of microcalcifiations, indicative of DCIS. She wasn't unfortunately correct. I did have DCIS.

BUT, hold on to the fact that, from what I've read on hear, a very high percentage of biopsies come back B9. Hoping for those results for you as well. Gentle hugs. Waiting is for the birds. Try to do something semi-productive, if you can. I know all too well it's terribly hard waiting.

Catdreamer

Thank you all for your support and encouragement. I have received my biopsy report. I have an appointment with a breast surgeon for Wednesday. I will also hopefully be getting information about another surgeon for a second opinion tomorrow.

My biopsy diagnosis:

Both masses were basically the same:

Infiltrating Ductal Carcinoma (identical morphology consistent with a single tumor clone)

Carcinoma cells arranged in a single file pattern.

In the larger mass, minor components of Lobular Carcinoma In Situ.

Positive for Estrogen receptor moderate

Positive for Progesterone receptor strong

HER-2 Negative

KI-67 (tumor proliferation activity) <10%, low (7%)

There may be more that is important. But that is what I gleaned from the pathology report.

It is weird, but now that I know for sure, I feel better. Now comes the dr meetings. And how do you even decide what treatments to do. I hope I will get more information from the surgeon.

Thank you again for your support and insights.

Catdre

MTwoman

so sorry you've joined our club Catdreamer! Deciding what treatments to do will basically be informed by the details (some of which you gave above, some not) like receptor status, combined size of the idc, and additional imaging (like ct scan etc), genetic testing (if you have family history or are below a certain age), and or genomic testing of your bc (you may have heard of the Oncotype or Mammaprint testing) that may be ordered at your next appointment. Each of the specialists will have their area of treatment to discuss with you and will review with you your specific case details, the risk your bc poses to you (risk of recurrence) and what their intervention would mean in terms of risk reduction offered vs risk of the intervention itself. (i.e. rads have risks, but the reduction in recurrence risk typically outweighs the risk represented by the rads themselves; typically after lx, but not mx). If you don't have a specific person that you want with you at your appointments to take notes, you may want to ask if you can record the information for your future review. It is awfully overwhelming at first and difficult to take in and remember all of the details. Starting a binder with your images and reports can also be helpful. You can keep a section with your questions and actually add answers (or options) as you get them. There will be many others coming to help give you more specific info, but joining the IDC forum could be a good start to getting you connected with them. Sending you warm ((hugs))