How do I pass the time?

JoyousRose

Hi there,

I had my core needle biopsy on Tuesday this week, and I go to the breast surgeon on Wednesday to find out the results. I am trying to see it as a bonus that I know when I will get the results - at least I don't have to have a mini heart attack each time the phone rings until then!

And yet waiting is exhausting. I don't know what I believe will be the outcome anymore. I have an unidentified, hypoechoic, 1.9 cm mass in my left breast. My ultrasound rated it as BIRADS 4c. There is absolutely nothing else I can do for the next 3-4 days but get through them a minute at a time if it comes to that.

I am 42, and our 20th anniversary is this week. By some miracle, our kids will actually be gone Sunday and Monday nights, one child will be home only on Tuesday. I think we will likely go out on Monday night to celebrate. I have work also so much of my day will be spent there Sunday, Monday, and Tuesday.

So, what do you suggest to help the minutes pass faster, especially at work? How can I be kind to myself and be productive?

NotVeryBrave

Yes - waiting for any amount of time is very difficult. It's good that you and your husband have a break from the kids to celebrate 20 years. That's great!

I guess passing the time at work depends a bit on what you do and how busy you are while you're there. How about a project you've been putting off that will keep you focused on something else? Researching something? Organizing something? Learning a new program?

There's no way to remove this from your brain, of course. Maybe you can catch some relief with some new chores for your mind. Good luck!

MTwoman

Joyous Rose, I have some info on a thread for people who are anxiously awaiting results. Perhaps it can help: https://community.breastcancer.org/forum/83/topics/855477?page=1

Hoping you get b9 results on Wednesday! Do let us know how it goes and if there is anything else you need from us. Also, it might be a good idea to take someone with you to the appointment. Someone who is level headed and can take good notes, just in case.

JoyousRose

Thanks so much MTwoman - my husband is going to the appointment with me.

I've been doing better than I expected. Yesterday morning I actually was in a good mood - convinced myself that biopsies are overall good things, and knowledge is a good thing, and results appointments can be looked forward to. And we went to the movies last night.

I'll be sure to update with my results - it will help me process whatever I hear.

Have a great day!

MTwoman

Well done JoyousRose! And please do let us know how it goes.

JoyousRose

Well, here is my update - absolutely no info, because they called me and postponed the appointment to next Wednesday because they don't have the pathology report yet. But I just checked on the page about breast biopsy on the website, and it does say 7 to 10 days before they will send the results to the referring dr, and it has only been 8. Since Friday and Saturday are the weekend here, they may not have them anyway until early next week.

Disappointing, but I guess I'll survive.

JoyousRose

Hi - I'm still hanging out here. I am supposed to get the core biopsy results at a scheduled appointment tomorrow, so I already called today to verify that the results have been received by the hospital, and they have.

Last Wednesday was just awful, getting the phone call 3 hours before the appointment to be told that they hadn't gotten the results yet. Today is two weeks since the biopsy, and four weeks since my mammogram and ultrasound.

I think I'm ready for answers, whatever they will be.

MTwoman

Good luck JoyousRose!

JoyousRose

RESULTS- good enough for now

Okay, so the pathology results were benign. One of the biopsy samples had signs of fibrosis, chronic inflammation, and a lot of macrophages.

The current plan is to follow up in two months with another mammogram and ultrasound, giving time for hematomas from the biopsy to reabsorb.

Thank you all for listening and giving support!

MTwoman

Yay JoyousRose! Good enough for now indeed! Go celebrate (and continue to follow up as recommended)

JoyousRose

Thanks MTwoman!

I've been thinking and lurking, because drs here don't seem to really tell you much. I was bothered by the two month follow up time - why not six months, why not a year? - and what I've come up with is since they said that this is to confirm the core biopsy results, that this short follow up period is because the imaging was a 4c, so the pathology as benign was discordant.

From everything I've read now, it looks like the standard of care should be to do an excisional biopsy (studies seem to show that about 7% of benign discordant core needle biopsies turn out to be malignant at excisional follow-up), but I guess they would need to do imaging again regardless. And who knows? maybe it will be going away, or look way different.

So, still waiting, still anxious, but much lower level.

MTwoman

My understanding of the standard of care when there is a discordant result is a reconsideration of all of the images, biopsy procedure notes and specimen to review the case and make recommendations. Sometimes, if the biopsy specimen identifies "normal breast tissue" without identifying what could be causing the finding on imaging, they believe that the wrong cite was sampled. But there were non-malignant findings on your pathology report. I would be tempted to schedule a consultation to have it explained to me. What those changes mean for your specific risk for bc and how long they are going to want to monitor them. I certainly understand your anxiety! ((hugs))

JoyousRose

Thanks, MTwoman.

My follow-up right now is supposed to be to do the mammogram and ultrasound, and then see the breast surgeon. So I will make him tell me what it all means when I see him (hopefully in October!).

MTwoman

Perfect! He should be able to put all the pieces together for you, especially with a new round of imaging. Good luck!!

JoyousRose

Just posting now to keep the chronology straight -

So about a week ago it was pretty clear something is going on at the incision site. Red skin, lump underneath, and my family Dr started me on a topical antibiotic and the next day it came to a head and burst. So I made it through the weekend, but I think I will go back to her and say that I don't really think this is resolving.

In the meantime I got a surprise in the mail today - the report from the radiologist who did the biopsy. So I was able to see that she had agreed with it as a birads 4c, and that after the pathology came back as chronic inflammation, she reviewed all the images and decided it was a 4b, and requested the mammogram and ultrasound in 2 months.

Now I am 17 days away from the follow-up imaging, and I am just kind of shaking my head at how long this all takes, and how frustrating it is when the biopsy doesn't really give an answer.

MTwoman

Oh JoyousRose, I am so sorry you still don't have any answers! You must be so very frustrated. So after a biopsy (that showed no malignancy) they still have you as BIRADS 4b? and intend to follow up with imaging? that sounds so very confusing to me. Did they explain to you the whys and wherefores?

JoyousRose

Hi MTwoman,

No one has explained much to me really, to be honest. The day I got the biopsy results was a total mess - they had rescheduled me with a different dr to receive the results when they weren't ready the week before as the dr I had seen before was going on vacation - then there was no record anywhere of my appointment, or where to go - we were on the 4th floor in the surgery department, as instructed - but then they were wondering if I was supposed to see the surgeon on the 4th floor of the outpatient clinic, but it didn't matter because the clinic was closed! In the end they found a dr in the Breast Health Clinic who was in the area and agreed to come into the hospital just to give me the results. By that point, I was just so relieved that we were going to have the results that day at all, and this was two weeks after the biopsy.

She seemed to think it was good news, and communicated the need to follow up in two months to confirm what the biopsy showed. My family dr, who I saw about the infection also thought it was good news.

It's confusing to me too, but I saw somewhere here on the forum a lady who IIFC had a fine needle biopsy, and was told they have to biopsy again but were waiting two months for the hematoma to reabsorb, so at least here is another case where two months was mentioned.

After the imaging tests are done and the reports are written, I will meet again with a breast surgeon. And then I will find out what they are thinking and what it is all about. Maybe they will want to biopsy again, maybe they won't. Should be interesting.

But the question I have - i came into the biopsy with a BIRADS 4c. If the pathology had shown malignancy, they would remove it. If they decide they want to do an excisional biopsy at this point because it came up benign instead, then why couldn't they have done so in the first place?

And if they aren't going to take whatever it is out - the pathology report didn't define it as anything (it's not a growth, or a cyst or a tumor or whatever, the dr who gave the biopsy results was very specific that it was not a growth of any kind, it is a mass) - then when and how will they address the fact that I found the darn thing in the first place because it hurt?

Yeah, definitely some frustration here.

MTwoman

JR, I just want to be sure I understand you correctly. You will be seeing the surgeon again in 2 months, after the additional images and reports are written? (not before). Well, #$%. Sorry, I would be super frustrated. It is understandable that after the confusion around where/who your results would be given to you, and that the doc that gave you the results had nothing to do with your care, that you were relieved enough just to get the results. I'm honestly waffling between encouraging you to get a second opinion (BIRADS 4c does have a high suspicion of malignancy) and thinking that 2 months isn't that long. But only you know how disruptive the wait and worrying has been to your life, and what your 'gut' is telling you. For the pathology not to have listed what the mass IS, and only to have said it isn't bc doesn't sound right. I am not a doctor, but that sounds IMO like a case of discordant findings (when the anticipated outcome doesn't match the actual pathology results). Typically, with discordant findings, all of the reports, images and procedure notes are examined to make sense of the results. It doesn't sound like that is happening, which is why I'm leaning towards a second opinion. Is there a well respected center anywhere near you where you could get a second?

JoyousRose

MTwoman, I was thinking about what I wrote earlier and I went back to look at the biopsy ultrasound report again, and I missed something important (Hebrew is not my mother tongue) My eyes caught the "After review of the imaging" and skipped over the second half of the sentence and caught the Birads 4b in parentheses (and English characters!) on the next line. The second half of the sentence actually said that the imaging was concordant with the pathology. So now I actually feel way more relieved than I did on biopsy results day.

The follow-up imaging is only two weeks away now, so shouldn't be too bad. And when I get in the room with the breast surgeon at some point I am going to ask a lot of questions.

As the appointments go - this is socialized medicine, and there is bureaucracy, and referrals - and within my health plan I don't think I could get a non emergency appointment soon enough, and I would need a referral or would need to go private and pay out of pocket.

MTwoman

Oh, that does sound different! imaging and pathology concordance is imperative, and 2 weeks away for confirmatory imaging (and follow up discussion with surgeon) even better. That follow up makes better sense! so glad you went back and re-read your report (scary reports in a second language can be really difficult, spent 6-7 years in another country so have similar experience). Please do update us in a few weeks?

JoyousRose

So an update after follow up imaging today:

They just did one mammogram image, really to verify the clip - I asked if I could see it and I did and as the radiologist said it looked the same as 2 months ago.

My ultrasound appointment was with the same Dr who did the biopsy, and I talked to her a bit about the infection that showed up a month ago. She mentioned that the pathology was not able to identify anything specific in the samples other than the chronic inflammation or infection, so I asked if having biopsied it could have caused this infection I have been dealing with at the biopsy site. She said it could be.

I am happy to report that the measurements she took during the ultrasound were about half a cm smaller than at biopsy time. The Dr was able to show me how we could see the needle track from the biopsy.

So I am scheduled to see the breast surgeon soon, and they gave me an appointment in a couple of months to follow up the infection with another US if needed.

So with that I will sign off from here for now - and I am really grateful for the community here and I know exactly where to come should I have problems in the future.

If anyone here does have experience with having an infection after biopsy, please do message me! I finish Augmentin today, but I am not confident that the infection won't rebound next week again.