Mass after breast cyst aspiration

Maggiebrego454

hi everyone! Looking for some advice. Last April I discovered a lump on my left breast. It was painful and palpable. I went to my doctor, who said it was probably a cyst, but because of my age (30) to do a mammogram as well with an ultrasound. So scheduled both for a few weeks later in May. It was a bilateral mammo done. Ultrasound was targeted to the area of the palpable lump. I'm heterogeneously dense. Nothing was seen during the Mammagram in the area of the lump. A focal asymmetry was seen in the middle central area of the left breast, but didn’t persist. They found calcifications in my right breast- scattered, occasionally grouped. No fine linear branching or pleomorphic calcs. For the ultrasound, the cyst was called simple measuring 3x3x3 mm found at 8oclock 6cm from the nipple. Both the cyst and asymmetry are benign. Calcs: 6 month f/u. Bi-rads 3. If cysts gets larger or more painful f/u.

So this was great. It was a simple cyst. Hurt like hell but fine. The calcs as long as unchanging are not an issue.

Fast forward to the 6 month f/u in 11/2017

Pain in left breast is worse in the cyst area. Slight discolored areas around nipple. Pain, itching on nipple area. Crusting and discharge as well. No changes or anything with my right breast.

Because of the new issues with my left breast. They decided to do a mammo on both again. And an ultrasound of the left breast: the area of the cyst and the nipple. Findings: mammo: follow up on calcs in right breast: the calcs are stable. Left breast: no calcs, no masses, nothing. Findings for left breast ultrasound: the simple cyst before was 3x3x3 mm, now it’s an 11x6x8 mm oval horizontal avascular separated cyst with circumscribed margins. Same location with an anechoic internal echotexture. There are increased posterior echoes. So the calcs in the right breast are deemed benign. F/u in 6 months. The cyst now changed, is labeled probably benign. F/u in 6 months. And still bi-rads 3. The radiologist told me to f/u with a breast surgeon about the pain.

Now after the holidays in February I met with a breast surgeon (who i dislike now) about my reports. She spent all but 2 min with me and said the cyst was nothing and I insisted on an aspiration because of how fast it grew and the pain associated. She agreed. At first I thought her abruptness was because she was unconcerned and I took it was a good thing. Now I’ve come to realize she has zero lack of concern with her patients. Also I had brought my imaging and reports with me as requested and she did not look at them once and insisted she had downloaded them from the radiology group’s site. So I made an appt for the biopsy in March.

March comes along and the aspiration is performed, well in my opinion, and the tech agreed. It was ultrasound guided and I tolerated it all well. And had no problems with healing. The size had changed yet again of the cyst and the tech said it looked like a cluster. He removed them without fault, and made additional holes to discourage regrowth and sent the red fluid for cystology. After the aspiration, they returned my imaging and reports from the radiology group I had left with them and failed to return anything from my 11/17 ultrasound and mammo. When I questioned it, they said they didnt have it but they were certain they had it scanned in and the doctor had reviewed them prior. I was livid.

Fast forward. They found the missing cd and report, misplaced with other patient records. And I receive my biopsy results and they are benign, but I see that they never even reviewed the 11/17 ultrasound. They used my initial ultrasound for the biopsy. The breast surgeon never followed up with me though I was told she would. The results came back with no malignant cells detected, benign aprocrine cell clusters, benign duct epithelial cell clusters, and amorphous debris. The surgeo was to follow up with me to schedule a follow up ultrasound in 4 to 5 weeks. I’m relieved because of the results and pissed at this doctor. I received no phone call and within 5 days the cyst had returned and was palpable.

I decided to schedule my f/u ultrasound with the radiology group I had been going to and to hold on the mammogram since everything had been stable just six months ago.

Skipping over the wrath I dealt with at the radiology group for not wanting a mammo that very day.. ugh

I had a targeted ultrasound done on my left breast last Thursday: exact words: there has been a re accumulation of the cyst with a complex multiseptate cyst measuring 6x4x6 mm at 8 o’clock 6 cm from the nipple. This is located within a complex cystic and solid mass like area measuring 2.5 x 0.7x 2.2 cm with punctuate Echogenic foci suggesting calcs. Correlation with mammo recommended. Mri recommendation. Complex mass is suspicious. Biopsy is recommended. Now bi-rads 4 suspicious abnormality.

Obv they’re mad I didn’t do the mammogram.. 3rd one in a year. Ugh. So they want a mammo of both breasts and commented on that as well. I didn’t think it was necessary since everything had been benign and treated as nothing up until now. Super frustrating.

So now my (terrible) breast surgeon has still not called me. Even after these results.. so I called today. Couldn’t even get a nurse on the line and had to resort to leaving a message.

Help!

Sorry this so long! It’s been a long drawn out scenario and I want to know if I should be concerned. I have found a different breast surgeon and may go there for a consult. should I biopsy this mass area? Or do another mammo? Or an mri? Or has this happened to anyone else following an aspiration. It’s been 2 months since the aspiration and now there is a very different looking cyst and a mass with calcs.

Any advice is helpful

Maggiebrego454

probably should mention: no personal history of cancer. 2 1st cousins diagnosed within the last two years. One maternal and one paternal. Both aggressive. Bone and breast stage 4 for both. Both are young. One is 37 the other 52.

Moderators

Hi Maggie, and welcome,

We just wanted to stop in and say hi and so sorry you're going through these worries. Someone will surely be by soon to weigh in with their thoughts and experiences! We hope you get this all figured out soon!

--The Mods

beach2beach

If I'm reading it all correctly the last , this past March, that area was aspirated and benign. It's now May and they see a complex mass within the same area. Unless something was lurking nearby that they missed, I'd tend to hold onto that it is benign, a mess of benign but pesky cysts. Maybe even some debris from the previous aspirations. Strange how it keeps resurfacing, very sensitive area I guess. I'm glad you are getting another opinion. Hopefully this surgeon will review ALL your films and pathology and determine the next best course of action whether its an MRI or ultrasound or biopsy. If it were me, I'd probably get the biopsy. I'd want to know for sure what is going on. Perhaps this Dr. will have an explanation on why it keeps returning.