confusing birad 4 mei vs biopsy

Ksc1968

HISTORY.....I had a biopsy scheduled for last july and when I went, they prepped me and started the ultrasound and my lump could not be found. It was gone, so I got to leave without having a biopsy done. I asked multiple times if they were sure nothing was there and they had two people check (including the radiologist herself). Fast forward to my yearly mammogram and my 6 month ultrasound follow up today. I received another birad 4 and a MRI recommendation.

Here is where I get confused. I hope I dont confuse anybody.

Prior to the biopsy in 7/2018 I was seen in January 2018 and the radiologist saw a spot he wanted to watch for a year or two. He got me a referral for an MRI and an oncologist consult and BRCA genetic testing (I'm adopted). The oncologist office called me after they saw my films and reports and said they dont need to see me. They weren't concerned. My dr said the MRI involved contrast (I have contrast issues) and my primary care dr felt I could wait for the 6 month ultrasound follow up instead of putting me through the contrast. Go forward 6 months to my next appointmemnt 7/2018) and I was recommended the biopsy (which they ended up not doing since the lump disapeared and they couldn't find it (The Radiologist chalked it up to a cyst that ruptured). I have extremely fibrocystic breasts.

Now today 6 months later the radiologist comes in to talk to me and says he looked up the prior report and doesn't understand why they did not biopsy it. I explained to him that I did go to get the biopsy, got draped, prepped, and ultrasound showed the lump was gone. He said well its still in todays ultrasound and mammogram. I asked how thats possible (they were very thourough at the biopsy appt looking for it and there was definitely no lump) and he wasn't sure. He said that it was 2.8cm before and today is was only 1.3 cm so it is significantly smaller. I asked if it could be a new cyst in the same general area and he said no. He gave me the same speech about getting an MRI (he recommended one in 1/2018 but I didnt get one because the oncologist and primary care dr didnt feel it was necessary). He said they were both wrong and I should have had it done. I asked a few more questions and left. Now that I have had time to process today I am confused as to why its not normal for a cyst to grow again. The last cyst/lump definitely was gone and now ones back, albeit smaller. He worreid me and said sometimes lumps can shrink when it spreads or if it encapusulates and it can be cancer. I asked him why he was so concerned if cysts come and go frequently with me with fibrocystic breasts, but he is heavily pushing the MRI. Of course I will get it done with the contrast and deal with any reactions if they happen. But here is my concern, I have seen two differnet radiologist and both times the man recommended MRI, each time saying I recommend you get it and he also gave me preferences for facilities, even though he says he's not supposed to do that. He then went into details about different MRI machines not being equal, etc. We discussed the option to do it without contrast and he said Breast MRI must have the contrast. So I wanted to get any opinions here. Is this normal? Should I be concerned since Im super cystic and a new cyst appeared in the same area? Does this justify the MRI? Why didnt he recommended a biopsy if he was worried like the other radiologist in July? ANy advice is super appreciated. Im very confused.

DATNY

My surgeon recommended me meu, he wanted a specific machine, he explained that not all MRI are the same. I fully trust him, and I believe his advice was for my best.

Rah2464

Please get that MRI if you can manage it. My issue did not show up on standard imaging (mammography and ultrasound) and was only found thru an MRI. You are blessed to have a radiologist who is in your corner. I hope everything works out well for you.