Just found out mass is BI RADS 4 over a month after ultrasound

TerrifiedAt29

Just for the record, I’m 29-years-old w/ no known history of breast cancer in my family. Three months ago, in order to continue prescribing me the birth control (Yasmin) I use to treat my PCOS symptoms, my gynecologist referred me for an ultrasound on what I casually mentioned was a “10-year-old cyst”. The mass had been looked at by my former PCP back in 2010. He said it was a “cyst” and that there was no need for any imaging/testing. It has never changed in size. During the ultrasound, the ultrasound technician (I actually thought she was the “radiologist” at the time) found a second, much smaller lump. I have a hard time feeling this lump at all. I asked her if they were cysts. She told me they were fibroadenomas and common in young women. She also mentioned that I have very dense breasts. I asked if I needed to speak to anyone else. She said, “No. You’re all set, dear.” Over a month later (last Thursday), I went back to the gynecologist to renew my prescription thinking everything is peachy keen. She comes in and says, “I’m so glad you came in. We tried reaching you on the 8th. The bigger mass needs another ultrasound in 6 months and the small one is bi-rads 4. We cannot renew your prescription at this time.” First off, they NEVER called me. No missed calls on the 8th. No calls from them on any day. When I called to ask if I needed to schedule another appointment in order to get more birth control refills, I was not told that they’d been trying to contact me or that it was urgent I come in. They also never called my emergency contact. Apparently the ultrasound technician isn’t allowed to say anything that could be misconstrued as a diagnosis. My former PCP was also wrong to never send me fo further tests on the original mass. I can’t stop crying. I can’t eat. I can’t sleep. I had to put my life on hold for most of my 20s to be a caregiver to my grandmother, and now it looks like I’ll never have a life of my own. I have no support system and no health insurance. I also experience suicidal ideation over my PCOS symptoms (hirsutism, acne— no weight issues) which can no longer be managed. I’m devastated with no one to talk to. They didn’t give me a letter (a, b, or c) next to bi-rads 4. I don’t know what that means. It may be weeks before I can see a specialist. Every medical professional seems to have screwed me over

Moderators

Dear TerrifiedAt29,

Welcome to the community. We are sorry that these breast changes and the associated worry have brought you here but very glad that you reached out for support. While you are waiting for some of our members to respond you may want to consider a few things. Most here will say not to jump to the conclusion that a BiRads4 lump automatically means cancer. It does not. You can read more about the BiRads classification here . Has your gynecologist suggested next steps for you. Have they referred you to another doctor or practice? If so can you call and ask upfront about payment and lack of insurance. The sooner you get more definitive information the more control you will have. For more information about Paying for your Care check this link. You can also check out these links for more information about Imaging questions and how to interpret your report. Can you get a copy of your report and run it by djmammo here on the boards.

We hear that this is an awful lot to manage on top of other health and personal issues. Being along is not easy, especially while dealing with a health scare so again we are glad that you reached out here. We take your mental health very seriously and ask that anyone who is presently struggling with thoughts of suicide to please seek professional assistance. The National Suicide Prevention Hotline is 800-273-8255. Please let us know how else we can be of help to you.

The Mods

Beesie

I'm so sorry that you have facing this situation. It does sound like somebody screwed up. I appreciate how scared you are but there are many reasons to not panic.

First of all, although the ultrasound tech is not supposed to say anything, the fact that her reaction to your imaging was so positive suggests that whatever concern the Radiologist saw that warranted the BIRADs 4 probably isn't something that is glaringly bad. The fact is that any area of suspicion with even just a 2% risk of malignancy will be recommended for biopsy. So the risk might be very low.

Second, fibroadenomas are very common in younger women. They are harmless. In teenagers (I had my first at age 16) often a biopsy isn't even done. But once we're a bit older, often a Radiologist will err on the side of caution and recommend a biopsy for what he is quite certain is a fibroadenoma. So while I'm just speculating here, that could be what's going on in your case.

The thing to understand about BIRADs 4 biopsies is that most of the time they are done to rule out cancer, not because cancer is suspected. So being sent for a biopsy with a BIRADs 4 doesn't mean that the Radiologist thinks your imaging has the appearance of cancer, but instead means that he wants the extra reassurance, from a biopsy, that you don't have cancer.

Do you have a copy of your imaging report? The specific descriptions of the two masses could be very helpful in determining whether this is a low risk situation or if it's higher risk.

Next, why do you need to see a specialist? Did your Gyn say this? Needle biopsies are usually done by Radiologists and there generally is no reason to see a breast specialist until after the biopsy is done (and then only if the result is cancer or a high risk condition). I've had lots of biopsies over the years and have always gone back to the same facility where I had my screening. Since the Radiologist at your facility recommended the biopsy, they should be able to accommodate you quickly. I'd think that your Gyn's office should be able to call them the schedule the biopsy.

Lastly, take a deep breath. Yes, this is a scary situation, especially with the delays. But most biopsies end up being benign so don't jump ahead to the worst case scenario. Hopefully you will get scheduled for the biopsy quickly, have a benign finding, and then you'll be able to put this crappy experience behind you and move on with your life.

Good luck and please let us know what happens