Bi rads 4 c

Ampmusic14

I noticed a very large left breast lump last December that is actually 4cm. I had a normal OB exam in October with no lump. As far as I know, the lump remained the same size since I found it. I finally decided to get it checked out because it started to bother me. I occasionally have some pain or tenderness and minor itching but nothing is consistent. So far I've had a mammogram and ultrasound. By the way I'm only 37 with no family history of breast cancer and I have two little kids... Fairly healthy... No one really talked to me after my mam or ultrasound. The techs just kept asking me if I had an injury to the breast which I said no. They also just told me I need to schedule a biopsy which is for next week. I got my results online through my medical chart... The nurse practitioner I see at my OB didn't have a lot to say except it's good that I went in. I'm basically convincing myself I have metastatic cancer. I'm freaking out!! Like I was getting at, my results didn't say much. Just that I have heterogeneous dense breasts, I was rated a bi rads 4c which I've read is not good at all. The results also said the size (didn't say anything about shapes or borders), said it's hypoechoic, which I read means it's solid... On palpation it does feel big, hard, and moveable. Results also said breast has calcifications and punctate echoic foci and that there is not any architectural distortion in either breast. My results didn't say anything else except all of that. I never got to see pictures of the mam or ultrasound... Can someone please help ease my mind??

Salamandra

Waiting time at the beginning is very scary. But Birads 4c is still not Birads 5. And cancer is still not metastatic cancer. And metastatic cancer still has treatment options.

I freaked myself out completely in between my positive biopsy results and my first medical oncologist appointment. It turned out to be very treatable and very positive prognosis.

There are *many* similar scenarios for you even with a larger mass - if it is cancer. Remember even with 4c, they are still ruling cancer out, rather than ruling it in.

Hang in there!

Ampmusic14

Thanks. I'm trying really hard. I still have to wait until Thursday for the biopsy and then I have to wait who knows how long for the results. I think I'm just freaking out because no one talked to me and I feel like the ultrasound and mam results are a bit vague so I don't have much to go off of other than I have a very large solid mass rated a Bi-rad4c. Whatever it is, I want it out, that's for sure. I'm praying and praying it's not the C word.

AliceBastable

Technicians aren't really allowed to give you much information. Watch some fun movies to get your mind off it. Do some silly stuff with your kids. You can pass the time freaking out or having fun, but Thursday is still the same distance away.

etnasgrl

Waiting is the hardest part. Once you know what you are dealing with, you and your doctors can create a treatment plan and start moving forward.

Yes, cancer is scary......BUT.....it is doable and not the death sentence so many assume that it is. Even metastatic breast cancer is treatable and many, many women live several years stable and well.
I know it's not easy, but try not to put the cart before the horse. Jumping to the worst possible situation is only going to cause you undue stress. Try to distract yourself as best you can.....watch some movies, read a good book, call up a friend, etc. Whatever will help with your mental well being.
I promise you that once you know the results, no matter what they are, you WILL feel a bit better. I know that sounds odd, but it's the not knowing that leaves us feeling so powerless and overwhelmed. Knowing where you stand means that you can start doing things to move in the right direction and that helps tremendously!

Sunshine99

It's so easy to say, "Don't worry", but it's human nature to worry. As many of us will tell you, do TRY not to worry, and don't do too much research on all the things it could be. Dr. Google is NOT your friend right now. When you get your results, you will feel better. Not knowing can be the hardest place to be.

Gentle hugs.

Anonymous

Also, once they know what they are dealing with the plans and actions will come real quick so its not like you are going to be waiting another few weeks/months for something to happen. In the meantime, try and keep your mind off the what ifs and getting worked up over something that may not happen. I know that is easier said than done, especially in this environment, but its important.

Ampmusic14

Biopsy done... Now I wait for the results which brings on more nerves. I didn't ask any questions... Just let the doctor do her thing. Chatted a bit with the ultrasound tech about my prior results. She just said yeah we don't really know what it could be, it's very weird and it'll be interesting to see what it shows. Hoping for the best!

Salamandra

For what it's worth, at my biopsy the surgeon suggested that I should try to set up an appointment with a breast surgeon. He wouldn't say it was cancer, but that's what he did say.

It flew completely over my head. I hadn't done any research yet and didn't even know my mammogram was birads 5.

Ampmusic14

Results are in. Can someone please help me?? I'm positive for cancer... Dcis is high grade also with invasive that is unknown. Estrogen and progesterone positive. How freaked out do I need to be??? I'm straight panicking right now.

keepthefaith

ampmusic, sorry to read that you are positive for BC. Try not to freak out, although I know it's hard not to. You will have a few more appts to go thru before you know exactly what your options for treatment are, so hang on tight. It can be a very emotional time and sometimes feel like you are on a roller coaster! But, come here for support. There are many here that can give you helpful tips and to help you cope. Most likely, you will have more tests and surgery, If you need someone to go with you to your appts, find a trusted person that can support you to help you take notes, etc. Stay away from Dr Google:). Best wishes moving forward.

Ampmusic14

Im open to all the advice and support. I know I'm just in straight panic mode right now. I don't want it to spread... I have two little babies... I'm just so scared.

Jettie

Hi Ampmusic,

Sorry to hear your joining our club, but it is a club full of awesome people!!!. Do you have any follow up appointments scheduled yet with either your OB/PCP or anyone else to go over the results and make referrals and treatment plans?

Beesie

Ah, I'm so sorry. Even when the news is expected, it's still a shock to the system.

First, don't panic. I know that's hard but all you know at this point is that you have breast cancer - you know nothing about the diagnosis. Over 80% of breast cancer diagnoses are early stage. And with rare exceptions, most breast cancers, even grade 3, are slow growing. So you have time to get additional tests and develop a treatment plan. It's natural to worry that the cancer might be spreading while you wait for surgery, but most cancers have been in the breast for 3-5 years (some as long as 10 years) before they are discovered, so in the scheme of things, a fews weeks or even a couple of months is not a long time.

The only comment I'll make about what you do know about your diagnosis is that you can ignore the DCIS. DCIS cells are non-invasive, so it is the lesser part of your diagnosis. Since most invasive breast cancer develops from DCIS, the majority of people diagnosed with invasive cancer are also found to have some DCIS. The DCIS will need to be surgically removed, but beyond that, any treatment that you get for the invasive cancer will be more than sufficient to deal with the DCIS. So put your focus on finding out about the invasive cancer - how large it is (until it's removed you will only have an estimate), the grade, the ER, PR and HER2 status, whether any of the invasive cancer has moved into your lymph nodes. That's what determines the stage of your diagnosis and your treatment plan.

Hang in there. Once you find out more and have a treatment plan in place, once you are doing something to pro-actively remove and treat this cancer, you will feel better. But for now, you have to live with being in limbo for a while, until all the information about your diagnosis is in. It's not fun, but it's part of the process. We've all gotten through it. You will too!

AliceBastable

Do something fun with those little ones! Freaking out doesn't help you or them or make the time pass any faster. Jot down questions for your next appointment when they pop into your head, then try not to think about them once you've written them down; it won't do any good.

Ampmusic14

Thank you everyone for the advice! Some referrals are in place. MRI isn't for over a week... Waiting for oncology to call me for an appointment. I know I'm ER and PR positive. The ER + is very high... They have the dcis as very high as well. HER is pending. My Nottingham score was a 6 with a score of 2. I think the invasive cancer is 1.2cm. Currently no lymph node involvement. That's really all I know. Only person I have talked to is my OB doctor. I'm trying to love on the kids and have fun, but they're 3 and 1 and are wild!! lol, and momma just wants to cry right now. I'm just in shock with all of it since I've only ever used birth control for maybe 5 years on and off and we have no family history... Still have more waiting. And I don't know how to tell my mom.

Salamandra

Hey Ampmusic,

Your initial stats sound very similar to mine. I was so terrified I wouldn't even google, and I wish I had, because I would have realized that the odds of my cancer being metastatic were very slim.

I remember thinking how it felt like I couldn't rely on odds anymore because to get that malignant biopsy you've already come out on the wrong side a few rolls. But that feeling isn't facts. The truth is, there is still an excellent chance for you to come out 'best side up' on many subsequent 'rolls'.

The beginning is so very very hard. I think I didn't exhale until after my first appointment with my surgical oncologist. Go easy on yourself, and just try to stay open to the (very real) possibility that after a few months of upside downness, your life will continue on much as before, and you will be just fine for the long haul.

How/what to tell your mom depends so much on what she's like and your relationship with her. If you are feeling like telling her will mean you'll have the stress of dealing with her emotions on top of her own, you don't have to tell her yet. A lot of women don't share the information even with very close friends until they feel like they have their own heads wrapped around it and have the energy to take on those conversations. There's also the possibility of telling her but prefacing it by telling her how you want/need her to react. "Mom, I'm going to tell you some news about something I'm struggling with. I'm having a lot of feelings about it. I need you not to ask questions/not to cry/not to give me advice/only to listen/call me back, etc."

Hang in there. The beginning is hard, but for many many of us, the challenge turns out to be more mental and emotional than physical. Wishing you a smooth path!

Anonymous

Regarding telling your mom - I would suggest waiting until you get more information and/or a plan worked out with start dates. It will be easier to tell her and calm her fears by letting her know that there is a plan, what the plan is, and that is is very treatable and curable. It also gives her more information so she has less to be concerned about the unknown and a solid timeline she can work with if you need help or she is the type to be motivated into action etc.

Ampmusic14

Thank you so much for the words. I appreciate all of you that are replying to me. Today was full of phone calls that gave me a big headache. I felt a bit better this morning and now I'm back to being overwhelmed. I have a breast surgeon appointment Thursday and oncology plus MRI next week. Dealing with work is another thing... Thankfully they're working with me so far. Just having had a baby last year is making things a little rough on that end. I ended up telling my mom today in person and texted my siblings just so they're in the loop of things. My mom was super shocked mainly because there's absolutely no family history of breast cancer and because I'm so young... So we'll see. I'm still terrified about the invasive part of my diagnosis. I don't want it spreading... No idea what to expect in the MRI. Do I have to remain still? Does it take a long time to do??

Ampmusic14

Im still having a hard time trying not to freak out... I don't know how you guys do it. Maybe it's because I don't have all my answers yet. I'm trying to occupy myself the best I can and keep busy, but I still end up having moments of breaking down. Do any of you take anything for anxiety whether it's medicine or cbd products?

Trishyla

The answer is yes, most people need something to help with anxiety. The running joke is "Better living through chemistry". Ask your primary care or Ob/gyn for a prescription.

Good luck. Things will get better when you have a treatment plan in place.

Trish

dysonsphere

There will be a lot of tests and a lot of waiting for results. I have a 6 year old and probably the best thing I did while I waited for the different test results was to take my son out and do things. Once I had the results back, it was a whirlwind. I had to do chemo and so I have not been feeling well enough to do anything since chemo started. While you can, regardless of what your treatment plan might be, it doesn't hurt to do some things with friends and family and eat your favorite foods just in case!

LiveLoveLaugh2020

Amp I'm so sorry you had to join the club. The beginning is the hardest. I had many breakdowns and many sleepless nights. Anxiety was through the roof. So yes, if you need something don't hesitate to ask one of your doctors.

I know it's so hard but try to keep busy with those babies. Once you meet with your doctors and have a plan you will feel better. Best of luck to you.

Beesie

Ampmusic, maybe what will help is reminding yourself that how you are feeling, the anxiety and freaking out part, is completely normal and it's what pretty much all of us experience when we are first diagnosed but holding for more information. That's what I kept telling myself - that my mind was doing what human minds do in this type of situation, and those natural fears have absolutely nothing to do with what's actually going on physically. Worrying about the cancer spreading is normal - but it doesn't mean that the cancer is spreading. What I did was teach myself to separate the mental and emotional process from the physical process; as I've said on this site many times, what I would do when I would start to feel stressed is give myself a figurative slap upside the head, and remind myself that it's all in my head.

That turned out to be a handy technique because the other thing that most of us experience, for months or even years after a diagnosis, is the fear that every little ache and pain is a sign of mets. Lots more figurative slaps upside the head for me, until finally those thoughts faded away and I realized that a headache is just a headache and my shoulder & back pain is my arthritis and nothing more than that.

Salamandra

Folks have covered the anxiety. Completely typical. My doc prescribed Ativan for me and I used liberally - I only wish I'd asked for it sooner.

The MRI - yes, you have to lie still, but not for 30 minutes straight. They'll scan for a few minutes at time and then adjust the machine. While they're adjusting, it's ok if you shift a bit. It was very strange but they are used to people who have never done it before and the techs were great at talking me through everything.

I would say it surprised me how I could feel the magnetic fields in my head. It wasn't painful (at least not over the 30 minutes) but it was strange!

Also - it can be cold! I asked for extra blankets wrapped around me and extra ones around my feet too. I felt a bit embarrassed and bad about sending them back and forth but I'm so glad I did and they were kind about it!

prepmom

Another tool, besides meds (which I also take), is meditation. I bought the Calm app and found it's lessons tremendously helpful. I learned that thoughts are not necessarily facts, although during periods of anxiety that's often what we take them for. Thoughts only have power when we give them power. Meditating helped me to recognize this. Sounds hokey-pokey, but once I put some time in, it began to work.

Ampmusic14

Just another update. Again I appreciate everyone that has been replying to me.

I met with the breast surgeon today. My plan of care still depends on my HER2 results. Hopefully I'll have them tomorrow and I hope it's negative. If the results are positive, I'll need chemo first, if it's negative, I go to surgery. I'm a T2 stage 2 so far... As far as we know, we don't believe there's any concerns in the lymph nodes... Still pending further evaluation when I have the MRI next week. Unfortunately due to the size of the mass, location and my small breast size, I'm not a good candidate for a lumpectomy... So it's looking like it'll end up being a mastectomy with reconstruction. I'm still super worried for the most part... Yet have a small sense of relief. I'm just scared of it spreading or being somewhere else in my body. She doesn't have any reason to believe it is though.

The tumor is definitely highly dependent on estrogen which is crazy to me. But fueling factors include pregnancies over 30, not breastfeeding, poor diet (mine isn't terrible, but could be better), stress, anxiety, lack of sleep and being overweight... I don't drink or smoke and don't have the family history. So now we wait for further results and appointments.

ShetlandPony

Ampmusic, please listen carefully...

It’s not your fault.

Say it.

“It’s not my fault.”

Ampmusic14

Still waiting on HER2 results... And still waiting to hear from plastic surgery. I'll likely end up having a bilateral mastectomy with reconstruction, but it scares me!

Ampmusic14

Another update... I've been upgraded to a birads 6 now. MRI shows the mass is a lot bigger than we thought.... I'm HER2 negative which is good. Still don't see plastics for two weeks... But oncology wants me to have surgery sooner than later.

Beesie

MRIs can over-estimate... hopefully that is the case. And since you have both DCIS and IDC, some of what the enhancement might represent the DCIS, which doesn't count towards the size of the tumor or factor into the staging or treatment plan.

The BIRADs6 simply means that you've had a positive biopsy - it doesn't say anything more ominous about your diagnosis.

Hope that you can get things moving quickly! Although you are not a good candidate for a lumpectomy, if you can't get things moving quickly enough with the plastic surgeon, one option might be to have a lumpectomy and sentinel node biopsy, so that the primary tumor is removed and can be assessed for size and sent for Oncotype testing, and so that your nodes can be checked. Those factors are critical in determining the treatment plan, particularly if chemo will recommended. You can then schedule a follow-up mastectomy with reconstruction. Maybe not feasible, but something to ask about if you are being urged to have surgery before you have everything lined up with the PS.