Surgery consult before biopsy? And 3 week wait til biopsy?

Silver6

Hi everyone, Nervous newbie here looking for some guidance. I had a mammogram in early Nov and was called back for a diagnostic mammogram/ultrasound. Then I was told I needed a ultrasound guided biopsy and an appointment with a breast surgeon, and the earliest that could be scheduled was almost 3 weeks out (due to u/s scheduling). Two questions:

1) is the 3 week delay reasonable? It seems like most people have their biopsies within days. I live in the suburbs of a large city and the facility is associated with my local hospital, if that matters. The waiting has been so difficult and I haven't even had the procedure done. I was fortunate the diagnostic mammogram and ultrasound were done only a few days after my screening mammogram, but I think that was due to a cancellation - other dates offered were 2 or more weeks out. I know potential staffing issues and COVID precautions may have created some scheduling challenges in general, but I also want to be sure I'm working with a facility that is responsive and operating within "acceptable" standards, especially should this progress further.

2) Is it common to meet with a breast surgeon *before* the biopsy? At first, I was told the surgeon would do the biopsy but then I was told when scheduling that no, a radiologist (in the adjacent office, where my original u/s was done) would most likely do it because their equipment is more sensitive and the mass is small (under 1 cm) but I needed to meet with the surgeon first. (The appointments are back to back on the same day) This is raising a lot of red flags for me.

Thank you.

Beaverntx

Silver6, the 3 week delay is not unreasonable from a scheduling perspective but it probably seems so from a personal perspective! The hardest part of this whole process is the waiting for tests, for results, for appointments...

In reading through threads on this site you will find the order of biopsy and first appointment with a breast surgeon are a bit like the chicken and the egg, which comes first varies! Apparently your facility wants you to have met the breast surgeon so you will have at least said hello before meeting to discuss results. It is logical to meet with a specialist to discuss next steps whether results are positive or negative.

MinusTwo

The delay is not unreasonable & I would go with the radiologist biopsy. However I chose to meet with a breast surgeon AND a a plastic surgeon AND an oncologist before I had the final results. I wanted to explore how I "matched" with them so I could move right ahead if it turned out that way. Probably an over-kill, but my choice to be in control as much as I could.

LoveLau

i had biopsy and saw surgeon next day followung day met the team cause they had meeting decided on bilateral when i needed only one. Thought that would help. Had surgery 6 days later. They didnt do mri or other tests. Did not really give me good emotional support. Sure they have navigator who was ready to answer questions etc but they didnt really help me much cause i didnt know what questions to ask. A hospital can look great on paper but thats not the important part its hope and encouragement and positve attitude. I hope they help you.

My advice to you is to slow down talk to people who will present the positive parts of treatment. I'm 5 years latter in remission with anxiety and depression. Do everything you need to do to get support. Dont allow people to say " get over it, or happiness is a choice." I was the one people turned to when depressed but those people ran away. I'm working my way back to get confidence and its difficult. I think if i asked more questions and thought more i may have been better. Im still hoping i can get better and when covid settles down go to new york to see my grandson.

I also believe oncologists need positive attitude.

God Bless you and all of us.

wondering44

Silver6

I am sorry to see you here with worry during the long waiting for tests and results.

I had the diagnostic ultrasound and mammogram on 06/29 and biopsy on 07/06. The only reason it took that long was the scheduling team had to confirm that I was not on specific vitamins or medications before the biopsy could be scheduled and the breast center was closed for the Fourth of July holiday. The same radiologist performed the diagnostic mammogram, ultrasound, and biopsy. The radiologist was considerate to let me know to prepare for a cancer diagnosis during both visits. She said she wanted to allow me time to prepare myself for the dx. I did not meet with the BS until after I got the diagnosis on 07/08.

I have not had any waits here for tests or scheduling except my surgery due to my PS needing an opening to be at the surgery. I can't imagine the wait is easy for what seems an extended period of time between your appointments. Perhaps it is that way for a lot of people.

I wish you the best during this time and many warm thoughts your way that your results are benign.

Dancemom

The whole thing is pretty much a hurry-up and wait game. Especially in these pandemic times. My mammogram was 2 months after physical exam because of scheduling. Recall was 2 weeks later because of holidays and scheduling. Biopsy was scheduled for 2 weeks later but then delayed another 6 weeks because I got covid at work (pre vaccine, but double masked). Biopsies were not by my surgeon. They are short and quick and you are awake. A little like the dentist in that respect. Once I had an initial diagnosis, then things kicked into high gear. I had all my tests, scans, MRIs, more biopsy, meetings with Surgeon, PS, genetics, MO, all set up by coordinators and surgery scheduled within a few weeks.

Many of my appointments are back to back in the same facility. They try to make it easier on us.

I often feel like I am just waiting for the next step. But then I remember that I can use this waiting time to do my regular life.

Rah2464

Silver three weeks is ok, I know just from the anxiety you would like it to be tomorrow. I think I had to wait four weeks on my first biopsy (I was in my early 30s) and I recall how excruciating that wait was. My second biopsy was within two weeks of findings on imaging. I think it is fine to see a breast surgeon before the biopsy to discuss your breast health. You will have already established a line of communication with a specialist to review any biopsy results. I would say that if the imaging showed anything extremely critical, there would be effort to move you to the front of the line, if that is of any help to you at all.

Silver6

Thank you all for your responses and kind words. This is all so new to me and I have no roadmap. I'd like to think if what they saw truly is concerning, I would be fast-tracked (maybe?), so perhaps the 3 weeks is a good sign. But on the other hand, the mass is (relatively) small so that may not warrant a quick appointment. Plus, meeting with the surgeon does not bode well, and I wouldn't say that any of the conversation so far has been reassuring.

It just seems to me that surgery of some type is in my future regardless, which scares me. (I've never had surgery and if it weren't for my anxiety about the biopsy results, I'd be freaking out over the prospect of the biopsy procedure itself. I don't handle dr. appointments well.)

exbrnxgrl

silver,

The reality is that breast cancer is not an emergency in the same sense that a heart attack or stroke is. Even larger tumors are not “fast tracked”. There are probably a few circumstances that may merit faster testing but those are rare. In general, breast cancer is slow growing and has likely been growing for several years before it was large enough to be detected. Of course the waiting creates stress but if you’re worried that the wait may jeopardize your health please put that thought aside. Take care

SpecialK

silver - sorry you find yourself in wait mode - it is indeed nerve wracking. I waited about two weeks from suspicious imaging to biopsy. In my case the referral for the biopsy itself had to go from my primary care to a breast surgeon, then to the radiologist who performed the procedure. My insurance also required pre-authorization for each step, so there was some degree of slow-sown to process that. I did not have an in person visit with the surgeon prior to the biopsy, but his office did coordinate the biopsy and the results were sent to him, not my primary care. My biopsy was an ultrasound guided hollow core needle biopsy - the most common kind. It was performed by the radiologist and an ultrasound tech in a breast imaging center, and they were excellent. Those results were sent to the breast surgeon, I received them five days after the procedure. A consult was then scheduled for about a week later with the breast surgeon, and my husband and adult daughter went with me for an in-depth explanation of everything that was known at that point and the likely sequence of events to follow. My subtype is an aggressive one, but I did not have surgery until about a month later, so fast-tracking is subject to OR room availability, surgery type, and surgeon's schedules. From suspicious imaging to surgery was almost two months, which is also fairly typical.

AMG2

Hi Silver, yes that wait is very hard. Mine was 3 weeks between US and biopsy, and then another 6 before surgery, and it seemed excessive to me, too, but my oncologist assured me that even grade 3 tumors (which mine looked to be after biopsy - downgraded to 2 after sugery) are not growing that rapidly, and a 6 week wait wouldn't affect anything but my own anxiety. It did help a lot to hear that from him, and I hope it helps you some to hear from us.

hang in there, and I'm so sorry for what you're going through. Hugs to you.

Silver6

just a quick update, in case this helps anyone:

The breast surgeon was fantastic - calming, reassuring and told me not to worry, that he thought it was a fibroadenoma. And it was! (Not sure if he really was that confident in the outcome or if he just knew I needed to hear positivity - regardless, I wasgrateful for his comments) I wish I met with the surgeon earlier, even if that meant 2 separate appointments. Waiting 3 weeks for the consult/biopsy was harder than waiting for the actual results!

I know everyone's situation is different, but even if my results were different, I felt reassured that this doctor would be on my team. (the ultrasound radiologist, who was NOT reassuring and had a terrible bedside manner, will never be part of my care team again if I have any say in that)

Thank you all for being so supportive.