How can a Dr. tell that a thickening is benign vs. ILC?

kibbles · June 2009

I see a breast surgeon three times a year for breast exams. I am 30 and have had two benign excisional biopsies (fibroadenoma). I have also had one full breast bilateral ultrasound but no mammograms.

Anyhow, my surgeon notes that I have thickened areas in both breasts (he calls them fibrocystic areas) and the ultrasound showed nothing there. How can the breast surgeon tell that these thickened areas don't have ILC in them?

taraleec · June 2009

I wouldn't think he'd be able to tell you that, without the area being excised and examined thru pathology.

kibbles · June 2009

I guess more specifically, how can a breast surgeon tell the difference between thick fibrocystic areas (which I apparently have according to breast surgeon) versus ILC. I have never been recommended to have a biopsy on my thickened areas (one in each breast, large areas).

idaho · June 2009

Get biopsies- that is the only way to tell if it is cancer or not. Don't wait. Tami

Texgirl · June 2009

Despite being an RN I allowed my GYN to continue to tell me that my thickening was also fibrocystic in nature....Ahh the things we learn AFTER diagnosis !! As all my mammos and dx. mammos AND my U.S. were always negative I went with that determination.What can I say ?

Finally I decided to get a second opinion at a lg facility..with a BC center. I was dx'd within one week. Stage IIIc and the rest is history....Always get a biopsy.

kibbles · June 2009

This worries me though I go to a top breast surgeon at a top breast cancer center. He keeps saying my thickening is fibrocystic. I never thought much about this until recently. I am scheduled for an appointment in a couple of weeks for my three times a year exam, I will bring it up then. What kind of biopsy do they do for this? I just had an excisional biopsy two months ago for a lump, turned out to be a fibroadenoma. Would it be excisional or core needle or something else?

Kleenex · June 2009

Well, you are certainly seeing a doctor who would seem to be perfect for this sort of follow-up. You should ask him the question you are asking us. I will say that my ILC was visible on ultrasound - it appeared as "oooh, we don't know what this is, but it's suspicious" - BiRAD 4. MRI is also good for imaging some of these things. So on the one hand, it might be "good" that nothing suspicious shows up on the ultrasound, and you are still young - breast tissue is normally thicker and denser at your age. On the other hand, you might want to see if the doctor would consider ordering you an MRI. Why do you have follow-up three times a year? Are you considered at high risk of something?

HensonChi · June 2009

I think they can only be sure if they do a biopsy.

hrf · June 2009

I agree that a biopsy is required.

All the doc's (GP, onc, surgeon) said little thickening didn't feel like anything to be concerned about. Mammo and u/s were clear. MRI showed "area of enhancement". It was ILC

sian · June 2009

Hi

I also have fibrocystic breasts and my Surgeon said I did not have cancer just fibrocystic areas but he sent me for an ultrasound just in case and my ILC did show up on ultrasound, there was no question about it they knew straight away, so if you have had an ultrasound on both breasts you have every reason to think its OK. Saying that if your gut feeling tells you not to accept that, insist on a biopsy.

Good Luck

Jane

wallycat · June 2009

Biopsy is the ONLY way to tell. I remember one of the breast-care docs calling me back to "feel a thickening" and using ultrasound...that was at least 5 years before DX.

All my mammos, ultrasounds showed NOTHING. MRI picked up a highlighted area, but that doesn't guarantee it is cancer (my twin had a highlighted MRI, then biopsy and hers was negative).

Biopsy confirmed ILC for me.

kibbles · June 2009

I will definitely address this with my breast surgeon at my next appt. in three weeks. The reason I go three times a year is because I have had three fibroadenomas diagnosed in the past year, so I get a lot of exams. I think I had 8 clinical breast exams this year between my gyn and breast surgeon! Ironically, I found a new lump one month after one of these exams, and it was already 2 cm. Got it removed, turned out to be another fibroadenoma. But my areas of thickening do concern me, though my breast surgeon is not concerned, nor is the radiologist who has done my many ultrasounds. I've seen them go over the thick areas with the transducer and they show me that there's nothing there, they say it's just fibrocystic areas. These same areas get cyclical pain with my cycles. The thick areas used to be all in just one breast but the other one got it too a few years ago.

I will follow up with this for sure.

angeljoy · June 2009

My breast surgeon told me ILC is notorious for not showing up on mammograms and ultrasounds. The best imaging they have for it is MRI. Mine presented as a "vague area" on digital mammogram and digital ultrasound. It did "light up" on MRI, but it took an excisional biopsy to know for sure that it was cancer. I thank God for the technicians and doctors who insisted on investigating this "vague area" further. It could very well be that your doctor and the radiologist are correct that these are only fibrocystic areas, but if it was me I would question them further and make them explain exactly why they believe this. Wishing you all the best!

Angela

ibeejojo · June 2009

I totally agree with Angela...get a good breast MRI and make sure it is a qualified breast MRI and not just a standard MRI....there is a difference. I had to go to UCSD for mine. Good luck. You could also have a breast lavage otherwise known as a breast halo pap smear. Insurance does not cover it an it costs about $75. Both Dr. Susan Love and a few other doctors are doing them. It sucks out the fluid in the breast and can determine whether you have cancer cells or a prime home for cells to develop. They say the test can predict up to 8 years in advance. Perfect for those who have fibrocystic breasts. Might help avoid all those painful biopsies. Either way be diligent and make them prove to you that you have nothing to worry about then you can let it ride. Just tell them you trust their judgement but you need it in black and white. I've said goodbye to too many wonderful young women in the past two years. I promised them all that I would do what ever it takes to get the word out. Women have empowered themselves in so many ways. I know it's hard to face a dx of BC but go with your GUT. Push it until you are comfortable with the outcome....not your doctor. Tell a friend to check her breasts regularly...tell her to tell her partner to feel for changes during foreplay and let her know. Tell your partner. Lets dispel the myths that "you are too young, you don't have a family history and most of all cancer doesn't hurt". Let us educate young women to take charge and demand answers when most doctors follow the old guidelines that most often lead to a late stage dx..................spread the word and demand whatever test you need to get the right answers..............lovingly.........a survivor.........Jo

How can a Dr. tell that a thickening is benign vs. ILC?

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