Question about a fibroadenoma
Hi! I have a question about benign fibroadenoma follow-ups. (this is a double post...posted in the not diagnosed forum but didn't get a response)
Last year I went to my primary care doctor (I have since changed primary care doctors) with the complaint of nipple discharge. I had never done a self exam at home (I'm 33) and decided it was time to do one. The right breast was perfectly find. With the left one I felt nothing odd or out of place (I am small breasted) but the instructions said to squeeze the nipple. I did and a little bit of fluid came out of a single duct. I did this again over the next 2 days and sometimes I'd get a little bit of fluid and other times nothing. The instructions said to immediately report anything abnormal to your doctor so I did. By the way, this fluid never comes out on it's own...I have to squeeze a bit to get it to come out.
My primary care doctor did a breast exam on both breasts and said that she felt nothing abnormal. She checked my prolactin level (well within normal range) and sent me for a mammogram and ultrasound. Right breast was normal on both tests. Left mammogram was normal but the ultrasound found a 1.6 cm solid nodule at 3 o'clock, 3 cm from my nipple. I got a BIRADS of 4 and was sent on for a ultrasound guided core biopsy. The impression on the ultrasound was fibroadenoma.
A few days later the radiology center did the biopsy. I watched everything and the needle definitely penetrated the nodule. The radiologist took 4 samples. He said that it definitely looks like a fibroadenoma and agrees with the first radiologist's impression but the needed to be 100% sure.
The pathology comes back as fibroadenoma changes with PASH (focal psuedoangiomatous hyperplasia). My primary care doctor told me that it's a fibroadenoma and I need another ultrasound in 6 months. When I got a copy of the pathology report I became concerned about the PASH so I went to my OB who told me that focal means very little and not to be worried. She said that my pathology report isn't scary and that she's seen many that are scary. She said to relax and just be sure that I go to the 6 month follow-up.
I wanted to be 100% sure so I contacted the university hospital by my house that has a great breast center. I went there. I saw a surgeon and nurse. He wanted another ultrasound done by their experts becaues they can get better images. I had that done 2 weeks later. The radiologist came in and did it herself and the technician initally did it. They were having a hard time seeing the clip that was put in during the biopsy. He said that they aren't impressed by the images (not being impressed being a good thing in doctor lingo) and to come back in 6 months. I did that and the tumor has remained completely unchanged. The technician said it looks exactly the same way it did 6 months ago. I also asked her to show me where it is because I cannot feel it which is weird because it's 1.6 cm and my breasts are small to begin with. She told me to wait so the radiologist can look at the images. She came back 15 minutes later with a piece of paper telling me to come back until I'm 40 because there are no signs of malignancy.
My question is, does this sound ok? I have no idea how long the fibroadenoma has been there since nobody can actually feel it (I get a yearly check-up from my OB). Maybe it's been in there for 10 years, who knows. It hasn't changed in 6 months so is it ok to ignore it until I'm 40 or should I go for another 6 month check-up just to be sure. I'm thinking that since this is well known breast center on Long Island that they probably know best since they deal with this everyday but in the back on my mind I'm questioning whether or not I should ask my OB for a check-up in another 6 months just to be sure. I always tend to question medical opinions and really don't want a bad surprise when I go back at 40.
Thank you.
Comments
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Your situation sounds almost identical to mine. In Sept I went for a baseline mammo (age 37) because I felt a lump on my left breast (gets bigger after ovulation). They did mammo and ultrasound and found nothing wrong with my left breast but found a 1.6cm solid mass on my right breast at the 2:00 position (which noone, including myself, obgyn and surgeon could feel) . I was petrified. Had an ultrasound core needle biopsy which came back as normal breast tissue. Just to be 100% sure they hit the correct spot I had a mammotome biopsy, which also yielded the exact same results...normal breast tissue.
Just had my follow up mammogram today (at 4.5 months since I was a basket case and couldn't wait another 1.5 months for the official "6 month follow up". Everything is unchanged. Spot is still there, but has not changed. I actually saw the 2 clips they placed on the biopsied area on mammogram today. The pathologist said nothing to worry about. I meet with my breast surgeon on Thursday just to confirm that all is okay, but the radiologist today didn't even feel the need to do an ultrasound again.
I will, however, be getting yearly mammograms...maybe even another in 6 months, which is fine by me. This past scare has taught me to be very proactive and insist on tests, procedures and reassurance if I feel something is "just not right".
Sounds like you in a similar situation. Trust me - it took A LOT for me to relax about this. In fact, I didn't feel confident (even with 2 benign biopsies) until today. In fact, I vomited twice this morning before my mammo. But, just try to just think positive and be happy with your results. I know - easier said than done. Been there, done that.
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I have had multiple fibroadenoma's and they can be there and no one knows it. When I decided to have my mastectomies they found a 2.5 cm fibroadenoma in my good breast and I never felt that mass and it didn't show up on my mammogram. Just be sure you do monthly BSE's so you know what is normal and what isn't and also yearly clinical exams with your gyn, that way you won't have any surprises when you go back at 40. I found my cancer myself and just had a feeling that it wasn't the same since I knew what the other lumps felt like. Good luck to you!
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Thank you ladies.
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Get it out! My fibroadenoma was removed, believed to be benign, but in the additional tissue around it was found to be breast cancer (Invasive ductal carcinoma.) An MRI revealed anpother site on the opposite side of same breast, which was never seen on mammo or ultrasound. i later read online that these fibroadenomas form as a means of telling your body something is in there that doesn't belong. In my case that was absolutely true. I took birth control pills for 13 years . I believe this was personally the cause. I will never know for sure but you won't know anything for sure until you have it taken out. This is nothing to play around with. I would demand that they surgically remove it along with extra tissue surrounding it. Feel free to private message me.
I wished I would have known that these things can and do develop. I now am missing a breast because of it but that is better than losing my life which would have possibly happened had I let it stay in there.
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I was dx with a fibroandenoma about four years ago but I only had taken birth control pills for about a year so I didn't think there was a connection between the two. It could not be felt and was only found through a mammogram and sonogram and dx through fine needle biopsy. I also have small breasts and I was dx with bc in August after a routine mammogram showed microcalcifications and biopsy confirmed bc. The tumor was very small and the drs could not feel it through exam. I think you should just find a dr who will follow you closely and don't wait until you're 40 for your next check up. You may also want to make healthy dietary changes and avoid processed foods and try to exercise.
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I've decided to go back to the breast surgeon after reading your stories. They did scare me but that's a good thing. I tend to be proactive but I also tend to have healthy and cancer anxiety and overanalyze and worry obsessively about these things. I am trying to stay calm because things look very good for me right now but I don't want to make a stupid decision that I will regret down the road.
Sooo...I'm back at the worrying stage again. I see the surgeon on Monday, the 15th to see if he will remove the fibroadenoma so I don't worry about it for 7 years.
About a month after the biopsy I noticed 3 swollen nodes in my cervical neck. I know they weren't there in April (long story but my neck was checked via ultrasound because I was concerned about something). They haven't grown and are most likely still swollen because I touch them to make sure they are staying the same or getting smaller. They have gotten smaller since I found them but are still touchable. They are around 1 cm...possibly slightly smaller. This set off fears of lymphoma so one node was FNA biospied with no malignant cells found just a reactive node. I also had a CT scan of my neck (which showed everything in my head from my eye balls down to part of the supraclavicular ares). Nothing abnormal but the 3 nodes which the radiologist didn't think much of. The breast surgeon wasn't aware of this as I saw it as a completely different issue. He did check my armpit nodes and supraclavicular area but not my cervical neck. Now I'm starting to wonder if these nodes are connected to my fibroadenoma.
I was wondering if a tumor that looks benign, is core biopsied as benign and has remained unchanged could actually me a type of breast cancer that has spread to my neck nodes. The tumor looks exactly like it did in May 09 so I'm guessing that it isn't possible. I'm guessing that a metastic breast tumor would look different after 6 months. Is this a good guess or a bad one? Ughhh...I hate anything medical. My life has been a mess since my doctor found a calcium level of 10.4 in January 09. After reading about high calcium I flipped out emotionally and anxiety has gotten a strong grip on me. My PTH was smack tab in the middle or normal and the calcium never to anything above 10.2 again. At last check it was 9.6 which the hematologist/oncologist told me is a good indication that the high calcium wasn't caused by a malignancy becasue the calcium with continue to be high (it's been checked numerous times at my insistance). I saw the hematologist after nagging my primary about the swollen nodes, lymphoma, and my fear of the calcium indicating a malginancy. Every doctor I've seen who has looked at and touched the nodes is well aware of the calcium issue and the fibroadenoma issue. I feel like such a medical mess that is in limbo all of the time. Everytime I see a doctor the first thing they diagnose me with is anxiety. I've been politely kicked out of 3 ENT offices and an endocrinology office (another long story but nothing is wrong with my thyroid which has been checked 3 times). In the past year I've had a colonoscopy, 2 back MRIs for a backache that eventually went away, a back x-ray before the MRI but I wasn't satisfied, numerous blood tests (numerous CBCs, numerous liver panels, metabolic, PTH, LDH, ESR or Sed rate, urinalysis, 3 pelvic ultrasounds for a small cyst, that went away, prolactin for the discharge, von Willebrands, bleeding time, 3 neck ultrasounds, a neck CT, abdominal and renal ultrasound, lymph node FNA, skin biopsy because the dermatologist was arguing with me that I cluster of spots on me was not petechiae when in fact the biopsy proved him wrong, 3 mammograms...1 for a diagnosis, 1 post clip insertion, and 1 because the breast center couldn't get a hold of my orignal mammogram, 5 breast ultrasounds...1 for diagnosis, 1 during core biopsy, 1 two months after the biopsy because I was still feeling pain from it where no pain existed prior, and 2 from the breast center to diagnose and follow-up). From all of this, nothing abnormal except for a minimally elevated calcium level which never reared its ugly head again and a fibroadenoma. I'm scared to death and am sick of being told that I'm anxious. I know I'm anxious...I live with it daily. If someone would just get rid of the fibroadenoma so I can be sure that I'm ok and get rid of one of the nodes so I know that I'm ok then I'd be able to get on with my life. I feel like I've aged 5 years in this past year from all of the worry that the orignal calcium test caused.
Ladies, I'm sorry I went on and on but maybe someone on here can relate and help me sort through this because it's been inside of me for a year and I am not getting much help from the specialists I've seen. My primary doctor has been great but he is starting to think I'm nuts too and is only sending me off to these specialists with the hopes of reassurance that I'm ok. He looked into my eyes twice and said, "I don't think anything is wrong with you".
I read so many misdiagnosis stories on here and on the lymphoma board and I fear that I am being misdiagnosed about one of these conditions because nobody will cut these things out of me. I've so had it. I don't trust most doctors because if they can't find it they assume you're nuts and don't want to listen to my concerns. My family has had it with me which at this point I understand. I've had it with me too but I can't get these stories out of my mind. Most likely I'm not one of these stories but I don't want to regret later what I could have fixed sooner.
Any advice or help?
Thank you so much. It feels good to finally get my concerns out in the open. If anyone can relate me help me sort through this. You can PM if you want.
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Well, I'm not sure this will help you. As a DES daughter I was in the habit of getting pap smears twice a year. Because I was at the doctor, I usually had a clinical exam of both breasts as well, and she would check skin, etc. And had a mammogram annually also--fourteen years in a row. In 2008 I flunked the mammo by showing up with a big lymph node in the corner of the film. When I went for the ultrasound, the tech couldn't find the tumor that went with it. She was a very experienced, very determined woman who knew something had to be there. Finally she flagged some of the architecture in the neighborhood of the node and scheduled me for biopsy the next day.
To make a long story short, there was a 1.6 cm tumor INSIDE a fibroadenoma that had grown around the cancer. My surgeon said "we just don't see that." He was 75 and has been practicing forever.
I had an unusual combo of IDC, DCIS, ILC, and LCIS, mostly IDC. I am much older than you--58 now, so 56 then. Cancer runs in my family, several different kinds. I never pestered my doctors because I didn't want to be a pain in the ass, and having been told you are fine, why push it?
Because you have to, if you think there is a reason to. Just because you are paranoid doesn't mean you are fine. I say, find someone who will remove it.
Warmest,
Cath
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Thank you Cath. I don't think that I've ever read of a fibroadenoma growing around a tumor (I've heard of the reverse in the margins but never this) and that's quite a combination of evil cells you have. I hope that your treatment is going well for you. I haven't read too much on this board (just enough to scare me into being more proactive about this tumor) so I'm not familiar with your posts. Everyone tends to do the age thing...you're too young so it isn't possible. I've read far too many stories of people not being within the usual age and getting this. Cancer doesn't know your age and doesn't care. If 1 bad cell decided to wreak havoc then you have to kick it in its butt no matter what your age is. Cancer doesn't discriminate based on age, regardless of all of the stupid stats. There is always someone in the minority and anyone, including oneself, can be in the minority. Cancer doesn't care who you are, if you have children, if you're 18 or 90. This is what I've learned and this is why I fight my doctors on everything. I don't like stats. There are always 2 sides to them and nobody knows which side of the stats you'll be on.
That is what I keep telling my family, just because I have anxiety about this stuff doesn't necessarily mean that I don't have it. My family history is negative for BC but on my mom's side there are 2 cancers both of which were from smoking after being told to quit. I don't smoke and never have so I don't think I'm at risk for either of those...bladder and throat.
I told my husband that I just want him to hold my hand through this process. He wants to fix it, the it being the anxiety. I told him that he can't fix it and that he doesn't need to. I just want someone to hold my hand and give me emotional support instead of trying to psychoanalyze me, which is definitely isn't qualified to do.
I hope that all of this is just my anxiety getting the better of me, but I'm from the school of better safe than sorry.
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Alligans,
Anxiety is really bad for you. I have it too but a friend gave me two books that have helped with the anxiety. The New Earth and The Power of Now. Both are written by Ekhart Tolle. I don't know if they will help you, but they help me to focus on the present and not worry about the future or the dwell on the past. Some days since my diagnosis I still feel anxious but not like I did before. I also like the website crazysexylife.com. If I could go back in time before BC, I would have changed my diet and gotten more exercise in my 30's. I was never overweight so I wasn't concerned with what I ate and I ate 100% processed foods and lots of sugary foods too. Another helpful book is How to Fight Cancer and Win by William Fischer which talks about the importance of diet and focuses on the Budwig Diet as both preventative and a cure for cancer. I know there is so much literature out there but the books I've mentioned were given to me by 2 cancer survivors. Just try not to let the anxiety ruin your present life.
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Good evening ladies.
I had my yearly exam with my OBGYN and discussed the fibroadenoma with her to see her take on it. She agreed that waiting 7 years is way too long. She got my ultrasound report from Stony Brook's breast clinic and read it. I looked over her shoulder and could only see "1.6 cm stable fibroadenoma..." She said that she wants to image it once a year. She tried to feel it and knew where it was but couldn't actually feel the lump due to the thick dense tissue covering it up. I asked her about the nipple discharge and she said that it's due to my hormones. As long as my prolactin level is normal (it is...very very normal according to my bloodwork from May) and as long as nothing else was found on the mammo or ultrasound that it must be hormonal. I'm not sure that I agree with that.
I'm going to post a question about the discharge in another thread. She doesn't know that I'm also consulting with a breast surgeon at Stony Brook on Monday. I wanted an unadulterated professional opinion.
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Hi Alligans,
The ultras sound report is your medical record and you should have a copy of it. Tell Stony Brook to send you a copy. I know fibroadenomas can cause breast pain. I finally gave up coffee, which is not easy, and the pain has subsided. Just a tip, in case you were having pain too.
Hope all goes well!
Curly Girl
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Im 32. I was diagnosed w a 2.6cm complex fibroadenoma 9 months ago in my left breast. It has no definite lines and has calcification. I have three smaller ones on the same Breast. It is so painful that I can barely stand to touch it. I can barely wear a bra or lay on that side. The pain doesn't subside. I had a biopsy done 9 months ago that confirmed it to be a fibroadenoma. It made me feel better knowing what it was.
Recently I started having a brownish color sticky nipple discharge, more pain, and burning. I was worried and went in for my follow up ultrasound. They seemed to not be worried about it and said that everything looks normal. The pain is "hormonal". But why is it every day, not just around my period. I can't help but feel like something is wrong. The pain radiates into my breast bone and my left upper part of my back. Could the biopsy be wrong? I can't help but worry. I'm weak, tired, dizzy, I've lost 15 pounds in the past 6 months. I shouldn't feel like this. I feel like I need more answers and I need to speak up since I see other people having pain as well. -
Terry, please go see another doctor. Nipple discharge is to be taken very seriously. I let mine go for about a year thinking it was hormonal. When I finally saw a breast doctor they recommended removing all my ducts. I had that done 2 weeks ago. They found an intraductal papilloma, typical hyperpasia, a fibroadenaoma and some other things. All of these are benign right now, but up my cancer risk to 30%. My doctors are taking this very seriously and have told me I need annual MRIs with contrast plus recommend I take Tamoxifen to prevent cancer. Seems like they should be doing something about pain and discharge in your case. Btw, all my tests--mamo, sono and culture of the discharge--were normal.
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Dear Friend,
Thanks, for sharing,
I have a fibro in dense breasts I am not allowed to take away
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