Went for the ultrasound...how much can a tech tell??? She said

If you can feel the lump get an appointment with a breast surgeon and have a biopsy done.  If the lump can be felt, it can be biopsied without ultrasound or other techniques.  Or call/write to the place where the ultrasound was done and tell them you don't feel you got an adequate exam and you want one with someone who has time to do a good job.  Remind them you can sue them if the lump should happen to be cancer and they didn't adequately look for it. Most places the tech cannot give any results info to patients, so you may need to find out if the tech is actually properly trained. Patients have a right to know the first and last name and credentials of every person providing services, so don't be shy about asking for that info. 

Can you request a breast MRI.  That should pick up what a mammo or US can't.  Best of luck to you, I hope it is nothing at all.

Linda

Flower123, it was because of a patient and experienced ultrasound tech that my lump was detected.  We could all see an unusual lymph node, but nothing was showing up on my breast.  She started at the lymph node and then edged very slowly while apologizing for pushing so hard.  Finally--more than twenty minutes later, she exclaimed, "There!" When she showed me the area I could detect nothing.  She said "It looks a lot like normal breast tissue, but there is something different about the architecture." It was a 1.6 cm lesion--the only one--made up of DCIS, IDC, and ILC, and hidden inside a fibroadenoma.  That is, the fibroadenoma encased it, making it almost invisible to the ultrasound.

My mom had breast cancer at 43 and died at age 60 from bone mets (this was in the 80's before current therapies were available; she never had chemo) and my brother and sister have had other kinds of cancer.  Nonetheless, my two youngest sisters have been denied access to mri and are regularly sent away from their annual screening after being told they are fine.  It makes me crazy.

I tell them both to change docs.  They tell me they like their docs.  I liked my gynecologist, too, but she missed a lymph node the size of a truck and never referred me for advanced screening despite my aging, exposure to DES, and family history.  The last few years before diagnosis, I had a funny feeling that I was being careless by not advancing a case, but we all like to be told we're fine, and I was no different.

There are different kinds of mri procedures, some that involve the injection of contrast, and some that simply use magnetic resonance to develop an image of the architecture of one's breast.  They involve laying still and entering a long channel. The resonator makes loud banging noises, but the procedure is not invasive unless they use contrast dye, which I think is for diagnostic procedures, different from screening.  (My other sister is screened with the contrast, because she has had cancer. Different centers do different things.)

If I were you I would get the most tests that I could, knowing what I know now.  Early detection is worth the extra stress, inconvenience, and the sometimes difficult self-advocacy.

It is only my opinion, but I might find a way to have that ultrasound repeated, just to be thorough. 

Warmest, 

Cathy 

Hi, Flower.  I think that the gynecologist has been your advocate, so I definitely would do what you did--make another appointment.  I would, in the meantime, write, call, or fax a written request to the other doctor(s) for copies of my records and reports.  Read through them, Google what you don't understand and pay attention to things you see in the articles and abstracts like risk statistics, likelihood of developing invasive or noninvasive breast cancer, and things like that.  You won't grasp it all, but you will get a sense of why this is all important and why it is wrong, very wrong, that you are being treated the way you are being treated.

Tell your gynecologist that you would like a referral to a different breast specialist in a different practice, would he like to make that referral?  Don't equivocate, tell him that you are not being treated properly in your current breast specialist's practice.  A 30 second ultrasound is not worth the trouble.  A two minute exam is insulting.  (He can order the mri, by the way).  Be insistent, but know that you probably don't need the referral anyway, you can call and make an appointment with someone else without his permission.

The fact is that if you have certain kinds of atypia, you are at an elevated risk of developing IDC or DCIS sometime in your life.  Not right away, necessarily, and maybe not at your young age.  But you are at risk.  You deserve to be heard each and every time that something doesn't feel, seem, or sound right.  Sometimes it's only our intuition that is the clue.  

The women in my family tend to worry that someone--doctor or whomever--is going to get mad at them.  Please don't think that way.  My mother went to complete idiots for her medical care because she didn't want to hurt their feelings.  You do not have to discuss this with the doctor herself, anyway.  You are entitled to second, third, and maybe fourth opinions on all of this.  All you want are copies of your records.  

If you read my other posts, you know that I am not in the habit of telling others what to do; I try really hard to limit my remarks to my own experiences and to carefully offered alternative points of view.  But you asked me what I think, so this is it.  I think you've been treated wrong, and you should have a repeat ultrasound, an mri, and a chance to have a frank and thorough discussion with a more accessible doctor.  Not because I think your lump is a "something"; no one knows that, but because at this rate you won't find out.

I'll never forget the ultrasound tech who took so much time and gave me so much compassionate attention.  I wrote her a thank you note because I think she might have saved my life. 

Please keep me posted, and follow your instincts and your heart.

Cathy 

When I was having my US they at first could not find where they should be looking as well.  I told them my daughter had had a dream that it was all a mistake, so maybe that was what was happening.  I had two spots, neither of which could be palpated, so I did not find it on examination.  Had mammograms since I was 35, diagnosed at 52, when the radiologist finally questioned one of the spots.  They finally found where they needed to be and it was positive.  14/32 nodes...going on 6 years survival.  I guess what I am trying to say is go with your gut......don't hesitate to question anything you don't understand or feel comfortable with.  That is your right as a patient, woman, human being.  And, that is the only way you can be confident that you are getting the answers you need.  Being positive is a great way to handle it as well.  I know that can be difficult but I believe that has gotten me to where I am today.  Best of luck and God Bless.

Hi Flower; try this,

"Dr., I'd like to ask you for a referral to a different breast specialist in another practice from the one that I've been going to.  I know that I'm high risk and as a careful patient, I'd like to have a careful doctor.  I don't feel comfortable at Dr. So and so's practice, and I don't think they are comfortable with me as a patient, for some reason.  I wonder if you could recommend someone who would take the time to explain my condition to me and tell me how we are going to manage it together in the coming years.  I also want to know if my last ultrasound can be repeated, since the one I was given lasted no longer than one minute.  I know from my research that that is not the way these things are normally done.  I believe I should have the mri you recommended; can you authorize that or would you prefer that I seek authorization from my new doctor?  If you could expedite an appointment that would be great."

You don't need to bad mouth anyone.  Sometimes the doctor patient relationship just doesn't work out.  No one needs to apologize; it isn't like that.  If you aren't comfortable, you just aren't. If he asks, just say that it isn't working for you, and don't say anything else.  This is new to you, but not to them; it just happens sometimes.  

It will be fine; don't worry about it.  I'd definitely ask him to check the lump and arrange for further testing.  

 Warmest,

Cathy