Paternal breast cancer history
So after two years of having a persistent, mystery lump in my right breast , I am getting ready to unleash the wrath of me upon my family dr. I have had two ultrasounds in the past two years neither has shown "the lump". Me, my husband, family dr and ultrasound tech can all feel it. I was told that my right breast is denser than the left and it's most likely due to hormones and age related changes is the breast. Two years ago I requested a mammo after the clear ultrasound, apparently they will not do a mammo because I'm in my 30s and that breast is dense. The latest ultrasound although it didn't find the lump they found a 3x2x5 cyst which I was told is too small to do anything with. So they are going to see me again in 3 months......
So now this brings me to paternal family history.....
From the very beginning of this I was told family history only counts on my moms side.... There is no breast cancer on her side.
My fathers side however does have breast cancer, both his moms side and fathers side......
I spoke with my great aunt today who is a breast cancer survivor. She has had two recurrences and has had both breasts removed..... She urged me to press this issue..... Her initial lump did NOT show on mammo, did NOT show on ultrasound. Needle biopsy came back OK. She personally wasn't happy until she sought a second opinion. It was then she was offered to have it taken out.... Two days later she was diagnosed with invasive cancer.
I cannot understand why my dr is soooo adamant that his side of the family's history doesn't matter.
Last time I checked I believe i inherited half of my DNA from him.
How do I go about getting the answers I need? I just want to know exactly what this is..... I feel like I am being dismissed and discriminated against because of my age...... And irrelevant paternal history.
Comments
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Trabby - paternal history is absolutely relevant. Frankly though, even without a family history a lump deserves to be investigated (mammograms miss ~10% of breast cancers).
In my case, all my family history is all on my dad's side - his sister (locally advanced BC at age 28), and 3 of his great aunts (breast for 3 and ovarian CA for one in addition to breast). Interestingly his mother died in her 90s of a totally unrelated ailment. I was 34 when my mammogram came back very mildly abnormal. The ultrasound picked up 2 small microcysts 3mm and 7mm. I self referred to a breast surgeon and insisted on a biopsy which everyone assured me would be benign (the radiologist actually told me it would "make my anxiety better" while they were doing it!) and, oops, lo and behold I did have early stage BC. In both spots. A subsequent MRI revealed an additional 9x8x5 cm area of more multifocal DCIS!
I am BRCA 1 and 2 negative FYI - my personal opinion is that there are other breast cancer genes out there that just have not been identified. My GAIL model score for developing breast cancer in 2010 was 0.04%. Long and the short of it - after reviewing my family history my onc also thought that I probably had some sort of hereditary BC issue.
If your doctor won't work with you, find another one who will - preferably at an NCI affiliated center. It is your body and your life, and no one else can or will advocate for you in the same way as you can.
Now, I don't want to freak you out overly much with my story, but I remembered feeling much the way you are describing - when I came home from my diagnostic mammogram I was crying - I knew something was wrong and I couldn't believe they were going to try to make me wait 6 months to see. I'm glad I didn't wait. You shouldn't have to either.
(((hugs)))
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Thanks for your reply candDsmom, I am planning on giving my family dr a lambasting on my dads side cancer history. After that she can decide wether to break the rules and get me a mammo or continue to do nothing other than tell me how hormonal women are in their 30's. The most frustrating thing about this is that they can't tell me what the lump is. There's so many things other than cancer that it could be and probably is...... I just want it to have a formal name. Over the last few years I have really lost faith in the medical system..... They preach early detection but impose all of these guidelines that either open or close the door to full assessment of the problem. Also there is not a single female dr in my city who will see new patients, I'm a little hesitant to walk into some strange male dr's office and whip out my boob on the first visit.
I find it very Unnerving that my great aunts cancer was missed by us/mammo and biopsy.... Luckily she got her diagnoses after she had it cut out. -
Consider asking for a referral to a breast specialist - even a normal/negative mammogram is not an "all clear" especially when you have dense breast tissue. You are not being unreasonable, you just want to know what it is...
Good luck!
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Thanks again..... There is not a breast specialist in my area though. The breast and cervical health program has two general surgeons who see women at the clinic. I have seen the one dr and he is the one that said the cyst is too small to do anything with so come back in 3 months.
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I had a 3mm cyst that they did ultrasound guided biopsy on... perhaps that is an option?
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Add another with history on paternal side. My father's mother died within 8 weeks of diagnosis from IBC. My MRI (with biopsies) showed extensive IBC, same day the Mammogram showed "all clear". I am so glad that my regular doctor was too busy to see me and I had to see another breast specialist that day! No BC on mother's side.
Can you request a MRI with biopsy of the area?
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When the dr told me the cyst was too small to do anything with he mentioned something about a wire, then recanted and said he will see me in three months. When I see my family dr I am going to ask her about a biopsy....
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Trabby, that doctor who thinks paternal family history of BC is irrelevant needs some education!!!
Here are links to abstracts of two papers about this:
http://www.ncbi.nlm.nih.gov/pubmed/21503821
("Breast and Ovarian Cancer: The Forgotten Paternal Contribution")http://www.ncbi.nlm.nih.gov/pubmed/12697961
("The importance of paternal family history in hereditary breast cancer is underappreciated by health care professionals") -
Hi. I too was told I was not at any higher risk due to paternal history.....I'm 39 years old and just found I have breast cancer. I found a lump in March 2011 beside my aerola on my right breast, sort of a thickening, hard and not painful. That was my only sign. I saw my GYN and due to my paternal history--grandmother, aunt, great aunt and cousin, he offered the BRAC gene testing to me. I was negative (thankfully!). Referred me to a breast surgeon, mammogram, ultrasound. The mammogram showed nothing, except extremely dense breast tissue, even though they marked the lump and you barely had to touch me to feel it. The ultrasound showed nothing! The surgeon only agreed to remove the lump because he knew how anxious I was about it (and it probably helped that I am a RN and used to work with him at the hospital!). But I was determined to have it out.....just to be sure, I wasn't leaving till he agreed. He told me it was nothing, he said 99% positive it would be benign. I had it removed on April 8, 2011, and it looked like nothing he ever saw. Like a yellow green bean shaped thing! Not like typical cancer, but it was hard. He still said 90% sure it was benign. April 12, 2011 he gave me the news. Cancer, but they thought it was non-invasive. Second pathology report showed DCIS. After looking at the mammogram himself, he magnified it greatly and saw 2 areas of concern (micro-calcifications), one on my Right and another on my Left breast. I had a MRI on April 22, 2011 and am awaiting that official report, and had a stereotactic biopsy on second area of right breast, found out 2 hours ago, that was benign. Didn't get to do the left due to complications on the right. But, after everything, I want and the doctor recommends bilateral mastectomy with immediate reconstruction with expanders. He says that my breast are so dense that the only way we can tell if it happens on the left is if I get another lump and many times it's invasive by then.
I guess my point is, please see someone else no matter where you are and how far you have to travel if you are not getting the treatment or answers for your peace of mind. I would have never known if I wouldn't have been my own patient advocate. I am praying that after the mastectomies (which by the way I'm scared to death of) they don't find anything invasive. I will pray for you and the others.
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Hi Ladies, My mother had breast cancer twice and it came from her fathers side. We did the gene tree all the genetic testing and there was nothing on her mothers side. I would also get another opinion. On one of the threads a doctor told a 30yr old women not to worry most women her age don't get cancer..... If I knew where he was I would go kick his a$$.
Mommyrnx2: hang in there. I had a double mastectomy with no recon. I didn't know if I would need rads or not. I hope to have new boobs in the next 6 to 8 months. I did ok with the surgery I think I was more upset over losing my hair. I will keep you in my prayers.
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I hope you can find another doctor that can order appropriate tests. I actually felt my lump, my doctor felt my lump, had mammo and ultrasound, then biopsy. (which revealed breast cancer) and then an MRI. when I got to the breast surgeon, she said "now tell me again how you found this lump?" and I said "i felt it" she said " yeah, it didn't really show up on the mammogram" I was like WOW and you KNEW where to look!! Her point was I will have to MRI instead of mammo now, but I also have dense breast tissue. It scared me because if I had gotten my mammo in the fall as I SHOULD have, they may have missed it and i may not have thought much of the lump and let it go for a while!!
I also have NO maternal family history, but alot of cancer on the paternal side. I would definitely try to get another doctor...good luck to you!!! let us know if you have any luck with another doctor! HUGS!!
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tracie23: Thank you and I will pray for you also! I told my daughter if I have to have chemo and lose my hair I'll get some wigs in different colors and she can have them when I'm done!
She thought that sounded great! Good luck with your reconstruction! Is it crazy to look at the positives of this? I'm a A cup now and at least with reconstruction I can go up in size and finally have a bigger chest! Gotta look at the positives! (BTW, my husband doesn't think this is funny, he could care less about a bigger chest, bless his heart! But I guess I either laugh about some of it or cry!)
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Hey ladies,
I haven't popped in in awhile other than to quickly cruise the boards. I hope today finds everyone in good spirits and good health.so with my rechecks looming next month I'm starting to get really nervous. I will be demanding that they cut this thing out.... Which freaks me out, but also I'm afraid of the results. My husband and I were talking yesterday, and I realized that there has not been a single month yet this year that I haven't gotten sick. Right now I have a nasty cold. The other day my chest and lungs hurt so bad I swore they were bleeding..... So naturally my mind is working overtime and reading too much into it I'm sure. I plan to make a point of mentioning my crappy immune system at my recheck. My question is " has anyone experienced being sick all the time.... Prior to diagnosis?
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Just thought I would put my 2 cents in here. I have BC coming from both sides -- Mother died of BC, sister is a 20 year survivor. She has a different father than me, so that is definitely on my mom's side. Father's side: He had 5 sister's. 2 had breast cancer, 1 ovarian and 1 brain. Also on my father's side, at least 5 of the daughter's of my aunts with some type of cancer have had breast cancer. I do not test positvie for the BRCA1 or 2 gene. NEVER has any Dr. tell me that the cancer history on my father's side is insignificant! They just say I have a double whammy. AND they had also said that the fact I am not BRCA1/2 negative does not mean that it is not genetic. It means that it is likely we have a gene that has not yet been identified. I have been getting mammograms since I was 30 yrs old because of family history -- every year. My breasts are fibrocystic and dense. I have almost always had to go back for additional views, US and/or MRI. I have had multiple biopsies and cyst aspirations. This year, the mammogram showed an abnormality. Got called back in for US. Referred to BS. He did a core needle biopsy. That came back negative, but he wanted to remove the lump anyway since the cells were abnormal and given my family history, etc, he figured we should take it out and be done with it. Guess, what?! It was invasive cancer! Thank God for my BS! It is Stage 1, medium growing. Who knows what would have happened 6 months down the road if he hadn't decided to take it out now instead of waiting. You should get that lump out or at the very least biopsied.
Now, that is my 2 cents!
Phyllis
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Thanks Phyllis....
I have been given such a run around over this.... I will be asking to have it removed next month.... Too long with no answers.... The only thing that has been certain is the lump is still there ( unidentified) and the worry at the back of my mind.
A friend of mine was told to come back in six months.... She demanded a biopsy.. Received an ILC diagnosis as well... Makes you wonder about dr's and the medical profession in general. -
Hi there....100% of my family history is on my father's side. My father even had breast cancer. There is a known BRCA mutation...actually two. ALL on my dad's side. I was always told that I had dense breast tissue and though I've been screened wtih mammo since I was 27...that stopped being enough when I reached about 33 or 34....then they started with compression views, sonograms and finally MRI. The MRI once a year and mammogram on the mid-year mark is what we went with. There are plenty of studies and reports about mammography not being the right screening tool for the young patient. My cousin had two tumors found (during pathology after mastectomy) that were NOT detected on Mammo. She is 35. My MRIs showed all the changes...the mammogram did not. If I were you, I'd insist on having a MRI. Where they go from there is depending upon the results. It sounds like you might be limited by the area you live in as far as obtaining adequate speclized treatment. I actually work in a cancer center and have all of the tools available and this is the course of study that they devised for me here. Best of luck...please let us know how it goes for you.
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I was diagnosed with bc on June 30th after it not showing on the mammo or ultrasound. When I went for my yearly mammo they were seeing something in the left breastthat turned out to be cysts, but I had been complaining to the breast specialist and my gyn that I had been having breast pain in my right breast since Dec 2010. Because they saw something in my right breast in 2009 and the family history, I have to do a breast mri the following week after the mammo. Through the breast mri they found the cancer and precancerous cells across from the area where the cancer is. I have a family history of bc in two of my sisters who are both doing chemo, in one sister the cancer came back, my mom's sister and her daughter both had it, now to find out that my dads sisters and some of their daughters all had bc too. The worst part is the waiting and not having all the answers. My doctor pushed the surgery back to give my brca results a chance to come back. I'm scheduled for surgery Aug 1st. His recommendation so far is lumpectomy, radiation and the oral meds for five years, but he says that if the brca test come back that I have the gene his recommendation may change. Not sure if it's her2, estrogen/progesterone or TN. Still have peace just need patience...
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My doctor told me Thank God for the breast MRI because it might've been years before they found it!! Themammo and ultrasound did pick it up.
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Your doctor is seriously uninformed. Father's side is just as relevant. All of our family's breast cancer history comes from my grandfather's side. And FYI, very often ILC does not show up on either mammo or u/s. Need MRI & biopsy to know for sure. Don't let anyone brush you off especially a doctor who doesn't deserve the title of doctor
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I also wanted to add that my doctor considers my grandparents and their health issues when considering my risk.
They always ask "sisters and mother with breast cancer?" on the questionnaire when you're checking into the appt - well I don't have any sisters and my mom has had lumpectomies, but no CA. However, mom's sister had a double mastectomy and mom's mother had a mastectomy. My father's mother died from ovarian. Another factor - Mom's sister died from bone cancer. So my doc looks beyond the sister/mother question. Cancer runs ramapant in my family. However, no heart disease, we all have low blood pressure and great cholesterol, as well as healthy weight and fitness. Just can't have it all, I guess! Every family has their "issue."
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