BIRADS category 3.. To biopsy or not?

They are the size of a grain of rice. You can't feel them and it identifies that the area has already been biopsied on future imaging. A lot more desirable than having to rebiopsy an area in the future because it isn't marked that it has already been checked.

You don't have reactions to them. Titanium is the same metal used in hip replacements, etc.

Do you want to keep having to rebiopsy the same spot over the years because you won't let them mark it?

I think all these posts are just feeding your anxiety.

Nobody has reactions to titanium--it is non-magnetic and won’t set off an airport metal detector. Not only that, it’s the metal they use for eyeglass frames for people allergic to the nickel in stainless steel (or even 14K gold). It has to stay in there so they’ll know where to look next time you get a mammo or ultrasound...or in the very, very, VERY unlikely chance you’d need a lumpectomy, where to find the tumor on mammo & ultrasound.

Take a deep breath. Several deep breaths. At first I thought you were unnecessarily anxious, but that there’s no real harm in getting the biopsy done in order to keep you from worrying for 6 months. But now you’re worrying about something as trivial and harmless as the titanium clip! I hate to make you even more anxious, but once the biopsy comes back benign and you’re advised to re-check in another 6-12 months, I suspect you will keep worrying (“what if the pathologist was wrong, what if they missed the part of the tumor that might have cancer, etc. etc.”). If you mistrust a benign biopsy result and insist on excision, you will worry yourself sick waiting for those results--and if they’re benign, you’ll probably still be waiting for the other shoe to drop. Trust me, it never ends--no matter the results.

Look, the fact is that life’ll kill ya. (I stole that from Warren Zevon). You could get hit by a bus. You could get shot as an innocent bystander in a gang-banger drive-by. You could choke on something with nobody to Heimlich you. You could get stung by a swarm of bees, carried away by a tornado, struck by lightning, catch a drug-resistant bug, You could fall down a flight of stairs and fracture your skull or spine. But no sane person twists their guts into knots worrying about those things. The chance your biopsy comes back anything other than benign is almost as remote--and the chance of anything going wrong by getting a titanium clip is nonexistent.

Being in the health professions carries the real danger of white-coat hypochondria. In my husband’s second year of medical school, he and all his classmates kept imagining the sound of hoofbeats and went looking for zebras--and were convinced they had symptoms of every disease they studied. It was ridiculous, and they eventually got back to reality and on with their lives. An example is one day years ago when I was going for my physical and booster shots. Before my primary care doc came in, the resident assigned to take my vitals & basic h & p looked at my toes and said they looked sort of purple--and asked me, “There’s a disease called lupus, you’re the right age for the highest risk of it, and I think you should ask your doctor to order an l.e. prep test.” My doc came in, I told her what the resident said. She looked at the thermostat in the room--it read 61 degrees. “Your toes are purple because you’re cold. I’m cold. But we won’t be for long,” she said, as she adjusted the air conditioner control. The she mentioned hoofbeats & zebras. (You can probably guess I never got lupus).

There are SO many REAL dangers in life to worry about--and eventually (unless you’re suddenly struck dead in your prime by a meteorite or runaway train), you will be old enough to encounter them. Then you will look back and beat yourself up for wasting the best and healthiest years of your life worrying unnexessarily.

Melly,

What area of nursing is your expertise? I'm thinking you can drawn on the factual information (Ie your medical hat) to help with anxiety?

Im surprised that you are concerned about the titanium marker. I take it, in your area of nursing, you have not heard about this?

Hi Melly,

I have almost never heard of the markers causing a problem, although one person thought they were, so she actually had them removed surgically. I have markers in both breasts and have no had difficulty with them whatsoever. The main issue is, can you deal with the anxiety if you have to wait six months for follow-up imaging? It's up to you; of course, but maybe you could opt to wait, and get some kind of counseling in the interim to help you get through the time period. It is true that biopsies can cause scar tissue to form, making imaging more difficult. I did have a situation where the radiologist would have waited, but the surgeon wanted to biopsy. This was in the untreated breast, but I guess the surgeon thought I was at greater risk of having DCIS or atypia in the other breast. It was only a few months after I completed treatment on the other breast, so I went with it. If I hadn't seen the surgeon, I would have, most likely, waited. They converted the BIRADS to a 4 so that they could do the biopsy...result...completely benign.

THey put me at a birads 3 with hypoechoic and lobulated nodule showing on my ultrasound should I push for more testing or wait the 6 months? This forum seems like a very helpful place where I'm hoping I can get a little clarification and reassurance. I am new to these boards and am waiting to go do my genetic testing in mid may (the first opening they had). every woman in my family has had breast ovarian and cervical cancer several times and some with a combination all before menopause as well as my aunt 48yrs old and cousin at 20 yrs old testing positive for brca1 gene and my sister 36 yrs old for colorectal cancer, so needless to say im 35 yrs old and worried due to multiple breast changes this year I have a lot of pain in my nipple almost like a hot iron going throught to my back and constant pain under both my arms. I had an ultrasound done a few weeks ago but haven't been able to relax since. i feel like somethings wrong and now i have to wait 6 months for ultrasound and until may for genetic testing. Any help you could give me with interpreting my ultrasound results would be awesome.

Multiple hypoechoic masses bilaterally measuring approx. 9mm in greatest dimension in right and left breast, appearance most consistent with simple and mildly complex cysts well as intramammary lymph nodes. most suspicious appearing nodule occurs in the 10 oclock position of the right breast 1cm from the nipple and measures 6x3mm in size. repeat bilateral u/s recommended in 6 months to confirm stability with particular emphasis on lobulated nodule in the 10 oclock position of the right breast approx. 1cm from the nipple. birads category 3 probably benign findings