So many questions
Comments
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Hi everyone. I could definitely use some reassurance or lessons learned. I have lots of questions... My surgeon is recommending a 3-month recheck for what seems likely to be papilloma and I'm wondering if that's standard?
Two weeks ago I noticed a bloody discharge in my bra one night. Gyn scheduled me right away when I called the next day. They sent a culture out to the lab and those results are indicative of a papilloma. The GYN referred me for mammo and US which showed no masses and could not detect the likely source of the bleeding, which was still occurring during the mammo. I'm 52, so I have been getting regular mammograms for years and there is no substantial change from the past. My breasts are also very dense (50-75%), so it seems that is not helping with diagnosis.
The bleeding stopped after 3 days. I saw the BS this week at the 14 day mark. During the exam and consultation she seemed to think it was likely cystic issue. She recommended a three month follow up, and moving to mammo and us every 6 months. She indicated I could pursue MRI but that it would probably also show nothing. I pushed for MRI which has been approved by insurance and is scheduled for the end of this week.
After our consultation BS called back late day to say she had just seen the lab report of the culture and hadn't seen it earlier when we had our consult. She definitely wants me to do MRI now, but reiterated that she didn't expect it to show anything. She said we'd talk about next steps afterwards.
My questions are...
Did anyone have an MRI that showed something the us did not?
Does anyone have experience with a situation where there's likely a papilloma but it doesn't show on imaging?
Is it standard to take a wait and see approach with this type of situation?
I really appreciate any informed input anyone has as I try to make sense of all of this!
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First let me say that I'm so sorry you are here with breast health concerns.
I'll try to answer your questions in the order you asked them:
Did anyone have an MRI that showed something the us did not?
Yes. I had an mri after my initial lumpectomy just prior to starting my radiation. There were 2 more areas of DCIS that had not been previously seen by mammo or ultra sound. MRI is much more sensitive, especially in dense breast tissue.
Does anyone have experience with a situation where there's likely a papilloma but it doesn't show on imaging?
I have no experience with papillomas, sorry.
Is it standard to take a wait and see approach with this type of situation?
The wait and see approach is very standard when the risk seems to be below 2% for bc. There is a BIRADS system (0, 1, 2, 3, 4, 5 and sometimes includes letters, like 4a, b or c) that corresponds to the statistical risk of something being breast cancer based on characteristics appreciated on imaging. BIRADS 3 is most likely benign and therefore is recommended continued followup at 3, 6 or 12 months. Anything 4 or up is biopsied. They wait a prescribed time to see if the finding grows during that time. If it doesn't, it is continued to be watched until it is either deemed "stable" (not growing) or has grown and is determined to need biopsy. 70-80% of findings that are biopsied are still not breast cancer.
Hope this helps!
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MTwoman, thank you for replying. It definitely helps! I feel like a stranger in this new world of breast health and am so happy to have found this site where there is so much support and wisdom. I'm dreading the MRI procedure itself but definitely looking forward to more information afterwards. I'm glad to know that your MRI picked up extra information but am so sorry that it was DCIS.
Also, thanks for explaining more about the Birads scores. I've seen lots of people refer to them in their posts but didn't know what it actually was.
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Mins_Mum, please try not to worry about the mri procedure, it isn't bad. They will give you something to relax, even if you tell them you don't need it (which I did) lolol. They just said, why don't you take it anyway? I was in one of the older machines (like a tube), you lie face down with your breast through a cut out in the 'bed' and go in feet first. I actually did breathing and meditation while inside and the time passed pretty quickly. It was a bit loud, but other than that, there is no discomfort. Don't be alarmed if the mri does, in fact, find something. It is very sensitive, but not specific (it finds everything, not just breast cancer). They then almost always have to biopsy what they find to verify. Make sure to get copies of all of your reports (not just the patient letter) so that you have them for comparison in the future. You are also entitled (by law) to copies of your images on cd. This is really good to have in case you are ever using a different imaging center or physician. Good luck!
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