Postponed biopsy...right call?
On Friday I was scheduled for a stereotactic biopsy due to microcalcifications that were found on my right breast. The microcalcifications were detected last December. Last week during a follow up mammogram, the radiologist noted that while the # remained the same, they appeared brighter and a biopsy was ordered. I spent a week worried sick. Friday finally came. I was in the biopsy room and the nurses were getting everything ready. I asked the nurse how much this procedure typically cost. I know $ should not matter when your health is on the line but my husband and I are both self employed and our insurance deductible is $6500. When she told me the biopsy would cost nearly $7,000 I almost fell off my chair. My husband is new in his business and money is really, really tight. To make matters worse, an uninsured driver totaled my vehicle in an accident three days prior. I was actually pretty sore from the accident as the airbags were deployed.
The nurse saw my reaction and my tears and said she would have the radiologist review my films to see if the biopsy was something that needed to be done right away or if it could wait.
The radiologist came down to the room I was in and talked to me about what she was seeing on my films. She said her concern level was pretty low...about a Birads 4a. She then said that it would be alright to postpone the biopsy. Her recommendation was a repeat mammogram in six months. She also mentioned that she would have her colleagues look at my films snd would call me in a few days if they think a biopsy is warranted in the near future.
I walked out of the office with mixed feelings. One was relief. What they were seeing must not look to bad. I also felt confusion. Would I have gone forward with the biopsy if my deductible had been lower? Would they have pushed it harder? Am I jeopardizing my life because of $$?
I am interested to hear what the other doctors have to say.
What would you have done in my situation?
Comments
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kjandkimom, We all have to make decisions in these cases, based on the information we have at hand, the realities of our life and our risk tolerance. I think it was a good idea to discuss the radiologists concern level, and for her to consult with other radiologists for consensus. We both know that 70-80% of biopsies come back b9, so it makes sense to try and understand not just the risk of the procedure (or not doing it) but the financial risk as well. I am interested in what the other doctors say as well. Hoping they are all in agreement so that you get a good clear message and feel better about your decision! ((hugs))
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kj, I would ask the social worker at your medical facility if there are any resources that might be available as far as financial assistance. If you are in a major city, there are usually Breast Cancer non-profits that may have help available. You may also try contacting the American Cancer Society, if you are in the US. I know where you are coming from. I am single and self-employed. When I was DX'd, I had two large deductibles to meet over my treatment period. I finally got them all paid off in a matter of 2 yrs. Of course, my DX was not calcifications. It was a full-blown tumor. It is sad that we have to even think about putting our health on the line because of high medical costs, either way. I hope you get it figured out.
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Hi K --
Not sure if this helps, but my experience has been that certain facilities will agree to a payment plan of three months should you wish to go ahead and believe that fees are too much financial pressure. Hearing bad news + taking on a very heavy expense is all so shocking. Some facilities are willing to work with you should you decide you wish to go ahead. Hope all works out for you on all fronts.
Belle xx
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If the consensus IS 4a, "In terms of the positive predictive value for breast cancer, a category bi-rads 4A mammogram is quite low at 13%" (from breast-cancer.ca)
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