Just had a stereotactic biopsy on Friday...

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kellic1969
kellic1969 Member Posts: 15
edited November 2017 in Waiting for Test Results

First, let me say that the procedure went well and I felt no pain during the procedure (for those of you that have to go through it, I had no issues, however, I was sitting upright and not on one of those tables where your breast hangs down). My mammogram detected architectural distortion, so I then was sent for an ultrasound in which the radiologist felt it was a radial scar which still needed a biopsy. The impression this radiologist gave:

Impression: Upright stereotactic biopsy of an area of architectural distortion in the left breast at 2:00, with top hat clip placement. Pathology and recommendations are pending. The differential diagnosis includes a radial scar versus malignancy. If the pathology results are benign and do not include a radial scar or elastosis, I would consider the result discordant and recommend surgical consultation.

I have no clue what that means. I'm guessing that he is expecting a radial scar diagnosis? I can't stand the waiting, I should know the results by wednesday. I just wanted to assure other women who are waiting on this type of biopsy that it is not bad, the waiting is worse.


Thanks!

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  • MTwoman
    MTwoman Member Posts: 2,704
    edited September 2017

    Sorry you're here kellic. So what it means is he IS expecting a radial scar. But since the presentation of a radial scar is similar to that of malignancy, if the pathology comes back with anything other than "radial scar, elastosis OR bc", then he'll consider that result discordant (meaning different than expected or doesn't make sense). When something on imaging matches the pathology results, that is concordant (results that go together or make sense) When results are discordant, facilities have a procedure which include review of all materials, images, biopsy procedure notes etc for a recommendation (which could include re-biopsy, or additional imaging like mri, surgical consultation etc). Waiting is awful. Try to keep yourself busy using distraction or alternately try relaxation so you can sleep and keep your head clear for taking in and processing final results and recommendations. Good luck!

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  • kellic1969
    kellic1969 Member Posts: 15
    edited September 2017

    Thank you MTwoman, I really appreciate it. The waiting is tremendous, but I will get through it by immersing myself in work.

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  • MTwoman
    MTwoman Member Posts: 2,704
    edited September 2017

    so glad you'll have results soon!

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  • kellic1969
    kellic1969 Member Posts: 15
    edited September 2017

    Update on my results. So, my gynecologist called me to tell me the great news that my biopsy came back benign, and no other tests are needed. After the call I went online where my test results are posted to take a look at it and this is what it says: The pathology results are benign but DISCORDANT with the imaging findings. Consultation with a breast surgeon is recommended. lol.. I guess I go with what my doctor says and not the radiologist?

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  • MTwoman
    MTwoman Member Posts: 2,704
    edited September 2017

    You need this discordant question answered. Can you call the imaging center and ask them what their protocol is for discordant results and when you should hear back? I would also go ahead and get the bs referral.

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  • Legomaster225
    Legomaster225 Member Posts: 672
    edited September 2017

    I had a discordant result between my ultasound and lymph node core biopsy. We redid the biopsy and it was in fact cancerous. I don't want to scare you but I would press a little further with both the gyn and radiology or surgeon.

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  • kellic1969
    kellic1969 Member Posts: 15
    edited September 2017

    thanks everyone! I'm going to call my doctor tomorrow. So far, every test has pointed to this being benign, but you can't be too careful, especially when you have two differing opinions

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  • MTwoman
    MTwoman Member Posts: 2,704
    edited September 2017

    We're all hoping the final verdict is b9 as well, but you just need to push a bit longer to get the discordant situation sorted out. The ramifications of each "opinion" are pretty significantly different. Hang in there!

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  • kellic1969
    kellic1969 Member Posts: 15
    edited September 2017

    I'm currently waiting on a call back from my doctor. I pulled my report from my insurance's website and it reads like this: The patient is status post stereotactic biopsy of

    architectural distortion in her left breast at 2:00. Pathology

    demonstrates fibroadenomatoid nodule. Sclerosing adenosis with

    calcifications. Ductal epithelial hyperplasia. Fibrocystic change.

    Columnar cell change. PASH. Benign ducts with calcification

    Impression: The pathology results are benign but DISCORDANT with the imaging findings. Consultation with a breast surgeon is recommended.


    So I wait for her to call me back as to why she wouldn't recommend a surgical removal.


    Thanks again for all the support!

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  • MTwoman
    MTwoman Member Posts: 2,704
    edited September 2017

    Have you scheduled the surgical consult? That would be the person who would recommend that intervention, in accordance with what your radiologist indicated prior to your biopsy. (discordant results = surgical consult)

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  • kellic1969
    kellic1969 Member Posts: 15
    edited September 2017

    MTwoman,

    I just heard from my gynecologist and she gave me a recommendation for a surgical consult. I guess us women have to take charge of our health. If I wasn't able to see my biopsy results online, then I never would have saw that discordant remark and I would have assumed that everything was fine. My gynecologist told me not to worry about any of this, but still. What if something else is going on and I didn't know it? So, I wait for the surgical consult to happen and they may be able to make sense of this issue. Do you happen to know what happens at one of these consults? Do they sit down and look at all the testing that I had and the results and then weigh the risks to see if having this removed would be riskier than leaving it in? Again, thank you for all of your help.

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  • MTwoman
    MTwoman Member Posts: 2,704
    edited September 2017

    As I understand it, the bs doesn't solve the "discordant" conundrum, the department where it all happened is supposed to. It should go something like this: all images, samples and procedure notes are reviewed and a decision is made about whether the sampling may have missed the area of concern (for example, "normal breast tissue is found instead of something that could explain the imaging findings), or whether the result is just different than expected, but actually could be genuine. Your radiologist gave you a limited set of phenomenon that would give the imaging results and is not willing to accept any other findings as concordant. I would want to talk to someone at the imaging center (where the radiologist works) as he set those expectations and you'd like to know what their "discordant" procedure is and when you should hear back about it. I would get the earliest available apt with the bs and discuss it with him/her (even if you haven't heard back yet) as the bs may be able to pull some strings and get answers. It is aggravating to have to be on top of things when we're worried, but we do have the most invested in getting accurate answers. Keep pushing, you can do it and we're here to help you!

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  • kellic1969
    kellic1969 Member Posts: 15
    edited September 2017

    I made the appointment with the bs and they were a little hesitant to make the appointment since I do not have a diagnosis and I have a benign pathology report. This appointment is not until November 6th. I have been dealing with this breast issue since the first week of June and am quite frankly fed up. When I had the breast ultrasound done in July, that radiologist was expecting a benign biopsy, the radiologist that did the biopsy literally told me he didn't know what it was and now he has these limitations on what it could be. So, with that being said, I left a message with the imaging center telling them I wanted another opinion and that I wanted these discordant results dealt with before I see a breast surgeon, so I will keep you up to date with this craziness.

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  • MTwoman
    MTwoman Member Posts: 2,704
    edited September 2017

    I am so sorry that you're still going through this process for over 3 months, but good for you for being clear with the imaging center. As the discordant results are theirs, they should be the ones to make sense of them.

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  • kellic1969
    kellic1969 Member Posts: 15
    edited November 2017

    Just wanted to do an update: I saw my breast surgeon this morning, he came in and said he was 98% sure that this cyst was benign. Then he asked what type of personality I have and I told him "anxious" lol, so he said lets just get this out so we are 100% sure and you can go on with your life. (I have been dealing with the uncertainty of this since early June). So I go in on the 1st to have an excisional biopsy. I'm grateful that all tests so far have come back benign and now my surgeon thinks it is as well. I'm also grateful for this board's support as well.

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