Biopsy with definite surgery

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Mechq
Mechq Member Posts: 19
edited March 2018 in Not Diagnosed But Worried

Hello. As much as I tell myself everything is okay it is hard not to worry.

I am scheduled for a biopsy Wednesday for archetectual distortion near a previously biopsied area. The radiologist said either way I will need surgery because there are multiple cysts in the same area of distortion. So I am confused as to why she is doing a biopsy of I will be removing the area. She told be it is about the size of a lime that needs to be removed. She wants to do the biopsy first as if it is cancer it will be a deciding factor of what's course of action to take. So I got home and processed all this and am still confused. Why a biopsy if surgery is necessary either way. And I am wondering if the distortion and cysts are being removed as a precaution. She told me the distortion is very small and shows signs of pulling or puckering. They also check lymph nodes via ultrasound and they were fine.


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  • Egads007
    Egads007 Member Posts: 1,603
    edited March 2018

    hi Mechq,

    All the tests and especially the waiting is downright frightening. You’re human so it makes good sense that you’re left worrying and wondering. It’s something each and everyone here knows well so we’re here for you. You’re right, whoever does your surgery has to know exactly what they are dealing with in order to proceed with the best course of surgery and treatment action in order to give you the best outcome. To proceed immediately with surgery would effectively have the surgeon going in ‘blind’. Perhaps another conversation with your Radiologist might set your mind at ease about the protocol they’re taking and why they are taking it. Like the surgeon you need information in order to process. Good news about the lymph nodes, I’m hoping the rest of your results are just as good. Keep us posted

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  • SummerAngel
    SummerAngel Member Posts: 1,006
    edited March 2018

    I had the same question when I had already been diagnosed with cancer in my left breast and "areas of concern" were found in my right breast. They wanted to biopsy the largest area, but by that time I already knew I would need a mastectomy of the left and just told the doctor I would do a BMX. The reason for the biopsy was for the lymph nodes. If the breast was cancer-free I could get a mastectomy without any lymph node dissection, but if there was cancer I would need it. It made sense to me once she explained it.

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  • Mechq
    Mechq Member Posts: 19
    edited March 2018

    Thank you for the kind words. I am not familiar with much of this as most aren't. There is so much info and honesty I am trying not to go online and be dr. Google. I am approaching it in a logical way and feel that since the area of concern is small as the radiologist said it is very treatable.

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  • KBeee
    KBeee Member Posts: 5,109
    edited March 2018

    The reason for this biopsy before surgery is so they know if they will need to do a sentinel node biopsy.


    I had a surgical biopsy with my recurrence. They were "sure it was not cancer" and were just removing it to appease me because my gut said it was cancer (and my gut has never been wrong). It was cancer. That meant a second surgery to ensure clear margins, check lymph nodes, etc. So...even though it is inconvenient to have a biopsy first, it beats multiple surgeries! Hoping yours is completely benign!

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  • Mechq
    Mechq Member Posts: 19
    edited March 2018

    Thank you that makes sense. I was told with archetectual distortion it is harder to tell what it is. But am I correct that if they area is small it is not as much as as a worry?

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  • KBeee
    KBeee Member Posts: 5,109
    edited March 2018

    There are rare exceptions, but yes, typically a smaller area is less worrisome, in my observation here.

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  • Mechq
    Mechq Member Posts: 19
    edited March 2018

    Thsnk you for your replies to my question. I think the anxiety is kicking in which under the circumstances is normal. When the radiologist told me the area with the multiple cysts and distortion would have to come out, it didn't occur to me to ask why. Now I am wondering if even if it is not cancer olif it is suspect that it may become something later on. If the area is the size of a lime that needs to come out is that still considered a lumpectomy? She did tell me there will be a difference in the appearance of my breast.

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  • Georgia1
    Georgia1 Member Posts: 1,321
    edited March 2018

    Hi there Mechq. Yep, with an area of that size removed your insurance company may call it a "partial masectomy," but it is still a lumpectomy. Interestingly, my husband figured out the size of the area I has removed in a lumpectomy (two small tumors close together plus surrounding tissue for 2 mm margins) and it was the size of a small lime! And even with a 34-B cup the cosmetic outcome was really good. Are you talking to an experienced breast surgeon? It does seem that women who get pushed into using a general surgeon, without breast cancer experience, have the least happy experiences and get the least information.

    Let us know how we can help.

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  • Mechq
    Mechq Member Posts: 19
    edited March 2018

    Thank you for the information. I am so completely uninformed. It didn't occur to me to go to a breast surgern. The radiologist told me I have the option of getting a second opinion because I told her I would not do the surgery at the hospital I gad the mamogram at. But wondering what would I do if one said get surgery and the other said no. So confusing. If they are suggesting surgery are they thinking this is a precancerous? There is AD next to the biopsy site with multiple cysts. The AD is seen on the Ultrasound.

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  • Mechq
    Mechq Member Posts: 19
    edited March 2018

    I got my results back. I still need to remove the area but they were negative for carcinoma. I am very thankful. The waiting is very nerve racking.



    FINALL DIAGNOSIS:

    Left breast, 12 o'clock, stereotactic needle core biopsy:
    Complex sclerosing lesion (see comment).

    Negative for atypical ductal hyperplasia, in situ and invasive carcinoma.

    Comment:
    Sections show breast tissue with dense stromal fibrosis (including pseudo-angiomatous stromal hyperplasia (PASH)-like features),
    focal fibro-elastotic changes,
    usual ductal hyperplasia (UDH),
    apocrine metaplasia,
    microcysts,
    sclerosing adenosis and columnar cell change.

    These features may represent sampling of a radial scar. Clinical and radiologic correlation is recommended.

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  • Egads007
    Egads007 Member Posts: 1,603
    edited March 2018

    Wonderful news! Very happy for you, congrats!!! Let us know how your procedure goes, hugs!

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  • Georgia1
    Georgia1 Member Posts: 1,321
    edited March 2018

    That's fantastic news!

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  • Mechq
    Mechq Member Posts: 19
    edited March 2018

    Thsnk you for the kind words.

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