Doctors have difference of opinions.

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Nckat
Nckat Member Posts: 5
edited March 2018 in Not Diagnosed But Worried

Hi, last month a found a lump on my breast. Its painful and since it did not go away, I made an appt with my GYN. She felt the lump as well and sent me for a mammogram and u/s. After I had those 2 tests done, the radiologist came in and said I had microcalcification and a 1cm lump that he was concerned about and ordered an u/s guided biopsy. That same day my GYN called me and told me she had received my report and that she felt more comfortable sending me to a breast surgeon for the biopsy. Today I went to see the surgeon and he said he couldn't feel the lump nor could he see it on his u/s that he performed in his office. So he then said he was going to refer me back to the breast radiologist. I'm so confused. Both clinics work together, he even spoke to the radiologist while I was there for my office visit. The breast surgeon says he doesn't think its cancer and refused to do a biopsy. He was very nice and said "My 1st priority is to do you no harm, I don't see it nor can I feel the lump, so since they did see it on their end I'm going to refer you back to them for an u/s guided biopsy because I don't want to miss anything either". I'm perplexed! He's a highly qualified breast surgeon where as the radiologist who read my report is a fresh off school guy. I don't want to have a biopsy if I don't need it but also don't want to risk no having it. I still have pain on my L breast so something must be causing it. The breast surgeon feels like its hormonal changes. Has anyone ever had conflicting medical opinions? Any input is appreciated.

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  • djmammo
    djmammo Member Posts: 2,939
    edited March 2018

    Nckat

    The radiologist will always have the better equipment. Period.

    The radiologist will always have the better training for reading imaging studies. Period.

    Let us know what the biopsy shows.

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

    Nckat, I'd do the ultrasound-guided biopsy, as recommended by the radiologist, which is performed with a fine needle. No surgeon/surgery required.

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  • Recap
    Recap Member Posts: 120
    edited March 2018

    Your clearly need the biopsy-the gray area is what is the best way to achieve it. I think your Gyn may have a personal opinion about needle biopsies vs excisional/lumpectomy biopsies vs mastectomy. I was refused by the surgeon also and turned back to the radiologist. The surgeon said it's really really tiny it can't be felt. Not true then not true now. So I have a very bad feeling about the entire process from beginning to end and into the future. I have no complaints about the radiologist's skill at reading images, performing the biopsy, and their equipment was top of the line. The issue is cutting open Pandora's box, in the safest way possible, and the risk factor you, the patient, are most comfortable with vs healthcare policy for the masses.

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  • Nckat
    Nckat Member Posts: 5
    edited March 2018

    Ok, I don't know if this makes a difference but I didn't mention I'm only 33. I spoke to my GYN today and she suggested I follow thru with the biopsy as my BRAD is a 4. Now I'm back to square one, scared. Thank you everyone for your input.

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  • Nckat
    Nckat Member Posts: 5
    edited March 2018

    My GYN informed me today that I'm a BIRAD 4. So I'm def going to have the biopsy. I scheduled for next week. Thank you for the help!

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  • Runrcrb
    Runrcrb Member Posts: 577
    edited March 2018

    better to have the biopsy and find that all is good than to continue worrying. Don’t let anyone convince you to do something ( or not do something) when your gut says otherwise. I found my lump and had to find it for my PCP. Ultrasound guided biopsy helps to get to the right place. The doctors at my imaging clinic did the biopsies. That’s where my breast surgeon sent me for the second and third ones (after MRI, pre surgery) so I’d be surprised if the surgeon does biopsies routinely. He or she will certainly send any specimens out for biopsy if you end up needing a lumpectomy or mastectomy.

    The worry is there until you get results but if you can, schedule the appointment and then try to do something that will keep you focused on other things until then as worrying won’t change the outcome.

    Goood lu

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

    Ultrasound guided biopsy is much less invasive than surgery. It’s the way to go. Wishing you benign results

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  • Nckat
    Nckat Member Posts: 5
    edited March 2018

    Ok, so I'm scheduled for my biopsy but I'm really really scared to have the procedure done. A few ladies have recommended for me to have an MRI instead, they say it will show if I have cancer. Is there any truth to that?

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  • MelissaDallas
    MelissaDallas Member Posts: 7,268
    edited March 2018

    An MRI would make it MORE likely you will need a biopsy. They are very nonspecific and show LOTS of stuff, much of it that turns out to be benign.

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  • leaf
    leaf Member Posts: 8,188
    edited March 2018

    I know you're scared. Everyone who is honest is scared when they get worked up for a possible breast cancer.

    No one gets diagnosed with breast cancer without a pathologist looking at a piece of tissue under the microscope, (except perhaps for the rare inflammatory breast cancer for which you don't have the symptoms.)

    There are 3 main types of breast biopsies: needle, core and surgical. Needle and core biopsies can be guided by mammograms or ultrasounds or MRI. They normally don't do surgical biopsies unless you've already had a needle or core biopsy that shows something suspicious.

    Breast MRIs are not perfect. Breast MRIs do not detect everything, and they often pick up things that are not breast cancer. Breast MRIs won't give you a definitive answer like a biopsy can.

    Some people don't know what they are afraid of, but some people do know what they are afraid of. Are you afraid of the pain, the cost, possible scaring? If its scarring, well, I've had 4 breast biopsies and 2 surgical excisions, and *for me* you can't hardly tell externally where any of these occurred (except the surgical excision I had in January 2018.) If its pain, then ask for plenty of lidocaine (the local anesthetic.)

    If you have a suspicious breast MRI, then they'd have to do a biopsy to rule out breast cancer anyways.

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  • gb2115
    gb2115 Member Posts: 1,894
    edited March 2018

    I was really scared before my first biopsy too. I am the biggest wimp there is, but the ultrasound guided biopsy really was pretty easy, all things considering. You'll have a teeny pinch while they inject the lidocaine. After that, you shouldn't feel anything. I was minimally sore the next day. You just want to be sure not to bump your breast afterwards to give it a good chance to heal up.

    Not sure about the MRI. For me, the progression was diagnosis via the ultrasound biopsy, and then an MRI afterwards to take a closer look and make sure there was nothing else hiding. Not sure if an MRI would save you from a biopsy or not. They'd probably want to do one anyway. Especially since the radiologist would have recommended an MRI if they thought it was needed.

    But anyway, the biopsy really isn't that bad. I promise. I think the IV you get before an MRI hurts more. I had an MRI last week and am still badly bruised from the multiple failed IV sticks.

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

    McKat, A biopsy is hte only definitive way to know. I had an MRI with my last diagnosis and it missed my second tumor. Bring someone with you when yu go to help ease your anxiety.

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  • INFJen
    INFJen Member Posts: 21
    edited March 2018

    Hi Nckat - Sorry you are going through this. I'm 36 yo and was diagnosed in December. I started out at the gyno who referred me to a radiologist to get testing done on a lump that was causing me pain. At the radiologist, I had mammos and ultra-sound done which showed troublesome signs such as calcifications, so I had an ultra-sound guided biopsy done which proved I did have cancer. After the cancer diagnosis from the radiologist, I was referred to a breast surgeon. I also had MRI's done but not until after diagnosis and before surgery.

    I agree that you should get the biopsy done first. There is no other sure way to know. Getting it done by the radiologist sounds normal to me. Best of luck to you.

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  • Polly413
    Polly413 Member Posts: 124
    edited March 2018

    You might consider asking for a prescription of a anti anxiety med for the day of your biopsy. My breast surgeon did my stereotactic biopsy and at my request she gave me a prescription for 3 pills (Xanax I think). She told me to take one pill when I left home (one hour drive away) and one when I got to her office. But the first pill relaxed me so much I didn't take any more and still have the other 2 pills to this day! Could walk around but I was very relaxed to say the least. No pain at all from the procedure and no problem whatsoever holding still during the procedure -- really almost asleep. It was great for me.

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  • Nckat
    Nckat Member Posts: 5
    edited March 2018

    Thank you everyone for your encouragement and support. I had my biopsy done today. I didn't feel my much pain but feel anxious about having a foreign object in my body (the marker). Now on to the wait. I'm praying for benign results but during the biopsy the radiologist found even more calcification than previously seen. That reallllllyyyy worries me. Ill keep you guys updated.

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  • djmammo
    djmammo Member Posts: 2,939
    edited March 2018

    Nckat

    Here is a good article about biopsy markers

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  • INFJen
    INFJen Member Posts: 21
    edited March 2018

    Nckat - Glad to hear that you got the biopsy over with and without too much pain. Good luck with your results.

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