WENT FOR MAMMOGRAM.AREA OF CONCERN IN LEFT BREAST
Went to my doctor due to some pain in right breast. She did a breast exam, felt nothing abnormal. Sent for diagnostic mammogram. Went for mammogram yesterday. Cyst found in right breast. Radiologist said that the right breast is okay. They are worried about the left breast. Area of concern found in left breast. Sonogram done same day on both breasts. Biopsy recommended for area of concern in the left breast. There is no palpable lump or other external changes. Area of concern noted at 12:00 position of left breast. Radiologist said there is something of concern (approximately 1 cm) in the left breast, need to go for further testing. Biopsy recommended. Scheduled for next week. I was not given a report for the mammogram or the sonogram. My doctor was sent the mammogram report via fax and called me and told me to go for the biopsy. I called and scheduled a biopsy for next week. I am 58 and worried. I do not feel any lump or pain in my left breast so this is a surprise. My ob/gyn doctor said that mammogram is classified birads 0.
Comments
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I’m sorry that you have this health concern. You can pick up your report and post here to our Radiologist who kindly helps interpret reports: djmammo
It may ease your mind some. The waiting is not fun. Wishing you the best of luck.
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Maybe it was some microcalcifications? Keep in mind most biopsies come back negative, but also a heads up that many breast cancers present without any palpable lump. I've never had anything you could feel--just detected from mammo. Get the biopsy for your own peace of mind and try not to worry unnecessarily.
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The sole purpose of a screening mammogram is to find a problem before anyone can feel it so it is working as designed.
Birads 0 just means that you need more imaging, it is a neutral designation neither good nor bad.
Feel free to post this and subsequent reports.
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Hi Jennifer, Djmammo is right, think of it the same way you do when you try to read the tiny writing on the side of an aspirin bottle. You have no idea of what the words say, you only know that there are words there. The words could be a warning or simply dosage instructions. You need a magnifying glass to see the words clearer. That’s what birads zero is telling you. They need to take a closer look to make sure of what it is, and a sample to confirm it. No doubt it’s worrisome, but keep in mind that the vast majority of findings are benign and that the numbers are on your side. Keep as busy as you can during the wait and know that everyone in this community Ishere for your support. Hoping the very best for you next week, keep us posted!
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I don't know what the report(s) said yet but the radiologist was there and she came into the ultrasound room with the technician and put the ultrasound wand on my left breast and they were looking at the screen and at each other. Then she said some things I didn't fully understand, she said it was about 1 cm. I put my hand over the spot where they indicated it was and she said, "(you cannot feel it.") I always thought that breast cancer would be felt as a lump. (guess I was wrong). I asked her if it what the word she said that I didn't understand meant 'spiculated' and I believe she said yes. I was so shocked my mind went pretty blank. She also mentioned that it could be from a bruise or something, I don't remember..? Maybe she was reluctant to say that it was definitely malignant looking, idk. My husband was in the waiting area, he was not called in to be with me when I was given this information. I was then told to get dressed and they escorted me out by myself. When me and my husband about 20 min. later got home my ob/gyn called me on my landline and said to schedule a biopsy. I should mention I had taken about a half milligram of xanax due to my extreme nerves (it was prescribed for my spinal stenosis symptoms to help with muscle spasms) and I think my mind wasn't as sharp as it usually is. I am scheduled for the biopsy on Weds. next week and frankly I am terrified.
I already have severe lumbar spinal stenosis and have a very difficult time walking. I don't have any real friends, I lost all of my friends when I became nearly non ambulatory at age 51, I can only walk with the aid of a cane and I walk very slowly due to weakness in my feet and lower extremities. So most people don't want to hang out with me because I can't keep up with people my age. My husband is the sole breadwinner. I cannot work, I am disabled from my spine problem. We also have a developmentally disabled adult child. (high functioning autistic). He works at a p.t. retail job and can drive but is a sensitive person, he also suffers from frequent migraines for which he takes triptan medications every 2-3 days. He had a brain hemorrhage at birth, his intelligence is about average but he is developmentally like a teenager of about 16. He is our only child. Needless to say I am now terrified. Have a very bad feeling about this. (had a sister who died from uterine leiomyosarcoma 15 years ago at a young age of 40). Meanwhile I had two grandmothers who lived to age 89 and a mother who is 81 who has never had any issues with cancer (except for some basal cell carcinoma skin cancer which was removed and cured years ago).
thanks for all your replies, I was so shocked when I started reading the stories on this site. I mostly read about my other health problem (spinal stenosis) on other websites. I should have been paying more attention to this topic since it is so serious.
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Jenn,
It is very understandable that you are worried ahead of your biopsy. Even in the event that the biopsy turns up something, you should know that breast cancer is very treatable. The 5 year survival,rate is something like 98%. Many women receive treatment, and are perfectly fine for many, many years. I have friends who are 20+ year survivors. It is a scary time, but there is hope.
I am so sorry that you have this to deal with in addition to your other health concerns. Sending hugs to you, and wishing benign results from your biopsy
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Got my reports as follows:
Targeted breast ultrasound: left
Clinical history: Architectural distortion 12:00 on screening mammography
Real time examination of the area of concern demonstrates a very subtle area of hypodensity and acoustical shadowing in the area of mammographic concern at 12:00 approximately 4 cm deep to the nipple. this is best seen with the patient sitting erect. Ultrasound guided biopsy is recommended.
IMPRESSION: Subtle area of shadowing at 12:00, 4 cm deep to the nipple corresponding to the area of mammographic concern.
Birads 4: Suspicious.
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When the US shows an abnormality that corresponds in size and location to the worrisome mammographic finding, a biopsy is recommended especially if the US finding, no matter how vague, has any suspicious features at all such as acoustic shadowing.
If the path comes back abnormal, this was "a good pick-up" as we say in the profession, by your radiologist as a mass per se is not yet visible on US which can indicate it was caught very early.
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Thanks for your reply, djmammo, can you explain in very plain English what it means? Does 4 cm deep to the nipple mean that it is 4 cm in size or 4 cm away from the nipple? And what is "acoustic shadowing" ?? I have no medical background at all. Thank you so much for your help.
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The 4cm describes location only. Its a measurement of distance from a visible landmark. The size of the abnormality is not given above.
Acoustic shadowing (AS) is an ultrasound finding related to the physics of the interaction between the sound waves of the US and the things they encounter. Think of looking at an home aquarium tank full of fish in a dark room. You shine a flashlight in from above. With no fish in the way the light travels all the way to the bottom and you see the sand and the rocks. If a fish swims into the beam you see a reflection off the top of the fish and a shadow under the fish that makes it difficult to see the sand and rocks. AS is basically the same but with sound instead of light.
The significance of the acoustic shadowing is that you can infer from it that there is something different about the tissue in the area of the shadowing compared to the surrounding tissue even though a mass is not seen. When this corresponds to the location of a suspicious mammo finding a biopsy should be performed. Let us know how the biopsy goes.
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Thanks for answering so quickly, djmammo. I read both of the reports and they are very overwhelming. I also have some cysts in my right breast that the US technician said were 'okay'. But when I read the report it stated that is was Birads 3. I'm not sure if they are going to biopsy some of these cysts that were seen in the right breast. I will try to type this out accurately, my typing skills are no longer top notch.
EXAM: US BREAST BILATERAL LIMITED
TARGETED BREAST ULTRASOUND: RIGHT
CLINICAL HISTORY: Pain medial right breast and indeterminate density at 9:00 on mammography, posterior third of the breast.
Real-time examination of the area of concern demonstrates no sonographic abnormality in the area of clinical concern in the medial breast.
In the retroareolar region, a 1.5 x 0.7 x 1.2 cm simple cyst is identified with mulitiple adjacent clustered cysts. Together the area measures 2.1 x 1.9 x 1 cm. This is of low index of suspicion. At 9:00 in the area of clinical concern, a complex septated cyst measures 0.7 x 0.5 x 0.6 cm and is of low index of suspicion.
IMPRESSION: Simple and complex cysts in the retroareolar region and at 9:00 in the area of mammographic concern. These are of low index of suspicion and can be followed sonographically in 6 months time.
Ultrasound-guided biopsy is recommended.
BI-RADS 3: Probably Benign.
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Do you think they will a biopsy on these cysts in the right breast on the same day as the biopsy on the architectural distortion area in the left breast? And then they will follow up in 6 months time with another sonogram?
I posted part 2 of the US exam first, which was the one for TARGETED BREAST ULTRASOUND: LEFT (in above post).
Thanks again djmammo for your timely help!
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Their recommendations: The cysts on the right will be re-evaluated in 6 months (pretty routine). That spot on the left will be biopsied.
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Okay djmammo, Thanks again for all of your replies and insights. I will let you know what happens when I get the results.
jenndenino578
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Hello, djmammo and all. I just got my needle biopsy results on my architectural distortion in my left breast. The biopsy was performed on Weds., April 4th. (It didn't even hurt much at all). The radiologist just called with some very good news. It turns out that no malignant cells were found and that I have a "complex sclerosing lesion." The contents of the needle biopsy were found to be benign. However the radiologist would like to follow up with a lumpectomy to remove any remaining tissue that was left behind to be absolutely certain. I will be scheduling this soon. (I am still in total shock that no malignant cells were found). Anyway, I am now very hopeful that I will soon be able to put this very scary experience behind me.
I want to thank all of you for discussing this with me. I will update any further biopsy results after the lumpectomy is completed and the next biopsy results are in. Hopefully these will also be benign and I can put this behind me till my next mammo and ultrasound screenings on my right breast cysts.
Thank you all for your wonderful website, it's great to have other people to talk to during a very stressful and scary time in my life.
Hugs,
jenndenino578
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That is good news. The "complex sclerosing lesion" is the more medically accepted name for a "radial scar". Its one of those 3 things that can come back from a biopsy of architectural distortion. The are universally removed as there can be association with some increased risk. Well done.
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Thanks for your prompt reply. I called my ob/gyn and she recommended a breast surgeon for a follow up consultation/lumpectomy. I am having my reports faxed to the breast surgeon. I have to bring all images on CD of mammograms, sonograms, etc.
I am wondering if there is a risk of this "complex sclerosing lesion" of possible becoming malignant in the future or if there is still a possibility of there being some hidden malignant cells in the tissue that is still inside my breast. Or are they just being overly cautious? I am definitely following through with having it removed either way. It's just a matter of getting the appointment which is in NYC (I am in another state). Bringing them the CD before the appointment and faxing them the reports....Also there is the parking issue in NYC. Hopefully there is a parking lot not too far from their office as I have mobility issues.
Thanks again for your prompt replies and all of your help and advice. Have a good weekend.
Hugs,
jenndenino
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The risk exists within the tissue of the radial scar so they will remove it and a little bit more all the way around to get a clean margin. I don't believe there will be an increase in your overall risk once its out.
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I read that it is a high risk lesion as follows... A radial scar is considered a high risk lesion and histological differentiation from associated carcinoma is required. FNA and core biopsies can underestimate the underlying associated malignancy and are controversial. The lesions are biopsied and removed..... So I guess that's why the radiologist and my ob/gyn want me to go to a breast specialist....so I'll be sweating it out a bit longer.
jenndenino
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I just re-read what I put above and I'm not sure if I'm misinterpreting what I read/wrote. I have no medical background so I don't know much about these things.
jenndenino
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I got my surgical pathology report and brought it along with the actual slides and all of the mammogram and ultrasound reports on CD to the breast center I have an appointment with the surgeon on Mon. the 23rd.
Final Diagnosis
Left breast 7.0 mm nodule at 12 o'clock. Ultrasound guided 14 gauge core biopsy:
Complex Sclerosing Lesion of the breast (see comment).
Fibroelastotic stroma containing entrapped tubular glands with ductal hyperplasia at the periphery.
Comment: Although it is a matter of debate, surgical excision should be considered in a case of a complex sclerosing lesion diagnosed on core needle biopsy specimen.
Microplasty and Immunohistochemistry: Immunostains for CK5/6, p63, SMMH and ER are not examined. Myoepithelial cells are preserved around the tubular glands entrapped in fibroelastotic stroma, not diagnostic for carcinoma.
I was very, very nervous typing the above, I hope I didn't make any errors... the stress is making me crazy.
jenndenino
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Went for my appointment to breast specialist in Brooklyn. The breast specialist (surgeon) reviewed my slides in their pathology dept, feels the condition is benign. He is sending them to MSK for "another opinion." He doesn't want to do unnecessary surgery because he thinks the scar tissue which results might obscure any future malignancy on future mammograms. (He got his training at MSK and is the head of the breast center I was referred to in Brooklyn.) So I'm still a bit in limbo but at least the news is positive.
jenndenino
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Hi Jenn - great positive news! I hope it’s given you comfort. Your surgeon certainly is on top of this. Let us know what the 2nd opinion brings to the table. Sending you peaceful vibes during the limbo stage
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Consensus Guideline on Concordance Assessment of Image-Guided Breast Biopsies and Management of Borderline or High-Risk Lesions from the American Society of Breast Surgeons
"Indications for surgical excision of radial scars (complex sclerosing lesions): Complex sclerosing lesions (CSLs), which include radial scars, may be identified incidentally at the time of CNB or may present as suspicious, spiculated masses on breast imaging. They are found to have associated malignancy from zero to upwards of 25% at the time of surgical excision, with most studies reporting rates close to 10%.58-62 Older age, imaging appearance, lesion size, and biopsy needle size have been noted as factors associated with upgrade,62-64 but as with other high-risk lesions, these findings are not consistent in the literature.65 Most CSLs should be excised, although imaging follow-up is reasonable for small, image-detected radial scars that are completely removed or well-sampled with large-gauge devices and in the setting of imaging-pathology concordance."
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Thanks for your reply, djmammo.
I was a little surprised that my doctor feels confident that my lesion is benign due to the core biopsy findings. He said he is sending the slides to MSK for "another opinion."
He was formerly with MSK as follows:
https://www.bloomberg.com/research/stocks/private/...
I guess I will find out more after they call me with the pathologist's findings from MSK. I would rather they just remove it and get it over with. I guess we'll see if he changes his mind.
Thanks,
jenndenino
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Thanks for your reply Egads007.
I'm happy that the news seems good but I'm still nervous. I have generalized anxiety disorder, along with lumbar spinal stenosis which makes it hard for me to walk without a cane and sometimes I have to use 2 canes due to my foot weakness in both feet unfortunately. The spinal stenosis has made me really neurotic due to my lack of mobility and has completely destroyed my self esteem due to my disability at a fairly young age. I don't know if I could deal with having bc. I don't even drive a car much anymore due to extreme anxiety! I only drive very short distances around my neighborhood rarely more than 3 miles from my house. On the positive side I told my 80 year old mom to go get her mammogram and she did last week. She made sure to get a 3D mammogram and they called the next day and told her that everything was okay, nothing unusual was seen. She had previously only had the 2D mammograms. My mom has Crohn's disease and had almost died a few years ago from an intestinal blockage. She has a lot to deal with with that disease unfortunately. I also have noticed a change in her mentally, she probably is showing early signs of dementia unfortunately. My family history also includes having had a sister who was diagnosed with uterine leiomyosarcoma at age 37 and we unfortunately lost her just weeks before she turned 41. We have no idea how that happened, I ask every ob/gyn doctor I see what possibly could have caused her to get that. Her early death also added to my anxiety disorder, plus having to see her have to deal with such a terrible disease.
I also have had two benign dermoid tumors removed from both of my ovaries, the first one was at age 19 for the first one where they removed my ovary and at age 51 for the second one which they just removed the dermoid. But the first one at age 19 probably is what put me into having anxiety for most of my life which has only been getting worse over the years as the dermoid (which they called a teratoma at the time) was very large and I was traumatized having it removed although I had a complete recovery. They seriously thought that I had cancer, luckily it was benign. this was in the late 70's before the MRI machine was invented, they only had CT scans back then, I think. Then they found the second one when I was 51 but it was a much smaller size and I had it removed via laprascopy. It was also benign but the doctor pretty much knew it was going into the surgery due to having an MRI w/ contrast scan. He found it due to doing an transvaginal ultrasound in his office ahead of time. Now I have these ultrasounds annually to check for anything abnormal.
I also lost my dad at an early age, he suffered a massive heart attack and died in his early 50's. That was in the early 80s. I feel that the doctors didn't know what they were doing. Plus my dad neglected his health, didn't go for regular checkups. But it's a long story. Medical science has come a long way since then.
I think if I could exercise a lot more it would help my anxiety, the most I can do is ride an exercise bike and walk around in my yard on the lawn which is exercise for my foot strength. It doesn't seem to be helping though. I really need a back operation to free my sciatic nerves from the pressure of the narrowing of my spine, bone spurs and a small disc herniation in my lumbar spine. And as bad as that is it isn't nearly as terrifying to me as having bc. But I am thankful for the breast doctor where I was referred to and feel very fortunate that he thinks the lesion in my breast in completely benign. I'm trying not to dwell on it too much. I do feel very lucky after reading some of the other people's stories on this site. I hate cancer and pray for a cure for this terrible disease.
thanks for your support,
bless you,
jenndenino
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Update: My breast specialist called today and he said the second pathologist agreed with the first one about the csl/radial scar being benign. My breast specialist wants me to go for an MRI w/contrast on Thurs. of next week to make sure there is nothing else suspicious to be extra cautious and to "close any doors..." I guess they will follow me closely afterwards. Keeping my fingers crossed. I'll post an update afterwards.
Best regards,
jenndenino
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Jenn - that’s wonderful news and I’m so happy for you! It sounds like you’re in great hands with your doctor, making sure everything is checked and double checked. This should give you peace of mind. I’m sorry to read about all that you’ve gone through and are going through with your health, you have a very full plate. Have you sought out any help for the anxiety through therapy? It sounds an awful lot like PSTD. Still sending you peaceful vibes...keep us posted
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Hi, Egads007
I'm a little embarrassed to re-read my post complaining about my back issues when there are so many women on this site (and some men) going through so much with cancer. I do have back issues but I will take them any day over what my sister went though with her leiomyosarcoma and death from that devastating disease. She actually went though a hell that I hope that no one would ever have to go though it was so awful. Spinal stenosis is not going to kill me most likely unless I have to run away from some dangerous situation (I can't run, on a rare day I can run a few feet when it lets up a bit). It's a very frustrating condition but I can live with it. (At least I'm not in pain most of the time, when my back starts hurting I lay down for a while and it goes away and the worst pain is usually no more than a 3 or 4 level, I think.) I don't go to talk therapy, I do get some medication from a psychiatrist for anxiety issues. He diagnosed me with GAD (generalized anxiety disorder). I'm not really depressed per se, I do have lots of anxiety though and maybe a bit of OCD (I will tend to dwell on things and do a lot of reading and researching). I enjoy watching videos on youtube and listening to music. I watch a lot of CNN to see the daily drama and I am able to do some housework such as laundry and I do cook dinner at night most of the time! I do miss being able to go out to stores shopping, I do most of my shopping online these days. Thank God my husband is able to do all of the grocery shopping, he is my rock.
Anyway my husband wants me to try and find a doctor who would be willing to do some sort of laprascopic procedure to get the bone spurs or whatever it is that is compressing my nerves going to my legs so the radiculopathy symptoms might let up a bit. I can walk pretty good most of the time with a cane (or two) when it gets bad my legs feel very heavy like they are partially paralyzed and my feet feel weak and I lose my footing. But it comes and goes. I've had nerve conduction tests, MRI's, I went to physical therapy, tried walking around on uneven surfaces in my yard on the grassy areas to strengthen my feet and lower legs, etc. My EMG (nerve test) was "normal". My reflexes are also normal according to the specialists (neurologists) I saw. I went to a very good hospital in Manhattan, NYC (HSS) for these tests. I really don't want to have surgery but I might try it in the future after I get this breast problem resolved hopefully. Like I said I am keeping my fingers crossed. At least we are fortunate that my husband has good health insurance. there are so many people in the U.S. who have no health insurance in certain states which declined to extend Medicaid and some of the best doctors do not take their Medicaid coverage (it's health coverage for the poor, disabled or low income people). I see that you're up in Canada where everyone is covered through the national health plan, I read up on various countries health care systems while we were trying to pass the Affordable Care Act in the U.S. 8 years ago.
P.S. My dad's death was tragic, he died young in his early 50's but it happened so fast I don't think he even knew what hit him. He died almost instantaneously from a massive heart attack. At least he didn't suffer, I hope.
My mom does have a full plate with her Crohn's disease but she is now in her early 80's and she had really good health most of her life fortunately. (she actually took care of my sister when she was in her mid 60's while my sister was in her last months, she was a very strong woman, my mother). She was only diagnosed with Crohn's about 2 years ago, before then they kept saying she had irritable bowel disease because her symptoms weren't that bad. It was only when she developed a blockage that they figured out that she had Crohn's disease. She didn't even want to go to the ER, my brother called me to tell me she was lying on the bathroom floor in pain one night, I told him to call an ambulance immediately. (my brother is a man-child) he still lives at home and he's in his 40's. They were able to clear the blockage with a naso-gastric tube (the tube causes suction in the bowel and by some miracle it re-opened). But she nearly died, she thought she "tough it out" by not going to the ER if you can believe it....but I digress.
Sorry to ramble on so much.....thanks for commenting and I do hope that you're doing okay.
Hugs,
jenndenino
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I'm so aggravated, I went for my MRI last week on May 17, 2018 and was told by the MRI technician right after the test that the results would be back in 5 days. I called the hospital where I had it done yesterday (May 24th) and left a message for them to get back to me.
Called again this morning (May 25th) and the receptionist (?) told me that the doctor was not in today and will get back to me on Tuesday as per the P.A. (his assistant). For some reason she couldn't tell me this information herself, instead she relayed it to the person who answers the phone!
This cannot be a usual practice from a breast center. Why is it taking so long to get the results?
My doctor lives about 3 miles from my house, I feel like driving over to his house to see what's going on.
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some centers have full time radiologists that just read MRIs all day. Some do double and triple duty reading x-rays and ct scans too. Each case is prioritized based on urgency. Breast cancer is usually slow growing so those scans get pushed to the mid to end of the stack. That’s why it can take 5 days. Especially if the radiologists are doing double and/or triple duty.Many centers also under promise and overdeliver (tell you 5 days but give you the results in 3). I know it’s hard to wait, but worrying today about what the scan results might indicate will not change the results that you’ll greceive next week...worrying only steals the happiness and productivity of today. 🍀
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