How much time the Rad spends with you

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djmammo
djmammo Member Posts: 2,939
edited October 2018 in Not Diagnosed But Worried

"But the radiologist was only in the room for a few minutes, how can they make a decision that quickly?"

"They hardly looked at the screen! They didn't even examine me"

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I have heard and read this enough that I feel an explanation is warranted. The veterans here know these facts well enough but there maybe some new to breast imaging, and this forum, that do not. This applies primarily to breast ultrasound and to full-time breast imagers.

1) US is digital and can be viewed immediately on the PACS unit in the rad's office. In fact the rad can often watch you being scanned in real time. When the tech finishes and says that they will discuss the case with the rad they go to the rad's office where they can review the entire case on PACS as well as compare it to all your other studies that are currently on line including your mammogram(s) and related reports. My habit was to review all the old studies while the pt was being scanned in order to save time. A decision is usually made by the rad before they leave their office to talk to you unless additional history is required from you to make that decision.

2) There are things in the breast that on ultrasound are immediately recognizable and do not need much time to diagnose. These include the definitely benign and the definitely malignant. They are what in the specialty of radiology are referred to as an "Aunt Minnie". When your aunt minnie comes to your house to visit you open the door and say "oh look its aunt minnie". You dont think to yourself "well she's about 70 years old and is wearing a red sweater; she's about 5'4" 100 lbs...hmmmm.......I'll bet that's my aunt minnie". No, you just recognize her.

3) In all these years of breast imaging I have hardly examined patient's breasts to make a diagnosis. I can see on the screen what they are feeling. Physical exam adds nothing to my impression. If however if the patient feels something and I see nothing on imaging I will do a thorough exam of the breast and attempt to feel what the pt is feeling then re-scan that area myself in the US suite.

So it should not always be surprising if they only spend a few minutes discussing your findings with you.



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Comments

  • JoyMrt5
    JoyMrt5 Member Posts: 40
    edited April 2018

    So based on what I’m reading if the radiologist comes right in and says we need a biopsy is that because he believes the spot is malignant? Is the purpose of biopsy to determine IF it’s malignant or to determine the type of malignancy

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

    My radiologist actually examined me and repeated the ultrasound herself. She said (about the tumor) "I want to find out what that is." It wasn't until immediately after the biopsy that she told me she was worried about it. I appreciated her honesty but it sure ruined the rest of the day, wiping away all hope. At that moment I knew she knew exactly what she was looking at.

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

    JoyMrt5

    Yes to both.

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  • Oceanblues30
    Oceanblues30 Member Posts: 3
    edited June 2018

    Hello so Monday I am going for a Bilateral diagnostic mammogram and a breast ultrasound. Will they do a biopsy right away if they feel it may be something? About 3 weeks ago I got a tinging pain in my breast soon after that it started to get red and a bit itchy thought maybe I was getting a boil. Then started a mass the size of my hand. I did go right to the dr he did not say anything just gave the prescription for the tests. Now the mass has shrunk considerably very small but the skin is now peeling where it is.

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  • LovesLife
    LovesLife Member Posts: 1
    edited August 2018

    I was just seen by the radiologist because of a 1.2 cm irregular mass detected in the left breast. I have an appointment in 3 days for the biopsy . I am very scared

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  • MommyB
    MommyB Member Posts: 10
    edited August 2018

    so my radiologist recommended a punch biopsy for thickening of the skin he saw on my ultrasound but the surgical oncologist said it wasn’t needed? I’m a nursing mother and was told to wean my 6 month old and come back in 6 weeks for a 3D mammogram. the doctor said and I quote “I don’t think it’s anything bad but if it is waiting 6 weeks won’t make much difference” and to come back sooner if my symptoms get worse. Can I not have a mammogram while breastfeeding?

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  • Moderators
    Moderators Member Posts: 25,912
    edited August 2018

    LovesLife we really understand how hight the stress and fear can be when you hear this. Try to stay calm, and take one step at a time.

    MommyB This site says that it is safe for a woman to receive a mammogram and/or ultrasound while lactating (https://www.lllusa.org/mammography-and-sonography-...). We would recommend getting a second opinion, and finding a radiologist schooled in reading reports from women who are breast feeding.


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  • afreshjoy
    afreshjoy Member Posts: 4
    edited October 2018

    By the same token, is there anything to read into the Dr. spending a long time with you? At my diagnostic mammogram the tech did the US, then the Dr did the US for about 15 mins and spent about 10nmins talking to me about the need for a biopsy.

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

    The only reading I'd be doing into it is what the radiologist said about the reason for and need for the biopsy.

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