Strange biopsy question
Do plastic surgeons do breast biopsies?
I am waiting to see my doctor at the high-risk breast screening clinic. I've been waiting about two weeks with two more to go but I'm thinking of trying to get in sooner.
I called because of a lump that I can feel. In talking with the nurse on the phone she said its probably a recurrence of a cyst or inflamed Montgomery gland that showed up on ultrasound 6 months ago. She said because it's returned that the doctor will likely send me to plastics to have it removed. Is this a biopsy? Plastics? Is that normal?
It isn't the same thing as was found on the US I'm pretty sure. Slightly different spot (just outside the areola) and it is very firm and immovable (like a tiny oblong bean or pellet. I can only feel the top, the rest seems rooted in). For this reason, I've been working myself up in to quite a state and don't know if i can wait two more weeks. I also have a tiny pimple like bump (slightly tender like a pimple that needs to pop but there is no head and it's been there at least 5 weeks). It's on the opposite edge of the areola.
Comments
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aspiration/vacuum biopsies are usually done with radiologists, and excisional biopsies/lumpectomies/mastectomies are done by surgeons.
Back in the good old days they were all called general surgeons. As volume of patients and volume of surgical options increased, general surgeons split off into multiple surgical specialties. My guess is your breast screening clinic dr is a radiologist, and the plastic surgeon sees the referred breast surgicals. A plastic surgeon will have the most experience with surgery on breasts, but it wouldn't hurt to ask if they operate solely on breasts (reductions, augmentations, mastectomies, and reconstructions) which is another indicator of experience.
ps for those of you adept w/internet, your state medical licensing website probably has a search engine to look up names to see if there has been any reports/sanctions/etc for a dr. My nephew was seeing a "specialist" in Lyme disease and I found he had been a surgeon whose license to operate (good movie title!) was revoked in several states so he reinvented himself as a Lyme disease specialist in another state.
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Thanks @Recap. That makes sense, though I just looked on the clinic web site and their team is comprised of Breast Surgeons, Plastic Surgeons, and High Risk Specialists (who I have my upcoming appointment, and regular ongoing screening, with). Either way, I'm guessing there will be some sort of surgery/removal and testing. I've called to try to move the appointment up because I literally am losing sleep, almost all of it, thinking about this now. And I know that the appointment is just the start, that waiting for results, if it comes to that, will be even worse.
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Is your appointment for repeat imaging? Where I am a new lump is an automatic fast track to the diagnostic mammogram and ultrasound, which I would think you could do if it has been 6mos since your last one, but maybe they want to verify the palpability of the lump on physical exam before they do the imaging?
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the appointment is because I recently noticed the lump, but base on talking with the nurse on the phone, she concluded that it is a recurrence of a cyst or infected gland that had shown up on the US but since went away. However, the more I think about it, feel it, etc. The more convinced I am that it is not that but something new and quite different.
I did manage to get the appointment move up to next Wednesday so at least I don't have to wait quite as long.
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If you feel that this is a new thing entirely then you should have some type of imaging done sooner than four weeks. If you've already had this same area imaged then perhaps it's okay to wait for a surgical excision. I just wouldn't want to go by a nurse's opinion over the phone ...
In my case - I found the lump and saw a doctor two days later. He sent me for diagnostic imaging (mammo and US) the same day. I had the biopsy two days later and had the preliminary results three days later.
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I had diagnostic Mammo and Ultrasound in November of the general area but not looking specifically for something in the exact spot. I had screen MRI done in December. Now I'm worried that I've relied too much on what the nurse said. I put it out if my mind for a while and now I can't think of much else. The problem now is my high risk specialist isn't even in office until next Wednesday when i have my appointment. My primary care physician is out as well (and I never see her about breast issues anyway since I go to the high risk clinic). I'm thinking of going to the walk in clinic just to have someone else feel it... but then not sure what they'd do --perhaps send me elsewhere for imaging but I'd rather stay with the high risk clinic I've been at for years. Or maybe they'd send me for imaging and then that could be sent to the clinic.
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Hmmm ... well, it hasn't been that long since you've had things in general looked at, but that doesn't solve the current concerns. I guess I would maybe call the specialist's office and ask about getting an US and/or mammo done prior to your scheduled appointment. They will most likely need that info to proceed anyway and at least you'd be getting somewhere.
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To your original question, I doubt a plastic surgeon does biopsies. The nurse's comment sound more like "it's cyst and when it's removed, the plastic surgeon is the right dr for the best aesthetic outcome." My guess - and I have zero medical education beyond what I've learned about my cancer and my husband's. haha
I don't know where you are but if you can see your PCP sooner, he/she can send you for ultrasound on the area of concern. I started with my PCP and had an ultrasound and then the dr there was able to biopsy that day (the imaging suggested cancer so they told me to schedule a biopsy).
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