Stereotactic Breast Biopsy - Surgeon or Radiologist??

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SOMANYQUESTIONS
SOMANYQUESTIONS Member Posts: 21
edited June 2018 in Waiting for Test Results

Hi,

I was called back immediately after my screening mammo. My mammo with additional views and ultrasound was rated BI RADS 4 Suspicious for 1) scattered fibroglandular densities, and 2) grouped calcifications with associated asymmetries in the lower outer right breast which demonstrate mild pleomorphism. The ultrasound shows: normal breast tissue without evidence of a suspicious cystic or solid lesion.

The report impression was written as: grouped calcifications with associated asymmetries in the lower outer right breast without a sonographic correlate for which stereotactic guided biopsy is recommended.

I have been given a choice of two surgeons - one who does the biopsy herself, and one who sends you to the associated radiology group and you get whomever is on shift that day doing the biopsy.

Who do I want doing my biopsy, the surgeon or the radiologist, and why? I have gone back and forth with pros and cons, but have no idea. Also, anyone with a similar mammo, how did things turn out? Does it sound bad? I know the pleomorphism is not good...

And do I want the sitting up or the laying down version of the biopsy?

Thanks so much for your input!

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  • Lula73
    Lula73 Member Posts: 1,824
    edited June 2018

    radiologist as they can mammo you in position, do the biopsy, drop the marker and mammo you Again to ensure the markeris in the right spot.

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  • SOMANYQUESTIONS
    SOMANYQUESTIONS Member Posts: 21
    edited June 2018

    @lula73 , wouldn't the surgeon have to do the same?

    Isn't a stereotactic mammo guided biopsy done the same way, no matter who does it?

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

    Stereotactic biopsies are done by radiologists, not surgeons. Surgeons cut

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  • Lula73
    Lula73 Member Posts: 1,824
    edited June 2018

    unless that surgeon has a mammo machine they are going in by feel/sight or by u/s if they have one. Could there be a misunderstanding and the options were stereotactic biopsy by radiologist or surgical excision by the surgeon... Or maybe it wasn't an option between the two but the order of the process: you'll have stereotactic biopsy by the radiologist and follow up with the surgeon for next steps.

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  • SOMANYQUESTIONS
    SOMANYQUESTIONS Member Posts: 21
    edited June 2018

    The referring gyno wanted me to see a surgeon first. She discouraged me from going directly to radiology to have the biopsy without her referring me to a surgeon because, as she explained, if I have anything other than a completely benign result, I'm going to be "hanging out with my positive result and no surgeon to see" - so I had to pick one and have her refer me to get things rolling.

    I know for a fact that one surgeon sends you to their breast imaging center and whichever specially breast certified radiologist happens to be on duty does the biopsy on the special mammo table. The other surgeon I am really not clear on, other than I keep being told she see patients in one town and operates out of a hospital in the next town over, and that she does the stereo biopsy personally herself - I just assumed it would have to be on the special mammo guided table also, but honestly, no one ever said one way or the other and because I assumed there is only oneway to do them, I didn't know to ask.

    I am going to call her office and ask specifically for details on how she does it exactly, and where.

    I can't stand how you can't call directly for the surgeon appointment. The gyno office refers you and then tells you the surgeon's office will call you in a few days based on how urgent they think your case is, or not. Meanwhile, I am a nervous wreck and scared out of my mind with no firm timeframe. At least if I had a timeframe to hear back, or an appointment date set...

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  • JoniB
    JoniB Member Posts: 346
    edited June 2018

    When I had a suspicious mammogram and told I needed a biopsy, I tried to get an appointment with a breast surgeon. Not one surgeon would see me before I had the biopsy. I didn't want to do the biopsy where I had the mammogram and didn't know what to do or where to go. My friend's cousin is a radiologist at a major NYC hospital and she ended up doing the biopsy and gave me the name of a surgeon when the results showed BC. At that point I could have gone anywhere since I had my results. I think seeing a radiologist is the way to go.

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

    The surgeon could have the equipment to do the biopsy. The surgery group I go to has their own imaging equipment, mammogram and stereotactic table and everything, so a surgeon could feasibly do this if they are equipped.


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  • SOMANYQUESTIONS
    SOMANYQUESTIONS Member Posts: 21
    edited June 2018

    After some ups and downs and back and forths about my decision, I finalized my choice this afternoon and made my appointment with the surgeon who does the biopsy herself. She uses the stereotactic biopsy table at the hospital. This might sound crazy, but one factor that helped me decide is her office picks up the phone and you get a human being, vs the surgeon closer to home you go into voicemail and menu hell.

    Consult is on Friday, 6/22 and unless there is some glaring problem at that visit, the biopsy will be done on Tues, 6/26. So, hopefully by the end of the month I'll know how much trouble I'm in. Thanks ladies.

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