is excision biopsy needed

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nosure
nosure Member Posts: 7
edited August 2018 in Not Diagnosed But Worried

I'm 23 year female and recently found lump in my breast. I had a sono mammography and the report says 3 lump (one in right 2.8*2.6 cms and 2 in left-1cm) benign fibroadenoma. FNAC report says "right breast shows biphasic neoplasm with predominant spindle cell components". Should i go for excision biopsy to find out benign or malignant? or should i monitor for another 6 months?

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  • fishfish
    fishfish Member Posts: 32
    edited August 2018

    what did your doctor says? For me. I have the same situation need to go for excisional. The doctor reason is that my core needle biospy result doesn't match what they see in ultrasound. My doctor said that most likely not cancer but it is in their procedure that they have to do it because it is a safety thing

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  • nosure
    nosure Member Posts: 7
    edited August 2018

    i have just done sono mammogragy and fine needle aspiration (FNAC). FNAC showed "right breast shows biphasic neoplasm with predominant spindle cell components". My doctor says for my age 23, lets keep under observation for 10-20 days before doing excision biopsy.


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

    nosure

    Here is an article relevant to your path report

    Was an actual fine needle aspiration done or was it a core biopsy? Occasionally an FNA will not provide enough tissue for the pathologist to make a positive identification of the mass. As you can see by the article both benign and malignant things share spindle cells as a feature.

    Does the path report mention anythhing about the amount of tissue being satisfactory or unsatisfactory for diagnosis? A core biopsy provides much more intact tissue for evaluation.

    Ask your doctor if a core biopsy can be done instead of an excisional biopsy as if this is benign, which is most likely, you would be able to avoid a surgical scar to get your diagnosis.


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  • nosure
    nosure Member Posts: 7
    edited August 2018

    fine needle aspiration was done and report said "right breast shows biphasic neoplasm with predominant spindle cell components".

    Since i'm 23 year old, doctor kept me under observation for 10-20 days, doctor said he will do excision biopsy if the lump doesn't go away in 20 days. he believes it might be due to period cycle.

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

    nosure

    That path report suggests its a fibroadenoma or related mass. These don't go away. Who did the biopsy?

    Is your doc a breast surgeon, a general surgeon, or primary care doc?

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  • nosure
    nosure Member Posts: 7
    edited August 2018

    "right breast shows biphasic neoplasm with predominant spindle cell components" -- is it fibroadenoma? well in that case i dont need biopsy right?

    or i need biopsy? do you think FNA is not enough to conclude?

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  • nosure
    nosure Member Posts: 7
    edited August 2018

    "right breast shows biphasic neoplasm with predominant spindle cell components" -- is it fibroadenoma? well in that case i dont need biopsy right?

    or i need biopsy? do you think FNA is not enough to conclude?


    my doctor is general surgeon (oncology),

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

    nosure

    My point was that kind of path result to me does not point to merely fibrocystic disease and as mentioned in that article, it could be either benign or malignant so further sampling or some sort is completely necessary. If they feel it needs to be removed to get an answer then so be it. If your surgeon is an oncology specialist then you should be in good hands and strongly consider taking that advice if it does not go away on its own.

    ===

    My personal preference for tissue diagnosis is core biopsy, I do not perform FNA's unless a cytology tech is present in the biopsy room with their microscope to insure that I got an adequate sample before ending the procedure.

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  • nosure
    nosure Member Posts: 7
    edited August 2018

    After 10 days of tablets and observation, Lump which was like marble turned like bag of peas. Now when i touch, it feels like peas. (not like marble anymore) Its PAINLESS. Doctor said its firm, movable, bag of peas when touched. Surgeon asked for excision biopsy. he said even if its benign there is chance it grows. so better to remove full as early as possible.
    I have decided for surgery in another 5 days. Is there anything i should be worried? will there be breast deterioration? Am so worried about later consequences. will they remove my breast in any case during surgery? am so worried. am 23 year female. Please help me.
    --------------

    Could you please tell what this report says (FNA)

    Microscopic features:

    A (right breast 3 X 3 cms ) - Smears show chiefly monomorphic loosely cohesive sheets of round to spindle shaped cells with round to oval bland nuclei, moderate to scant spindled eosinophilic cytoplasm, occasional foamy cytoplam seen. Focal plasmacytoid cells and mulinucleate giant cells seen. Few clusters of ductal epithelial cells and myoepithelial cells seen against a background of RBCs, no evidence of atypia mitosesr /granuloma seen.

    B ( left 1 cms size ) - Smears are cellular and shows branching monolayered clusters of ductal and myoepithelial cells. Focal apocrine change noted. The background shows bare nuclei.

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

    nosure

    First of all at 23 y/o it would be extremely unusual for you to have breast cancer. And yes there are benign things that can grow over time and those are usually removed early. No one will remove your breast while you are asleep in surgery. What is written on your consent form is all they are allowed to do while you are under anesthesia so read that carefully when they ask you to sign it. Have them explain it in full. Not sure what you mean by "deterioration" but there should be no bad later consequences of the surgical procedure itself.

    I am not a pathologist but that report indicates that no cancer was seen. Other parts of the report makes me think there may have been a previous infection or inflammation there. Have you ever had an infection or inflammatoin of any sort on that side? Have you had a prior injury? Nipple ring or other piercing there?

    ====

    Now this part is just my personal opinion. At your age I would tell the surgeon that you do not want a visible scar. A good number of breast surgeons these days have training in plastic surgery techniques so as to minimize scarring after surgery. Ask them if they can do that for you.

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  • mustlovepoodles
    mustlovepoodles Member Posts: 2,825
    edited August 2018

    I just want to back up djmammo. There was a time, before 1985, when women would go to sleep not knowing whether they would wake up with both breasts or only one. It was terriblly stressful, but doctors genuinely thought it was better for women to not have to undergo two surgeries, even though it meant they had no say in what would be done to their bodies.

    Thankfully, we live in a better century now and we understand that women have the right to decide what happens to them. No doctor in a civilized country would dare take your breast off against your will today. Can you even imagine the lawsuits? They understand now that these surgeries are safe for most healthy women and there is seldom any reason to rush to breast removal without careful consideration.

    Your surgeon is suggesting excisional biopsy. I think you should consider it. If you continue to have concerns about the possibility of removing your breast, bring it up with yiur surgeon so he can put your mind at ease. He won't know you are worried about this if you don't tell him.

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  • nosure
    nosure Member Posts: 7
    edited August 2018

    Thankyou so much for the information and support.

    Doctor is performing surgery with plastic surgeon too.

    I'm so glad that there is community like this to help people. I would like contribute to this in anyway possible.

    That you so much for everything djmammo and mustlovepoodles

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