Arch distortion, Radial scar for 4th year. 3rd biopsy Monday

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afreshjoy
afreshjoy Member Posts: 4
edited March 2019 in Not Diagnosed But Worried

Hi, I have had an architectural distortion / radial scar /complex sclerosing lesion for 4 years now that they've been testing and watching. I have had 2 biopsies where they aspirated the cells and showed no evidence of malignancy. They put those little clips in there after each biopsy to mark where the biopsies happened.

I had my diagnostic 3D mammogram yesterday and just like every year, they took more mammogram images. Then the tech did an ultrasound for a long time and then the doctor came and did one for like 15 minutes. I will be having my 3rd biopsy on Monday. 😕

The doctor said he's never seen this situation before in his 20 years. I was watching his face and when he got to the suspicious area he took a deep breath. He said "man, I just don't know what to do. I mean you've been at this for 4 years now. It's not changed on the mammogram which means it doesn't appear to be growing and that's a good thing. But I can't explain it and I just can't say if it's cancer or not. I have to biopsy it again. The marker is not where it should be but they can also move so I can't say for sure that they've gotten cells from the actual area or not. I could surgically remove it, but that would take a month or longer to get scheduled and it's more invasive. I could do an MRI but that can give us false positives all over the breasts that we'd be chasing bc an MRI picks up everything and you have a very dense breast. We really a need pathology. I think we should do another biopsy and go from there. I don't think it's cancer, my gut really says its not but I can't say for sure without more data"

When I asked if this biopsy was going to be definitive (bc the other 2 produced a Birad 3 instead of 2), he said "I hope so"

So now. I'm back at a Birad 4. They said 7 cm, but I'm not sure if that means the area is 7cm or if the area is located 7cm from the nipple. I remember last year the size was 3.2cm and they used the word spiculated. I have heterogeneously dense breasts (4).

What questions should I ask? Should I get a second opinion? His face showed concern while the words were reassuring. I wish I had asked him what specifically he hadn't seen in his 20 years and if it was still the same size on us and if it was still apiculated. Does he mean the radial scar, I know it's rare but certainly he's seen a radial scar in his lifetime?

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Comments

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

    Why hasn't the complex sclerosing lesion been excised? They usually are.

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

    afreshjoy

    Mel Dal is correct. I have never seen anyone follow a RS. I have never been in a position to biopsy one twice.

    We don’t recommend long term surveillance on things with even the slightest malignant potential. We follow things over time to prove they are benign, not to wait for them to “go bad”.

    Who was the first one to say to you “We can follow this”

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  • afreshjoy
    afreshjoy Member Posts: 4
    edited November 2018

    Here is what the actual report from the tomo and us last week said:

    FINDINGS:

    There are 2 biopsy clips in the upper outer quadrant right breast. Laterally in the upper outer quadrant right breast

    posterior third there is a persistent area of architectural distortion, similar to multiple previous studies. No new abnormality right breast.

    Stable appearance left breast with no new or suspicious abnormality.

    RIGHT BREAST ULTRASOUND:

    At 10 o'clock (7 cm from the nipple) there is a irregular hypoechoic solid appearing abnormality measuring 1.2 x 0.8 cm

    with mild shadowing on harmonics. This is present within an area of echogenic glandular breast tissue. A biopsy clip is

    present anterior to this area but appears separate. There is no palpable mass on exam.

    IMPRESSION:

    1. Ultrasound abnormality upper outer quadrant right breast at 10 o'clock (7 cm from the nipple). Patient has undergone

    biopsy of architectural distortion upper outer quadrant right breast (2017 )with benign, nonspecific pathology results.

    Mammographically the area of distortion is stable. However, there is an ultrasound abnormality in this region which is

    indeterminate, and not previously identified. Biopsy of this ultrasound abnormality with clip placement is recommended.

    2. No abnormality left breast.

    RECOMMENDATION: Ultrasound-guided core biopsy of abnormality 10 o'clock right breast.

    BREAST COMPOSITION: The breasts are heterogeneously dense, which may obscure small masses

    C4D3: BIRADS CODE 4: SUSPICIOUS

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

    afreshjoy

    Interesting. Another biopsy is clearly indicated. The key will be the position of the next biopsy marker. They will place this marker in the new US finding after the cores are taken. After that a mammogram will be performed to demonstrate its location. Ask if the marker lines up with the stable architectural distortion.

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  • Dena_01
    Dena_01 Member Posts: 7
    edited March 2019

    Afreshjoy -

    I would like to follow up with you on how things have turned out for your following RS.

    I have been following the same AD (with 2 inconclusive/discordant biopsies for RS or anything else I would need to be be concerned) about for almost 3 years now. Just to let you know you arent alone in wanting to not go in for surgery immediately.

    Mine has unfortunately changed and I was just told this morning that watching and waiting was not something they could support at this point.

    I hope you are no longer on here due to excellent turn out for you..but still curious.

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