Need biopsy
Hi all--
Like I assume many here, I am freaking out right now but also don't want to unnecessarily stress out my friends and family since there's nothing they can do...so I'm so glad there is a board like this.
I'm 43 and I just got my first mammogram last week. My last PCP told me that the guidelines had changed and I didn't need to start screening until later (after 45 maybe?) but when I moved to NJ my doctor here said I was "overdue". My best friend also convinced me to go. So I went, I don't handle pain very well and the initial mammogram was brutal. My best friend said "at least you only have to do it once a year!". Until the phone call the next day. They told me I had very dense breasts and so needed to come in for a repeat mammo and an ultrasound. At first I thought it was just due to the denseness, but when i saw the report in my chart there were two areas of suspicion (one in each breast) they wanted a closer look at.
Fast forward to yesterday--my repeat mammo and u/s. This time I premedicated with some aleve and a xanax and that helped quite a bit with the pain but of course still stressful. The worst part was that after the ultrasound, the technician came in and said I was all clear and I would just need to come back in for a repeat in 6 months and sent me on my way. In the dressing room I heard my name called and it was the radiologist finding me to say she changed her mind and instead wants a biopsy on my right breast. I had ALMOST gotten away. When i read the report in my chart it says birads 4, suspicious for malignancy, and an "ill-defined hypoechoic area".
It's so frustrating because at every turn everyone is saying "it's probably nothing", or "it's just because it's your first one that you have to come back", or "it's those dense breasts", and even the radiologist said "it's probably nothing but I want to biopsy it". Is it something, or is it nothing? So my biopsy is scheduled for 1/3 (that is a long time to wait to find out if you have cancer!) and I have to try to enjoy the holidays with this hanging over my head and not wanting to share it.
Comments
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NJGirl, 80% or more of Birads 4 biopsies ARE benign, so it probably IS nothing to worry about, and yes, it is very common on first mammograms, because there is nothing to compare to see if this is your "normal." Since initially they were going to give it a Birads 3 (short term follow up), it genuinely does sound like they on't find whatever it is a very low level of concern - they are just being prudent. I know this doesn't help the waiting and the "what-ifs", but try not to make yourself nuts at this point.
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NJgirl,
As Melissa says, this is pretty routine in the screening world -- since you have no baseline to compare to, the doctors are simply being cautious. Try your best to not worry too much, and we'll be sending our positive thoughts your way. Please keep us posted with what you find out!
--The Mods
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Big hugs to you. It is so scary, I know. Like you have heard, most biopsies are benign. I had a BiRads 4 turn out benign last fall. That ended up being my non-cancer side when I was diagnosed this year. Many many are benign. Better to be completely safe, and if it does show up as something concerning, to deal with it as soon as possible.
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Thanks to all.
My biggest problem is that I am a very, very logical person. Logically, I know that the odds are very low that this is a real problem, and that it most likely IS that it's my first, it's because I have dense breasts, blah blah blah. But despite how very logically I can view the situation from a 20,000 foot view, I can't convince my emotional side that everything isn't going to fall apart. And now every tiny thing I notice (did I feel a lump in my armpit? Is that cancer?) are being amplified. So it's a fight between my logical side and my emotional side. I hate it. And I hate that I didn't even want to get the mammogram to begin with, due to the chance of false positives at my age/risk factors, and here I am, best case scenario, being one of the false positives. Grr!
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Back again with more confusion!
I had my biopsy last Thursday, the 3rd. Fortunately for me, it wasn't terribly painful (seems to be either fine or excruciating, based on what I read). The radiologist took about 6 samples and i'm healing up slowly from it (the bruising is worse than the actual pain was!). He called me this morning...and like everything related to this for me, it's not a clear black/white answer.
He told me the samples he took were benign. BUT. He really doesn't like the look of the mammogram (architectural distortion). He feels like he took a lot of tissue and what he took was benign, but he wants me to meet with a breast surgeon and get a breast MRI before he is comfortable moving to just watching. He said the MRI is almost 100% sensitive for cancer and so if it's negative he will be comfortable, but that I need to talk with the surgeon to see if they will want to remove it or just watch. UGH!
To be honest, right now I would be happier if he had called me and said "yes, it's cancer and we have a plan for it". It's this "well it's probably nothing but I don't like the looks of it" stuff that is truly killing me. And I know how our health care system works, but if the MRI is 100% at detecting cancer, why didn't I just get an MRI to start with! it's so frustrating!!!
Thanks for letting me vent.
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The good news is, it sounds like you have a very careful doctor!
I hope things turn out to be fine!
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I feel for you and the frustration and sorry you're going thru this. I'm 46 and hadn't had a mammogram in 4 years, then got called back for a 2nd mammogram and then a biopsy due to calcifications. When I got there, they wanted to not do the biopsy (after I had been waiting for 2 weeks for the appt) and send me for an MRI because of dense breast tissue but when I had the mammogram, that wasn't even an area of concern, I pushed to do the biopsy anyway so we did and the calclifcations were benign but now they still want me to do the MRI because of dense breast tissue so doing that in a couple of weeks.
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I'm sorry. That's so frustrating.
I think there are two big reasons they don't use MRIs earlier, one good one and one frustrating one.
The good one is that MRIs are sensitive enough to catch many things that are actually not problematic and don't need treatment, but once you catch it, there is pressure to investigate further and it can lead to many needless biopsies and even lump/mastectomies, plus all the surrounding anxiety and side effects.
The frustrating one is that MRIs are much more expensive for health insurance so they demand doctors justify the cost by showing that they really really need one and cheaper imaging won't do.
There is more consensus and publicity now about the limitations of mammograms for dense breasts. IMO, as soon as they see that someone has dense breasts, there should be a shift to alternate screening strategies. Yearly MRIs are probably overkill and have their own risks, but at least a baseline MRI and maybe every 3-5 years. At least until they figure out something better.
But that doesn't do you any good now. The waiting for results and information is so so hard. Be as easy on yourself as possible and try not to pressure yourself to feel or be any particular type of way.
Hoping for good (and/or at least definitive!) news for you soon.
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