Two Mammos show nodule growth, US can't find anything

OGKats · January 2019

Hello, thank you for reading my post. I am new to the forum and after reading many great questions and insightful answers I am hoping to get your thoughts on a nodule that has grown and shows
on 2 mammograms but not on the US.

I am a 67-year-old woman whose Mother and Aunt both had BC (Mom during her 30's). Though my Mother lived, she developed gangrene which went badly for her. I was told that their BC's placed me at higher risk so have been screened every year
since my 30's. 10 days ago, I had my annual Mammo which showed a 5mm
nodule (found last year) had grown to 8mm (this year). It’s in the left breast 1o’clock, deep (not
just under the skin), I cannot feel it but have noticed a light burning/bruised
feeling in that area nonstop for about a month (my understanding is pain usually
is a sign it’s Not BC). But because of its growth Radiology requested a follow-up
Mammo plus US (both done yesterday). The nodule was again seen on this 2nd
Mammo but not on the US. The US Tech who mentioned she had been a Tech
for some time, said she couldn't find such a small deep nodule due to my large very
dense breasts (size D) and left to get her Supervisor to come finish the
screening. However, after a minute the Tech came back in and said the
screening was finished and would be submitted to the Radiologist for
review.

Since 2009 my clinic has become 'very' frugal
when it comes to testing and Specialist referrals. Because the US could not confirm the nodule I really believe my own MD will take the watch and wait approach. But, I wouldn't be comfortable if presented that course of action. I think I’m
considered high risk due to my family history and because the nodule has shown
growth so I would like your thoughts …. Is the nodule small enough to not worry about, should I just let it go if I get an "Everything is Fine" letter or, should I wait
6mths -1year for follow-up as I understand many women do or, with my Mother’s BC
and the fact the nodule has grown should I be more proactive? If more
proactive what would those options look like since the US doesn’t show anything?

Sara536 · January 2019

If it’s cancer, it is never too small to deal with. An MRI would probably be the next step. (And a second opinion.)

Dani444 · January 2019

I agree, seems an MRI would make sense. Can you get a referral to a breast surgeon

leftduetostupidmods · January 2019

US doesn't always see. I had microcalcifications shown in the mammo. US immediately after didn't sow anything. Had stereotactic biopsy after that that showed DCIS. Then breast MRI showed 10 cm tumor area. Post-op pathology showed 4 cm tumor with 3 invasive types and 2 non-invasive. MRI didn't show node involvement while pathology showed 3 mm tumor in sentinel node. So honestly I think that only if you have a lumpectomy or at least a biopsy you'll know for sure. Imaging is not 100% accurate.

leftduetostupidmods · January 2019

Also, sorry to say this, but BC does hurt. We have somewhere here a thread on the forum where we dispelled the myth of "BC doesn't hurt", a lot of ladies did have pain. I did. I am not writing this to bring you down, only to encourage you to push for at least a biopsy.

OGKats · January 2019

Thank you each for your responses. I actually have been waiting to hear the
conclusion on the diagnostic Mammo and US tests both taken 1/16. Today I finally received 3 letters, 2 from Radiology
that do not specify which test they are referring to but both are dated 1/17
and 1 from my MD dated1/21. Briefly this
is what each said…

#1 Radiology …. “We are pleased to inform you
that the results of your recent left
breast imaging study performed 01/16/19 are: Benign”

#2 Radiology …. “Your recent left breast imaging study performed
01/16/19 showed a finding that requires additional imaging studies for a
complete evaluation. If you have not
already been contacted, please call to schedule as appointment for these tests.”

#3 MD …. “I am contacting you regarding
repeat left breast mammogram and
ultrasound showed possible normal glandular tissue. Thank you for your time in this important
matter.”

I still believe it’s most likely a cyst but
am now more confused (and honestly a bit upset) than I feel I should be. I would like more clarity rather than maybes
and dismissal ...and I’m not sure exactly how to proceed with such contradictory
letters. For the MD’s letter I believe
glandular tissue is referring to my dense breast but what in the world does “possible
normal mean?”

I’m remembering the US Tech, in her words, couldn't
find such a “small deep nodule due to my large very dense breasts” so went to
ask her supervisor to finish the screening.
However, the supervisor never came in and the test was sent as-is to the
Radiologist for review. I assume letter #1 is from US but have to question,
how can the nodule be considered “benign” when the tech couldn’t find the lump? I actually now look at it like I was given the allotted time and she didn't want to waste anymore looking. I know it’s there though because Mammo has found
it now 3 times, and like Sara536 said " If it’s cancer, it is never too small to deal with"

I’m trying to get a more rational (than
emotional) approach before calling my MD.
Are these letters actual contradictions or not? Looking at this more objectively wouldn’t the
better path be a follow-up MRI or at least both Mammo and US again within a few
months? While I'm not exactly ready for a lumpectomy, Is it prudent to wait another
year for my annual Mammo?

Sara536 · January 2019

You need to follow up on that #2 letter from radiology. You were asked to make an appointment for further imaging, so they have not forgotten you. I think this sounds like a call back for a “diagnostic mammogram" in which case the radiologist will be right in the next room. You might want to ask to speak to him directly to answer your questions.

Rah2464 · January 2019

OGKats - my cancer was not detected accurately by mammogram and ultrasound. I too had dense breast tissue (although I was very small) and the mass was close to my rib cage. The mass was clearly visible on MRI but without it, who knows how long until I was diagnosed. And that little voice you are hearing telling you to push isn't being overly emotional, it is rationally responding to your intuition. Given your family history, I think you are spot on to push forward for an MRI. My best to you.

leftduetostupidmods · January 2019

I agree with you, it's very confusing. And yes, push for an MRI

OGKats · January 2019

Thanks again all of you for giving me such quick feedback.

Sara536, I was told the 3rd Mammo (1/16) was a diagnostic mammogram. The tech used some kind of flat plastic ladle to squish the breast down for the xray and then the finished images showed "grids" penpointing the nodule area. The 3 Mammos and the US were done right next to one another (same office) and with all these tests I have yet to even catch a glimpse of the Radiologist let alone speak with him.

Seachain, the other thing you mentioned was BC can hurt. Thinking about it last night I finally realized a similar feeling. Have you ever had sore muscles and used a tad to much mentholatum or capzasin heat type topical cream? That resulting heat/burn feeling is what this discomfort feels like.

Rah2464, If you are comfortable with it, may I ask how large your cancer was and where it was finally located?

OGKats · January 2019

Yesterday I spoke with my MD's nurse and requested an MRI. I explained my confusion that 3 Mammo's have shown the nodule but the US did not, and also with the 3 contradictory letters I received. Honestly I didn't expect an answer back for a couple of weeks as she said the Dr was on vacation. However, last night I received a call back from the nurse. She said after looking at my record she agreed so sent an email to my MD who immediately responded back that he would approve the MRI so to go ahead and schedule it.

I just want to thank all of you for helping to clear my mind on this and giving me a direction other than just being passive.

Two Mammos show nodule growth, US can't find anything

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