Biopsy performed by Radiologist or Breast Surgeon?

Yes, it is perfectly normal for a Radiologist to not speculate. She is recommending the biopsy precisely because she can't be sure what the mass is, so unless she has a really clear idea in advance (a BIRADs 4A biopsy or a BIRADs 5 biopsy), it makes sense to say nothing. Do you know the BIRADs rating of your imaging? That will provide a guide as to what the possibility of malignancy is. A BIRADs 4A biopsy has a less than 10% chance of being cancer. A BIRADs 5 biopsy has a 95% chance of being cancer. BIRADs 4B and 4C fall in-between. A BIRADs 4 (with no A,B,C,) has about a 20% - 25% chance.

A core needle biopsy is best performed by a Radiologist - they are the experts on that procedure.

A surgical biopsy, on the other hand, would be performed by a Surgeon.

Good luck with the biopsy. Hoping for a benign result.

Mimi: my BS referred me to radiologist for the needle biopsy (ultrasound guided).

My biopsy was also done by my radiologist.

In my case, the sequence of events was regular 3D mammogram, diagnostic mammogram + ultrasound shortly after that (not the same day), biopsy Friday of that same week at the same location as all the mammograms, call on Tuesday to say welcome to the BC club.

Same for me, Lukesmom. All three of my biopsies were done by the radiologist within an hour of an ultrasound. Great guy. Tried very hard not to hurt me, even though one was right behind the nipple. (Very painful area for a biopsy)

Here's hoping for benign results, Mimi820.

Trish

BIRADs 4B indicates that the Radiologist assesses the cancer risk to be >10% but <50%.

Hypoechoic means the mass is solid, not fluid, i.e. it's not a fluid-filled cyst.

https://breast-cancer.ca/ultrahypo-echosolid/

Mimi, when I was informed by the radiologist reading my mammogram that I was being referred for a biopsy, she told me another radiologist would perform the procedure since it was to be a stereotactic biopsy and not an excisional biopsy. She also told me that they refer for biopsy anytime the chance of malignancy is greater than 2%.

I knew I wanted to go somewhere else for the biopsy and any necessary follow up treatments, so I had my images and records sent to a breast surgeon at a dedicated breast care facility about an hour and a half away. He called me to say that they (he and the radiologist there) agreed the area should be biopsied and scheduled an appointment for me to consult with him. At that consultation, he explained the findings on my mammogram more thoroughly, pointing out that there were actually two areas of concern. He then scheduled me for the biopsy which was performed by a radiologist, but he also said that one of the areas to be biopsied would be difficult to get to and if the radiologist wasn't able to get to it, then he would perform a surgical biopsy. The first radiologist never said anything about two different areas of concern, so I was glad that I had my report and images reviewed by the surgeon. It only added a few days to the entire process even though I went out of town for that second opinion. (although of course at the time it felt eternal).

I'm sorry that you had to wait over a weekend before you could start to move forward with your plan. I can empathize about just wanting the biopsy done already.

Best of luck to you and hoping for benign results!!!

Great news that everything is benign!!! Thanks for letting us know your results. And be sure to celebrate your good news!

Mimi, glad your results were benign.

Are you aware that in most cases frozen sections that are analyzed by Pathologists during surgery provide preliminary results only? I've been hanging around here a long time, and I can't tell you how often I've seen women come out of surgery thinking that they are node negative because nothing was seen in the quick analysis of the frozen section, but once the more thorough post-surgical pathology results are available several days later, they find out that they are in fact node positive. It's devastating.

For this reason, my hospital (a leading cancer-only hospital) won't do frozen sections/intraoperative pathology unless there is a strong expectation that cancer will be found and this finding will impact/change the surgery in process. In most breast cancer cases where it's not apparent from previous imaging that the nodes are likely to be positive, a frozen section is not done.

We all wish that the process was more patient-friendly, not just for biopsies, but for surgical pathology and for imaging reports. Progress is being made, but sometimes if you want something done properly and thoroughly, it takes time. And in the case of pathology and radiation assessments, it usually takes 2 sets of eyes before a report is released.

do they need the frozen sections to send to Oncotype places ?

thanks Beesie!!