A few questions after callback letter

Every facility and doctor is different. Many facilities require a requisition from a PCP for the initial screening, but often the Radiologist will order any diagnostic imaging that is required as a result of the first visit. The fact that they need your PCP to provide a requisition, and the fact that your PCP is taking so long, is specific to your facility and your doctor. I'd suggest you follow-up with your PCP. Could your PCP's office have sent the requisition directly to the screening facility?

If you are worried about the freckle, I'd suggest a dermatologist. I doubt it's connected to the mass seen on your mammogram. If I have my terms right, the nodule is at the back of your breast (i.e. close to the chest wall) but is directly in line with your nipple. So I don't think it's actually near your nipple. Hopefully someone will come by to correct me if I got that wrong.

From the description, it sounds as though you might have a small cyst. Ultrasounds are much better than mammograms at identifying cysts, which are fluid-filled; the ultrasound can "see" the fluid whereas a mammogram just "sees" the mass and can't identify if it's solid or fluid-filled. Hopefully that's the case, that this is just a harmless cyst. If the mass appears on the ultrasound to be solid, then it's possible that a biopsy will be recommended. If that happens, the important thing to know is that 80% of biopsies turn out to be benign.

Good luck!

TColorado--Beesie is a treasure and all I can do is agree with her. Odds are greatly in your favor of it being benign. But I'd start to be the squeaky wheel with your PCP's office just to get this behind you. I've also never heard of any mole/freckle on the skin being related to breast cancer.

djmammo, thanks for the clarification. That's interesting - from reading this board, it sometimes sounds like a lot of women move from test to test without gettting requisitions from their PCPs, so I wasn't sure what the process was in other jurisdictions. What your office does with the requisition form makes sense.

I'm in Ontario. The requisitions from my PCP's practice do not include the same wording as yours (I was curious so I just checked), but there have been many years when I've been shuttled straight from a mammogram to an unscheduled ultrasound, or immediately booked for a follow-up diagnostic mammo, ultrasound or biopsy, without my PCP's office being contacted first. That said, the final reports always have my PCP's name listed as the 'ordering physician'. I think the difference may be that this is a single payer system, so there is no issue about getting insurance approvals or anything like that - if the test has been ordered by a doctor, the government will pay. There might be some unwritten agreement that Radiologists have the authority to order any additional tests that are immediately required and either a separate requisition is not necessary, or perhaps because approvals and payments aren't a concern, the paperwork (i.e. getting a requisition from the PCP for the files) is dealt with later.