Question about where to go from here

jpn0707 · January 2020

Hi everyone - I had my screening mammogram back in mid Nov and was called in early December that I needed to come back for more views. I had moved away from the area and I guess the new imaging center had a hard time getting my records but I wasn't aware of the delay so I was quite surprised to get a call 3 weeks after the mammogram that I needed to go back.

Not my first rodeo in getting a call back because I have very dense breast tissue. I went for the diagnostic mammogram and the radiologist suggested an ultrasound. With all of the previous call backs, I never went past the additional mammogram views. I had the ultrasound and the radiologist suggested a breast MRI. With the holidays, I wasn't able to have the Breast MRI until mid Jan and only because I went to a different hospital. Long story short, the Breast MRI suggests the need for a biopsy (stereotactic). My primary care doctor referred me to a surgeon but I cannot get in to see him until mid Feb.

In talking to some of my friends who have also needed a biopsy, they do not understand why I am seeing a surgeon and are suggesting that an interventional radiologist should be doing the biopsy. I tried calling the breast health navigator at the original hospital to see if this is the correct protocol but no one has returned my call.

I just don't want to be making the wrong move because all of this waiting is hard. Any thoughts from experience on who should perform a stereotactic biopsy? Thank you.

ctmbsikia · January 2020

Hi. In my experience breast surgeons do not perform biopsy's unless it's being excised in an OR setting. In my experience most radiologist/Dr's that are on staff at a radiology center are the ones doing the procedures. You and your BS, and your referring GP would get the results afterwards. I would call where you had the MRI and get the biopsy appt done before your mid Feb. appt. Good luck, let us know how it goes.

MinusTwo · January 2020

Or an Ultrasound biopsy if OK, since that's less hassle. But yes, my radiologist did my biopsies.

KBeee · January 2020

Most often the radiologists do the biopsies...either stereotactic or ultrasound guided based on location. Call and ask why you were referred to the surgeon for the biopsy. Perhaps it is because of location. If they have no reason then ask if they can do an ultrasounds or MRI guided biopsy.

keepthefaith · January 2020

Breast surgeon did my core biopsy, but not the same as stereotactic. I would ask the radiologist if they can do it or ask PC if they can refer someone who can get it done sooner, if that's what you want..

My tumor was close to my chest wall, so happy to have it done by a surgeon specializing in breast surgery. It's important to have someone with experience and that you are comfortable with.

Good luck and best wishes for benign findings!:)))

Beesie · January 2020

Yes, as the others have said, it's the Radiologist who usually performs a stereotactic biopsy. Perhaps your PCP doesn't know this?

You should talk to your PCP's office and request that they send in a requisition for a biopsy either to the Radiologist who ordered the MRI, or to the Radiologist at the facility where you had the MRI. If your PCP's office won't do this, ask why.

Betrayal · January 2020

The Breast center at hospital system where I had my mammogram and then ultrasound insisted I had to see a breast surgeon before they would even schedule me for the core biopsy they insisted I have based on the US results. So while it may be the radiologist who performs the biopsy, and yes, mine was done by the radiologist, I had to see the breast surgeon first. As far as I was concerned this was just a way to increase my insurance payment for a BS consult pre-biopsy and then I had to see the BS once the biopsy results were in. The BS only confirmed my need for the biopsy and had nothing else to offer then. So itreally depends upon the hospital system you are dealing with when this occurs and the PCP's usually want little to do with this in my experience.

Ingerp · January 2020

Yikes—I honestly don’t know what kind of biopsies I had but they were always done by my BS. (I had a BSfrom about 10 years ago due to some ALH.)

jpn0707 · January 2020

Thank you ladies. I called the Breast Health Navigator. She said that the breast surgeon I have the appointment with does perform biopsies at their facility. I am going to stay the course because he comes highly recommended.

djmammo · January 2020

Biopsy

I am a bit biased but the bottom line of any procedure is how many do they do a year, and how many appointments are available each week/month. In my last practice we were doing 4-6 biopsies per day, offered every day M-F half of them done in the AM and half in the PM so each of us did a fair number of biopsies per year.

Compared to a surgical procedure, these image guided biopsies are usually not worth the surgeon's time plus they would have to have an US machine and a stereotactic set up or have a deal with radiology to use their equipment. One practice I was in years ago allowed the surgeons to use our stereo tables. They only have to do a handful a year to maintain their accreditation for doing these procedures so we supervised them for each of their cases.

SummerAngel · January 2020

Interesting. My BS did my left-side biopsy, and a radiologist at a related facility across the street from the BS did my right-side biopsy. When the radiologist who read my mammogram and ultrasound was discussing where to send me for my left-side biopsy (no problems with the right were identified at that time), they decided to send me to the BS instead of across the street because the imaging indicated it was most likely a fibroadenoma and I think they wanted the BS to take another look before performing the biopsy, which she did.

djmammo · January 2020

SummerAngel

Wanted them to take another look at the imaging?

Question about where to go from here

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