Six-month follow-up, then another Six-month follow-up?

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ShetlandPony
ShetlandPony Member Posts: 4,924
edited November 2020 in Not Diagnosed But Worried

I am preparing to talk with a young relative about her situation, and would like input and ideas.

She undergoes breast imaging not routine for her age for two reasons. First, family history consisting of two second-degree relatives with ILC, one diagnosed postmenopausal, and one diagnosed premenopausal (me). Second, related to this, is our genetic mutation which may confer about 30% lifetime breast cancer risk (among other cancers). (Also she has two second-degree relatives on the other side of the family who were diagnosed with bc, one premenopausal and one elderly, no known genetic mutation on that side.)

Six months ago her breast MRI saw something that resulted in a six-month follow-up recommendation. So I assume it was birads 3. She recently had the follow-up MRI and ultrasound. The information I have so far is that the area of concern was bigger, but again a six-month follow-up is recommended. So it must still appear “probably benign". But it's bigger. So I'm thinking, why do they screen if they are just going to kick the can down the road another six months?

On the one hand, a birads 3 only has >0 and <2 % chance of it being cancer. On the other hand, the thing is bigger. That plus the family history/genetic thing makes me nervous about waiting. Maybe she should request a biopsy.

Thoughts?

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  • MinusTwo
    MinusTwo Member Posts: 16,634
    edited October 2020

    SP - I agree. A biopsy seems like a sensible way forward at this point. You didn't say how young, but if I remember correctly, Beesie had her first biopsy in her teens.

    Depending on the placement of the 'area', if they can do an ultrasound biopsy I found that the least invasive.

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  • LillyIsHere
    LillyIsHere Member Posts: 830
    edited October 2020

    SP, if it was my sister, my close friend, I would suggest biopsy ASAP. In my case, some microcalcifications were found in mammogram and I was recommended to check in 6 months since my chance of BC was less than 1%. The old fashion doctor who checked my mammogram told me 6 months or she suggested to try a biopsy even though other doctors didn't think I needed it one. The doctor who performed the biopsy told me that less than 20% of biopsies are BC. She called me that night to tell me the biopsy revealed BC. From my own experience, I would never suggest waiting 6 months.

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  • ShetlandPony
    ShetlandPony Member Posts: 4,924
    edited October 2020

    And those microcalcifications turned out to be stage II ILC, Lilly. Another reason I am wary of bc being missed is that the family history is ILC, and ILC may be missed more often because it may not appear typical.

    MinusTwo, thanks for your input. If my relative can access a copy of the report, I can see what the radiologist calls the thing or area in question, and where it is. Also, I want to know how expert the reader is, what kind of facility, etc. and did they communicate with an oncologist who has the genetic/family history information before recommending waiting six more months. I know there are several things it could be other than bc. Just would rather err on the side of caution.

    I may suggest she get a second opinion at a major cancer center, where the radiologist will review the images, and then she will be at a good place where they have enough experience with younger patients, in case she does proceed to biopsy.

    This had better be nothing.

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  • Cowgirl13
    Cowgirl13 Member Posts: 1,936
    edited October 2020

    I would also suggest a second opinion at a major cancer center. From what I have read here, ILC can be very sneaky.

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  • MinusTwo
    MinusTwo Member Posts: 16,634
    edited October 2020

    Agreee SP - Hope she can easily get to an NCI center or at least a major teaching hospital.

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  • ShetlandPony
    ShetlandPony Member Posts: 4,924
    edited November 2020

    With much coaching and support, she did get her records, images, and an appointment at the nearest NCCN center. It turns out there were two areas, but neither had gotten bigger. That was a misinterpretation because of MRI vs. ultrasound, I believe. In any case, the experts reviewed the imaging and recommended another MRI in six months just to check. She also got a baseline mammogram which looked fine. We all feel much better and agree with the plan.

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  • Tuc
    Tuc Member Posts: 70
    edited November 2020

    Yep.

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  • Tuc
    Tuc Member Posts: 70
    edited November 2020

    Yep, I'm not the best person to respond-- I'm biased-- especially since I've been sick for a LONG time --- but still have not gotten answers. Hope you do.

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  • MinusTwo
    MinusTwo Member Posts: 16,634
    edited November 2020

    SP - glad your friend got good news.

    Tuc - please remove the picture of you breast from your profile. That is against BCO policy.

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