Two biopsies and frustrated

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Harley07
Harley07 Member Posts: 164
edited November 2020 in Waiting for Test Results

I’m 63 and had my annual tomosynthesis screening mammogram on 8/27. Previously had stereotactic biopsy on left breast in 1999 - results were benign. Mother and maternal aunt both had BC.

Received a callback due to a spiculated mass in right breast (<1cm) and had a diagnostic mammogram and ultrasound on 9/25. BIRADS 4 and recommended a biopsy. Radiologist said it is high likelihood of cancer, but not life threatening.

Had the US guided core needle biopsy (different radiologist) on 9/30. Unfortunately, the 4 specimens were too sparse and the few ductules present were compressed and compromised. The pathology report indicated only fatty tissue and recommended a stereotactic biopsy which was done on 10/7. During the VAD stereo biopsy (yet another radiologist) the marker from the first biopsy was accidentally removed. They took 6 samples. Pathology report said high risk benign lesion with minute focus of ADH and atypical vascular proliferation associated with hemorrhage. High risk results are concordant with imaging. Recommend surgical consult. Also noted biopsy marker is 2cm medial to the spiculated finding on CC view. RF tag should be placed accordingly. What does this mean?

All imaging and biopsies were done at the same highly regarded breast center.

I have an appointment with breast surgeon in 3 days, but am frustrated at the inconclusiveness of the biopsies and wonder if this is even a serious or concerning issue? Perhaps I should just wait for my annual screening next year and see if there are any changes?


Thanks in advance for your thoughts.

Comments

  • MelissaDallas
    MelissaDallas Member Posts: 7,268
    edited October 2020

    Harley67, the excision needs to be done. About 20% of the time on excision for ADH found on needle biopsy there is DCIS or invasive cancer found in the area where the ADH was found. As to the marker, it sounds like they are trying to fine tune where to place the tracer seed for the surgery based on the marker placement based onmammogram in one view.

  • Harley07
    Harley07 Member Posts: 164
    edited October 2020

    Thank you Melissa for your comments. I‘ll plan to see the surgeon this week and listen carefully to her recommendations

  • SuperJ13
    SuperJ13 Member Posts: 8
    edited October 2020

    Hi Harley07- did you get any clarity on the atypical vascular proliferation? I’m currently awaiting results of a 2nd opinion on biopsy where atypical vascular lesions were found. Weird thing is that these AVLs typically occur in radiated breast tissue, but I did not have radiation.

  • Harley07
    Harley07 Member Posts: 164
    edited October 2020

    SuperJ13 - I saw the breast surgeon earlier today. She is not concerned about the vascularity as she said it was from the first biopsy which was still healing.

    I will be having an excision biopsy on November 5 to remove the atypical ductal hyperplasia. The BS pointed out it was a minute focus of ADH so while there is generally a 20-30% chance of malignancy, she doesn’t think it’s a big deal in my case. I’m not stressing over it at this point, but am still frustrated. I pointed out to the BS a note on the radiologist’s final report (he read the diagnostic mammogram, but did not do either biopsy) after the second biopsy where he pointed out the marker from the 2nd biopsy is placed 2cm medial of the spiculated lesion on the diagnostic mammogram. The BS had missed that note and commented it was ‘odd’. It makes me think they missed the lesion in question on both the US biopsy and the stereotactic biopsy. The BS said as long as the radiologist inserts the RF tag correctly prior to the November 5 biopsy, she will excise the correct lesion. I will request that the radiologist who read the diagnostic mammogram be the one to insert the RF tag, but I don’t know that the breast imaging center can guarantee his availability.

    What type of biopsy did you have? Wish you the best with your results. Please keep us updated.

  • Harley07
    Harley07 Member Posts: 164
    edited November 2020

    The results of the excision biopsy showed 5mm IDC. I'll be meeting with the surgeon tomorrow to discuss complete findings, further surgery and radiation.

    The forums have been very helpful and I'll be moving over to the Newly Diagnosed forum once I have complete info.

  • MelissaDallas
    MelissaDallas Member Posts: 7,268
    edited November 2020

    Harley, I’m sorry yo fell in the crappy 20% on those excisional biopsyodds.

  • Harley07
    Harley07 Member Posts: 164
    edited November 2020

    Thanks Melissa

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