Worried - Another Inconclusive U/S 2nd yr in the Row

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Elctrcldy
Elctrcldy Member Posts: 14
edited November 2020 in Not Diagnosed But Worried

Back story - Last summer I went in for a routine mammo and U/S and that ended up being biopsied on my right breast and being diagnosed as complex sclerosing lesion with focal papillary features and microcalcifications present (according to my pathology report). At the time, the doctor ruled out carcinoma.

Being the optimistic person I am, I put this behind me but given it's 2020 well...

Went back last week for a routine checkup but something is noticeably different. For the past few months, I've noticed pain in both breasts which I brought up with my obgyn during my examination. At the time (Sept) I thought it was part of my cycle which is hard these days since I don't have a period anymore bc of an IUD. Now I'm not so sure as it seems it never went away. The mammo again came back clean but the U/S came back as inconclusive (same as last year). There is not one but now two hypoechoic lesions in each breast and they want to take a look at both breasts. At this point, I don't want to freak out but I am wondering, how common is it for this to happen to women every year? I am 40 yrs old. Is it also common that it ends of being biopsied as frequent as every year? Can this mean I may be a greater risk? I never got a BRCA test, should I? None of the professionals I have interacted with suggested that I do. My mother had breast cancer (I think Stage I) so not sure how concerned I should be. I am looking at experiences or if anyone has any insights to share. Thank you for your help.

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

    If you haven't had regular ultrasounds, push for that next. Then push for a MRI before a biopsy. Less invasive.

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  • Rah2464
    Rah2464 Member Posts: 1,647
    edited October 2020

    I am with MinusTwo. Push for a baseline MRI, given that your mother had breast cancer. That should also clarify if something needs to be biopsied. You haven't said, but has anyone described your breasts as dense? That can make imaging tricky with mammography alone, and sometimes with ultrasound.

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  • Elctrcldy
    Elctrcldy Member Posts: 14
    edited October 2020

    Hi thanks for replying. I will check with the docs on getting an MRI if it comes to that. With last year's biopsy, I was told because it is complex and that it was larger than 1cm, they were required to remove it. So I am wondering what are the odds of the same thing happening again this year and if anyone experienced the same diagnosis.

    I do have dense breasts which is why I get and ultrasound in addition to a mammo. I also have fibrocystic breasts. I also breastfed both my children more recently my 3.5yr old which ended about almost two years ago. I always assumed my lumpiness was probably due to my breasts being ravaged by breastfeeding but now the pain (both breast and right neck/shoulder like I'm experiencing engorgement heat) and the inconclusive ultrasound has me worried.

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

    Elctrcidy - My breasts used to hurt all the time. Typical with fibrocystic breasts. One thing that worked for me was to give up caffeine entirely. Once I was no longer drinking coffee everyday, most of the pain ended. It's a pretty non-invasive thing to try - although I do understand if you're hooked on caffeine it may not be that easy.

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  • Elctrcldy
    Elctrcldy Member Posts: 14
    edited October 2020

    MinusTwo, I have heard cutting coffee, chocolate and tea help but I'm having a hard time with this! I quit drinking alcohol back in July and while I was fine giving that up, I don't know if giving up coffee or chocolate will be as successful. It's been my lifeline during this pandemic. I think I will try to go from two cups per day to one and go from there. I just need to commit.

    I've also tried taking vitamin E and evening primrose oil and that has helped alleviate some of the pain. I did read that IUD's (which I'm on Mirena) can cause this too so maybe it's time to talk to my doc?

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  • Elctrcldy
    Elctrcldy Member Posts: 14
    edited November 2020

    Just an update, I had my follow-up and bilateral targeted U/S where they noted two hypoechoic lesions. The radiologist spoke with me and thinks that it's probably benign (BI-RADS 3) but also mentioned that I can take one of two paths: (1) another checkup in 6 months or (2) MRI. I do not have the details on the report yet but I do have any appointment with my specialist tomorrow. I am not sure which path to take at this point. He mentioned with the MRI that on one hand is can give you some solid answers but on the other hand can raise more questions. In anyone's experience, did that ever happen where there were more inconclusive findings from an MRI? I thought the MRI is pretty accurate in detecting cancer. Anyways, I am meeting with my specialist tomorrow to get her feedback.

    Also, I am not sure if I being crazy with all this. My mom was diagnosed with mestatic breast cancer at 46. I also found out several of my family members (paternal) have recently died from cancer (pancreas and brain) and my cousin (maternal) was diagnosed with cancer (not sure which one) and he is in his 30's so I seem to be in the gene pool.

    On top of this, I went for my physical expecting it to be pretty boring only to find out my EKG revealed a prolonged QT interval and now I need to see a cardiologist so I am experiencing a lot of anxiety around my health. Thanks for your input/ feedback.

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

    MRIs are notoriously sensitive but nonspecific, so they lead to lots of (benign) biopsies. Additionally, you may have issues getting your insurance to pay for an MRI based on Bi-Rads 3 (almost certainly benign) imaging.

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  • CBK
    CBK Member Posts: 611
    edited November 2020

    Yes, after I was diagnosed with malignancy on left side they sent me for MRI to check out some things they wanted a better look at on the right.

    And then they sent me for a second MRI... on my way to a third I received my genetic testing back which told me the girls were coming off anyway so no 3rd MRI.

    Melissa is right these MRIS are extremely sensitive and if you have dense breast tissue I think it may add to it.

    Btw after that right side was biopsied there was nothing of concern or malignancy on that side. It’s so stressful I know,please try to take it one day at a time. You should feel more centered hopefully when you meet with breast surgeon. Good luck!

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  • Elctrcldy
    Elctrcldy Member Posts: 14
    edited November 2020

    Thanks for your response and I never thought about insurance coverage so that is also helpful. Yes I think I will find more comfort speaking with my breast surgeon. I finally have the report - see below. What I gather is that oval is typically a good sign? It may just be from fibrocystic breasts so I will see what the specialist says. Thanks for your help!

    Ultrasound of the right breast 5 o'clock region and ultrasound of the
    left breast 4 o'clock region was performed on the area of interest.
    There is a flat oval 4.4 mm well marginated hypoechoic nodule at the
    right 5:00 axis, 2 cm from nipple.
    There is a flat oval 5.9 mm well marginated hypoechoic nodule at the left
    4:00 axis, 3 cm from nipple.

    IMPRESSION: PROBABLY BENIGN
    Two options:
    (1)Further evaluation with breast MRI,
    OR
    (2) A follow-up ultrasound in 6 months to demonstrate stability.

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