Anxiously awaiting mammogram
Hi there. I’m 30F, who has a new lump on the inner lower part of her right breast. I found it while experiencing issues with breastfeeding my 8mo old, where I had a clearly clogged duct on the outer right side of the same breast. I noticed the new lump while trying to massage out the clog and applying heat. Now that the clog is gone, the hard smaller lump remains, strange in shape & very hard. It is more internal than near the surface, and is more palpable when my breast is less full. My OB has now ordered bi lateral mammogram & a follow on ultrasound same day ( Wednesday). I assume the “straight to mammogram” route is due to Covid, as it would not be wise to bring me in for just a manual exam when imaging seems to be indicated. It is still stressing me out, as it is ever present and I can’t help but “check” to make sure it’s still there. I have this additionally anxiety that it will disappear before my mammo on Wednesday and I’ll look like someone making up symptoms (I recognize this is ridiculous). I’m having dreams that I show up and they can’t image me because I didn’t do a good job emptying my breast’s with the pump prior. I have a very supportive husband thank goodness, but I just want this to be over.
I guess I do have a question - is there ever a situation where a biopsy is not indicated after a mammo of a palpable lump? Everything I read (I know - stay away from google) makes me question why you wouldn’t get a biopsy if there is a palpable lump that does not feel like a cyst. Thanks for reading.
Comments
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"is there ever a situation where a biopsy is not indicated after a mammo of a palpable lump?"
The answer is that there are often situations where a biopsy is not indicated after a mammo and ultrasound of a palpable lump.
It's the combination of the two screening modalities that can help determine whether something has a benign appearance (a BIRADs 2 assessment) or is highly likely to be benign (a BIRADs 3 assessment, indicating less than 2% risk of being cancer). Mammograms and ultrasounds 'see' into the breast differently and each will show the lump differently. Based on what both show, the Radiologist will make an assessment. An example of a lump that would be a BIRADs 2 is a simple cyst. Example of lumps that would be a BIRADs 3 are complicated cysts and fibroadenomas. All 3 of those types of lumps are much more common than cancer, particularly in someone your age. A BIRADs 2 requires no follow-up. A BIRADs 3 comes with a 6-month follow-up for re-imaging, to confirm stability and benign appearance.
As for your lump not feeling like a cyst, as someone who over the years has had more cysts than I can remember, I can say that they didn't all feel the same and some I would say didn't feel like a cyst. So don't draw conclusions based on how the lump feels to you.
Good luck on Wednesday.
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thank you so much for your reply and reassuring words about cysts. I am hopeful that the combo of 3D mammo & U/S gives a good picture. I have so much anxiety about the breastfeeding causing issues with imaging, but hopeful that the breast specialists at this med center are experienced with that!
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Welcome, Chiphin! We certainly understand your worry and are here to support you. Please keep us posted on what you learn after your mammo!
The Mods
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Welcome Chiphin! There is much support and information here, esp. should you need us after getting results though I hope that is not the case for you! Please let us know how things turn out after imaging, ok?
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thank you Mods & LivinLife. I'll make sure to update after Wednesday.
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I actually have another question if that is alright. Should I mentally be prepared for a biopsy on Wednesday if the BIRADs assessment indicates a need for tissue biopsy? Or would this normally be a separate appointment (honestly covid/pre covid may change things)? Just trying to gauge expectations for childcare should the need arise.
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Chipin, maybe, but not likely. Almost certainly a stereotactic (mammogram guided) biopsy would be a separate appointment. I did have a quick ultrasound guided biopsy at one diagnostic imaging appointment
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thank you all for your guidance & kindness. The radiologist reviewed everything on the spot & it appears to be normal breastfeeding tissue! It was noted that my breast tissue is super dense, regardless of breastfeeding. Because of this, coupled with my family history, I was directed to contact the geneticist within the breast division, as my mother is a ATM and PALB2 carrier. The radiologist said this could give them a better indication of how often I should be screened going forward. Thank you again!!!
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Great news on the imaging! And definitely a good idea to talk to a genetic counsellor. Good luck with that and let us know how it goes!
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Wonderful Chiphin!!! Thanks for letting us know!
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