Question about Discordant Results
When I met with the breast surgeon prior to my biopsy, he mentioned that if there was discordance between imaging and biopsy results, he would want to perform surgery to remove the suspicious area of micro calcifications. I was a little surprised as I just assumed that a benign biopsy result would be the end of this scare. Or at worst, maybe that would require just another test. Is this typical? Has anyone else had benign biopsy results and still needed surgery to remove the area? (As an aside, no palpable lump has been felt
Comments
-
Sunnygurl, do you have, or can you access on a portal, your radiology reports? It would be really helpful to know specifically and exactly what they say. Additionally, it is a good practice to obtain and keep copies of all imaging and reports for future reference and if you should ever need them for comparison purposes at another facility in the future.
That said, it sounds like the surgeon strongly suspects there is a non-benign process going on, and that if the (always) limited number of cores don’t reflect that he wants it investigated further. Are their benign things that tend to look “ominous” on imaging? Yes, a few. It absolutely does happen that benign biopsy results do not agree with what the imaging appears to show, in which case an excisional biopsy is performed to resolve the discordant findings. Excisional biopsies are also done when needle biopsies reflect atypical findings like atypical ductal or lobular hyperplasia or lobular carcinoma in situ (high risk condition) because about 20% of the time on wider inspection DCIS or invasive cancer are found around or within the sampled area. Does this absolutely mean you have breast cancer? No, too early to say that. If it is any consolation, I found my surgical biopsy to be easier than my stereotactic one
-
I got the same "pep" talk, but from the radiologist, after a recent stereotactic core biopsy of 2 sites (no palpable lumps, BIRADS 4a, microcalcifications). She prepared me for discordant results, because they could not clearly see microcalcifications in the cores they were getting from one of the sites. She predicted I would need a repeat core biopsy at a different facility, with a better table, that afforded a better approach to a difficult site.
However, this became a moot point because cores from that site showed atypical ductal hyperplasia (one of the lesions MelissaDallas mentions), which apparently always merits an excisional biopsy (happens next week).
They could see microcalcifications in the cores from the other site and the pathology came back as fibrocystic change, among other stuff. They are content with the benign result there and it needs no further follow up. Hopefully this is what happens for you!
-
Hi, so your breast surgeon performed the biopsy? Not sure if breast surgeons who perform their own biopsy can comment on radiology-pathology concordance.
Radiologists usually comment on concordance. When biopsy path results comes back radiololgists re-review the case to determine "concordance" (does it all jive? i.e. imaging findings match what the pathologist saw under the microscope) and radiologists then make a path addendum with recommendations.
Anytime there are discordant findings (usually the scenario is imaging looks suspicious & pathology came back benign) sugical excision is the next step. A surgical excision gives the pathologists a bigger chunk of tissue to look at under the microscope and do special stains on.
-
The radiologist performed the biopsy but I met with the surgeon that same morning of the procedure.
Ok, so I understand that I should ask for all of my medical reports (I have an appt with the breast surgeon in 2 days so I will ask then). I also feel more comfortable now that any discordant results which would lead the doctor to perform a surgical excision biopsy is simply just a more thorough investigation of my breast. And that is a good thing and reassuring to me. Thanks for your input!
I am baking Xmas cookies to keep me distracted...I will have to make cookie deliveries (since covid has prevented us all from having Xmas get togethers!)
-
I just wanted to update (since I really appreciated hearing about other members' updates while waiting for my tests and results). My biopsy results came back benign (very big sigh of relief) and after consulting with the pathologist and radiologist, instead of removing the area in question, the surgeon said he is comfortable putting me on a 6-month monitoring plan!
Thank you to everyone who offered info and support! And best wishes to everyone with their journeys through screening and treatment, especially during this trying time of covid. Stay safe everyone!
-
Great news, Sunnygurl!
-
That's good news that your medical team is in all agreement on a 6 month follow-up, Sunnygurl. Thanks for letting us know!
We'll see you in 6 months, hopefully with the news that everything is stable and looks good.
Enjoy the holidays!
-
Soooo happy for you Sunnygurl!!!
Categories
- All Categories
- 679 Advocacy and Fund-Raising
- 289 Advocacy
- 68 I've Donated to Breastcancer.org in honor of....
- Test
- 322 Walks, Runs and Fundraising Events for Breastcancer.org
- 5.6K Community Connections
- 282 Middle Age 40-60(ish) Years Old With Breast Cancer
- 53 Australians and New Zealanders Affected by Breast Cancer
- 208 Black Women or Men With Breast Cancer
- 684 Canadians Affected by Breast Cancer
- 1.5K Caring for Someone with Breast cancer
- 455 Caring for Someone with Stage IV or Mets
- 260 High Risk of Recurrence or Second Breast Cancer
- 22 International, Non-English Speakers With Breast Cancer
- 16 Latinas/Hispanics With Breast Cancer
- 189 LGBTQA+ With Breast Cancer
- 152 May Their Memory Live On
- 85 Member Matchup & Virtual Support Meetups
- 375 Members by Location
- 291 Older Than 60 Years Old With Breast Cancer
- 177 Singles With Breast Cancer
- 869 Young With Breast Cancer
- 50.4K Connecting With Others Who Have a Similar Diagnosis
- 204 Breast Cancer with Another Diagnosis or Comorbidity
- 4K DCIS (Ductal Carcinoma In Situ)
- 79 DCIS plus HER2-positive Microinvasion
- 529 Genetic Testing
- 2.2K HER2+ (Positive) Breast Cancer
- 1.5K IBC (Inflammatory Breast Cancer)
- 3.4K IDC (Invasive Ductal Carcinoma)
- 1.5K ILC (Invasive Lobular Carcinoma)
- 999 Just Diagnosed With a Recurrence or Metastasis
- 652 LCIS (Lobular Carcinoma In Situ)
- 193 Less Common Types of Breast Cancer
- 252 Male Breast Cancer
- 86 Mixed Type Breast Cancer
- 3.1K Not Diagnosed With a Recurrence or Metastases but Concerned
- 189 Palliative Therapy/Hospice Care
- 488 Second or Third Breast Cancer
- 1.2K Stage I Breast Cancer
- 313 Stage II Breast Cancer
- 3.8K Stage III Breast Cancer
- 2.5K Triple-Negative Breast Cancer
- 13.1K Day-to-Day Matters
- 132 All things COVID-19 or coronavirus
- 87 BCO Free-Cycle: Give or Trade Items Related to Breast Cancer
- 5.9K Clinical Trials, Research News, Podcasts, and Study Results
- 86 Coping with Holidays, Special Days and Anniversaries
- 828 Employment, Insurance, and Other Financial Issues
- 101 Family and Family Planning Matters
- Family Issues for Those Who Have Breast Cancer
- 26 Furry friends
- 1.8K Humor and Games
- 1.6K Mental Health: Because Cancer Doesn't Just Affect Your Breasts
- 706 Recipe Swap for Healthy Living
- 704 Recommend Your Resources
- 171 Sex & Relationship Matters
- 9 The Political Corner
- 874 Working on Your Fitness
- 4.5K Moving On & Finding Inspiration After Breast Cancer
- 394 Bonded by Breast Cancer
- 3.1K Life After Breast Cancer
- 806 Prayers and Spiritual Support
- 285 Who or What Inspires You?
- 28.7K Not Diagnosed But Concerned
- 1K Benign Breast Conditions
- 2.3K High Risk for Breast Cancer
- 18K Not Diagnosed But Worried
- 7.4K Waiting for Test Results
- 603 Site News and Announcements
- 560 Comments, Suggestions, Feature Requests
- 39 Mod Announcements, Breastcancer.org News, Blog Entries, Podcasts
- 4 Survey, Interview and Participant Requests: Need your Help!
- 61.9K Tests, Treatments & Side Effects
- 586 Alternative Medicine
- 255 Bone Health and Bone Loss
- 11.4K Breast Reconstruction
- 7.9K Chemotherapy - Before, During, and After
- 2.7K Complementary and Holistic Medicine and Treatment
- 775 Diagnosed and Waiting for Test Results
- 7.8K Hormonal Therapy - Before, During, and After
- 50 Immunotherapy - Before, During, and After
- 7.4K Just Diagnosed
- 1.4K Living Without Reconstruction After a Mastectomy
- 5.2K Lymphedema
- 3.6K Managing Side Effects of Breast Cancer and Its Treatment
- 591 Pain
- 3.9K Radiation Therapy - Before, During, and After
- 8.4K Surgery - Before, During, and After
- 109 Welcome to Breastcancer.org
- 98 Acknowledging and honoring our Community
- 11 Info & Resources for New Patients & Members From the Team