What options do I have now?

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ThisIsMyUserName
ThisIsMyUserName Member Posts: 4

Hello-

I had a BIRADS 5 lesion biopsied 12 days ago and am still awaiting pathology results. I am awaiting an MRI appointment. Should my dr be ordering any more tests?? Should I not have a meeting with a team of people set up for when we get the word that I have invasive (suspected as I have at least three swollen and one thickened auxiliary lymph node) breast cancer.

Scared to be waiting while the cancer spreads,

Me

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  • AliceBastable
    AliceBastable Member Posts: 3,461
    edited February 2021

    Try to take it one step at a time. Cancer doesn't spread fast except for IBC, and you'd have a completely different set of symptoms for that. I know you want answers, but breast cancer is very seldom a matter of great urgency. The MRI will verify (or not) the location and any lymph involvement. From there, and with the biopsy results showing what type of cancer you have, it will determine if you get surgery first or chemo or some other treatment. The "team of people" is a tumor board, at least in the states, and they don't meet with the patient, at least very seldom that I've seen, but with each other. You will see most of them individually, but again, that depends on the type and order of treatment they determine will work best.

    Try to do some fun things in the meantime! Snow stuff if you have it, or watch silly movies, or dance to lively music. It helps keep anxiety at bay, makes the time pass more quickly, and creates fun memories that will balance out any possible bad ones as you move forward.

  • Beesie
    Beesie Member Posts: 12,240
    edited February 2021

    Where are you in Canada? I'm in Toronto. I've had lots of biopsies. My results have never taken that long, and usually situations that are highly concerning are prioritized. But I'm in a big city so your situation might be different.

    The last time you posted, you had an initial radiologist report that provided a BI-RADS 3 for a couple of masses and a recommendation for diagnostic screening for a different area of concern. Obviously a lot has happened since then. Could you fill us in? It's impossible to know what to recommend to you without better understanding your situation and how you got to where you are now.

    For example, who said that they would order an MRI? Who are you waiting to hear from about the scheduling? Usually MRIs are done prior to a biopsy; a radiologist might order an MRI in the hopes of being able to avoid a biopsy or to provide more information before the biopsy. Or MRIs are done after a diagnosis; usually in that case the MRI is ordered by the surgeon, who wants to know more about what's going on inside the breasts prior to operating. Other tests, such as CT scans and bone scans, are done at the discretion of the medical oncologist depending on the specifics of the diagnosis, and may be ordered prior to surgery or after surgery. Your situation is different - you've had a biopsy but no results. So it's odd and I wonder if the MRI scheduling is on hold until the results are in. Other tests would not be scheduled until the results are in and until you see either the surgeon or MO.

    Did you have the biopsy done at the facility where you will be having treatments (if you are diagnosed) or at a separate screening/diagnostic facility? Have you followed up with your doctor or the facility about the results? Does your facility have a patient portal? "Should I not have a meeting with a team of people set up for when we get the word" - who is coordinating your testing and results at this point? Your family doctor? A doctor will need to refer you to a surgeon and oncologist and usually this isn't done until biopsy results are in. Have you talked to your doctor about next steps?

    To AliceBastable's point, most breast cancer is slow growing. So slow growing that it's believed that most cancers have been in the breast for years before they become large enough to be detected by imaging. The time waiting for results isn't much in the scheme of things. If a cancer is going to spread, it's already had a lot of time to do so. That's not to scare you, but to make the point that by the time we find out that we have cancer, if something bad is going to happen, the seeds of it happening have already been planted. The goal of systemic treatments (such as chemo and anti-hormone therapy) is to kill off those seeds.

    I hope you get the results soon and, if you do have cancer, I hope that the process for moving forward is laid out clearly for you. For now, all I can suggest is that you follow-up with whatever doctor ordered your initial screening.




  • ThisIsMyUserName
    ThisIsMyUserName Member Posts: 4
    edited February 2021

    Hello, and thank you for this message.

    I’m in Oakville and had my biopsy at a breast screening centre in Burlington.

    I had originally contacted my doctor as I noticed both my nipples would pull in and sink when I lifted my arms.

    A mammogram and ultrasound were ordered.

    When I went for my appointment, I was told that because am currently breastfeeding I would have an ultrasound only.

    The ultrasound showed three lesions in my L breast. Two were birads 3 and the other was echogenic, had irregular ill defined boarders and although not noted in the report, appeared taller than wide in the images on my cd copy I requested. The report stated that “ultimately a core needle biopsy may be required”

    I received a call to come back because they wanted more images of the suspicious lesion so they ordered a mammogram.

    The mammogram showed absolutely nothing because I have very dense breasts.

    The radiologist who read the mammogram assigned a birads three overall and recommend follow up in three months.

    I was really shocked, angry, scared, and definitely NOT ok with this. How could the mammogram diminish the findings on the ultrasound?!

    I called my dr and after a lengthy presentation of why I needed a biopsy, he finally begrudgingly agreed to order a biopsy.

    14 days ago I had a biopsy of my breast after the tech and radiologist looked at the lesion themselves. The radiologist was breathtakingly frank and told me exactly how she felt about this “highly suspect” lesion.

    Her report noted a taller than wide echogenic lesion with spiculated boarders and three swollen auxiliary lymph nodes, one that has thickened.

    She aborted the auxiliary lymph node biopsy after one pass because it was deep, kept pushing away, and was too close to a large vein.

    She requested an MRI (I assume) to better look at the other two lesions in my L breast and to check again the R breast as that nipple pulls in almost MORE than my L breast.


    So now I’ve been waiting for 12 days for an MRI appointment. I still haven’t heard anything.

    I spoke to my family doctor yesterday and he was very short with me that we cannot do anything until a pathology report is received.

    I cannot stand waiting and I feel like we’re moving at a snails pace.




  • Beesie
    Beesie Member Posts: 12,240
    edited February 2021

    Okay, that's very helpful.

    It sounds as though the MRI was ordered by the radiologist because she wants to see if additional biopsies are required. Will the MRI be done at this same facility in Burlington or have you been referred to a hospital? If you have not already done so, I would suggest calling whatever facility will be doing the MRI to find out where you are on the list and when you can expect to hear from them. You can also call the Burlington facility to ask whether anyone can tell you when the biopsy results will be available to your doctor (assuming they will send the results through to your family doc), although I'm not sure that anyone there would be able to help you. I'm guessing since this is just a testing facility and not a hospital that there is no patient portal.

    As for anything else, your family doctor is right. He needs a reason to refer you to a cancer centre and that reason will be the biopsy results. Cancer centres and surgeons don't book patients on speculation. At this point, you are still in the hands of the radiologist who has not finished the assessment. What you can do in the meantime is some research. IF you are diagnosed, do you know which hospital you want to be treated at? I would think you would have the option of any cancer treatment hospital in Halton Region. My suggestion would be to get onto the website of the hospitals to see who the breast surgeons are, and do some internet research on these breast surgeons. Figure out who you want to treat you, so that IF you are diagnosed, you can tell your family doctor that you want a referral to Dr. XYZ at hospital ABC. This puts the control and the choice of treatment centre and doctor in your hands.


  • Beesie
    Beesie Member Posts: 12,240
    edited February 2021

    ThisIsMyUserName,

    Have you received your biopsy results yet?

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