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Breast Cancer (Expert Forum)

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Am I overreacting?

Questions posted in the Breast Cancer Forum are answered by medical professionals from The Cleveland Clinic. Topics include Breast Biopsy, Chemotherapy, Hormone Therapy, Lumps, Lumpectomy, Lymph node dissection, Lymphedema, Mammograms, Mastectomy, Radiation Therapy, Reconstruction, Self Breast Exam, and Surgery.

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MedHelp Member's Question

Am I overreacting?

by clarion, Sep 07, 2003 12:00AM

Tags: breast, Cancer, breast cancer, benign, biopsy, nodes, ultrasound, Lymph Nodes

At my annual mammogram, a spot was identified as suspicious. It could not be visualized on ultrasound, but subsequent mammographic views confirmed that there was something there. It's extremely small, and in the past I've had a benign cyst (determined through biopsy). The doctor did not think the current spot was likely to be serious, and he was going to wait six months and then recheck; I became uncomfortable with that because this growth (whatever it might be) is very close to lymph nodes. Ultimately, the doctor was able to aspirate by locating the area in relation to the lymph node, so the cells will be tested.

Was I way overreacting to be worried about waiting 6 months? My concern was that if he happened to be wrong and there was a malignant growth, it could grow into the lymph nodes quickly. However, it is likely that I will have more cysts in the future, so I want to develop a reasonable attitude. At the same time, I don't want to take risks that would delay necessary treatment.

Thank you.

Doctor's Answer

by CCF-RN,MSN-rf, Sep 08, 2003 12:00AM

Dear Clarion: If a spot shows on mammogram and cannot be confirmed as a cyst with ultrasound, then it is not at all unreasonable to pursue it. If you are not comfortable with waiting, then you are correct to ask your doctor about alternatives. A lump's closeness to a lymph node would not necessarily mean that it could spread faster. The lymph system runs throughout the breast so if "a cell" can escape, it could get to the lymph system easily, regardless of lymph node locations.

Member Comments (5)

by surgeon, Sep 07, 2003 12:00AM

It's your body, and your health. If you are uncomfortable with waiting, then doing something else is the right choice. In fact, since the area was only found on mammogram, I'd be concerned that unless the aspiration was done under direct xray guidance there's no way to be certain that what was sampled was in fact the area seen. The way to sample an area only detectable on xray is with a "stereotactic biopsy." The fact that the shadow was close to lymph nodes, per se, doesn't have any impact; if it's benign, it's benign. If it were cancer, it can spread to lymph nodes by getting into the lymphatic channels, no matter in what part of the breast it is. The issue is the comfort level you and your doctors have, based on the appearance of the shadow, and your history. Followup is fine as long as all the players are equally on board. You are the main player!

by clarion, Sep 07, 2003 12:00AM

To: Surgeon

Thank you for your response. I guess I was feeling guilty for wanting to pursue this immediately. I've had an awful lot of death in the past few years, including mother and sister, and I'm trying to be very proactive with my health. Being assertive is still difficult for me, so I appreciate getting your feedback. My doctor was ready to listen to me and respond, for which I'm grateful.

by Elfey, Sep 08, 2003 12:00AM

Don't ever be afraid to be aggressive with your healthcare. I just had a similiar experience where my OB ordered an ultrasound which showed nothing and was willing to go with that test result. I wasn't willing to accept that, so I called the plastic surgeon that did my breast reduction and he got me in to see a breast specialist within one week. It does appear to be nothing, but I would rather be safe and not wait 6 months. When some breast cancer websites are calling it "an epidemic", you can't be too careful. Good luck to you!

by nurse12hr, Sep 10, 2003 12:00AM

I was encouraged to wait and follow up with a suspicious area on mammo.  I was not comfortable, even after a second opinion agreed that I was not at much risk of it being cancer.

I insisted on a biopsy. It was cancer.  I am so very glad I followed my inner instincts on it.  That was almost 10 years ago.

Not saying that is the right thing for you to do.  But you always have to do what is in your heart; that way you will feel at peace with whatever happens.

good luck!

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