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A Plethora of Endless Biopsies...
I am meeting a lot of women it seems who are in what I call the biopsy hamster wheel. Every mammogram means they have to get a biospy. On some level, this seems ridiculous. All of them are benign. These women are very tired of this and some of them now suffer permanent pain or disfigurement from all the biopsies.
They found a 5 mm microcalcification in my right breast and everything else is fine though I have cystic breasts.
The thing is, I didn't USED to. I have only developed this since I turned 50. My breasts are different now which makes sense. I am going into menopause! This does not seem to matter to any of the doctors I have seen. If my breasts are newly cystic due to hormonal changes, will an endless series of painful biopsies be the answer?
Why isn't there some kind of regime of non-surgical treatments available to see if these micrcocals go away over time with hormonal treatments, taxmoifen/taxol, herbal treatments with followup exams esp with woman at low risk?
I am concerned because weird things happen to our breasts when we get menopausal and there seems to be
a very reactive jump into procedures that later cause permanent problems of their own. I met a woman who has had 5 biopsies, all benign. I'm sorry but something is wrong here and she now suffers with permanent pain from all these procedures.
I have to question this. I'm sorry. And I am choosing to look into alternative treatments initially with monitoring.
They found a 5 mm microcalcification in my right breast and everything else is fine though I have cystic breasts.
The thing is, I didn't USED to. I have only developed this since I turned 50. My breasts are different now which makes sense. I am going into menopause! This does not seem to matter to any of the doctors I have seen. If my breasts are newly cystic due to hormonal changes, will an endless series of painful biopsies be the answer?
Why isn't there some kind of regime of non-surgical treatments available to see if these micrcocals go away over time with hormonal treatments, taxmoifen/taxol, herbal treatments with followup exams esp with woman at low risk?
I am concerned because weird things happen to our breasts when we get menopausal and there seems to be
a very reactive jump into procedures that later cause permanent problems of their own. I met a woman who has had 5 biopsies, all benign. I'm sorry but something is wrong here and she now suffers with permanent pain from all these procedures.
I have to question this. I'm sorry. And I am choosing to look into alternative treatments initially with monitoring.
FYI, I am getting a thermography, having my hormone levels checked via blood samples, and then entering a series of hormonal, bioidentical, etc treatments, changes in diet, supplements, etc. with a followup thermography in three months. This is through a naturopathic clinic of some reknown. Many women have been "cured" of their leisons/microcals of the type I have by this clinic and their approach. I am doing this because there is an issue only with one small area in one breast, no mass of any kind (MRI was negative) and my diagnosis from other doctors I have highly fibrocystic breasts. (I never used to! Must be from turning 50 are being peri-menopausal). This is my decision on treatment for now. May not be the right one for everyone but no biopsy for now. We will see how the non-invasive
approach goes.
Thanks to all.
approach goes.
Thanks to all.
Thanks to all for your input. My radiologist and ultrasound dudes told me that ten years ago, they might not have found my microcalc and the diagnostic imagery has advanced tremendously. So there is a lot going on--the technology is far better meaning more diagnoses which is probably why I am meeting SO many women who are getting biopsies.
You also bring up an excellent point Teddy in that recently, my doctor sent me a letter certified that she was not responsible if I chose not to get a biopsy immediately. It was kind of strange but she was doing it to cover herself LEGALLY thus the push to get us to surgery right away. Malpractice concerns which is our very litigous society makes sense.
But I also know she cares very much that I do the right thing and believes I need a baseline biopsy (this is what they call them by the way now--baseline biopsies). So it seems to me it is a combination of new diagnostic technology which is great, legal concerns, and
taking the most preventative action FIRST which is most of the times the most invasive. I can say if I do get the biopsy and it is benign, I will probably not get another one for a long time. I am not going to get 5 in a year or get one every single time I get a mammogram. This is a risk but so is the constant pain of procedures. I wish medicine could help us more with this. I really do. I think there are too many women scared and freaked out some of which may be making the wrong decisions and getting surgeries and mastectomies needlessly.
I was told in situ carcinomas do not leave the breast and take a very long time to develop if they even do develop into cancer and women have been walking around with this for a very long time and have lived to be 100 years old. It is only in the past decade or so it was able to be diagnosed. Each woman's is different. Each has to make her own decision based on mindfulness and thoughtfulness and family history, etc but I beg the medical establishment to help us work through this and no I do not want to cut my breasts off. I am tired of doctors, even one of which callously said to me, "we can just lop them both off if you want." I was horrified. Lop them both off? My God.
This has to stop. Yes, I know doctors need to cover their legal
posteriors but again, stop scaring women. This is as new to the medical establishment as it is to us. Help us to make thoughtful decisions not rash ones. Show us the research. Take the time to talk to us and do our own research. Don't go immediately to "lopping them off." I walked out of this doctor's office by the way and will not go back.
This is what I am choosing to do. It may not be right for other women.
Thanks to all who are responding to this post. I think it is a discussion women need to have.
You also bring up an excellent point Teddy in that recently, my doctor sent me a letter certified that she was not responsible if I chose not to get a biopsy immediately. It was kind of strange but she was doing it to cover herself LEGALLY thus the push to get us to surgery right away. Malpractice concerns which is our very litigous society makes sense.
But I also know she cares very much that I do the right thing and believes I need a baseline biopsy (this is what they call them by the way now--baseline biopsies). So it seems to me it is a combination of new diagnostic technology which is great, legal concerns, and
taking the most preventative action FIRST which is most of the times the most invasive. I can say if I do get the biopsy and it is benign, I will probably not get another one for a long time. I am not going to get 5 in a year or get one every single time I get a mammogram. This is a risk but so is the constant pain of procedures. I wish medicine could help us more with this. I really do. I think there are too many women scared and freaked out some of which may be making the wrong decisions and getting surgeries and mastectomies needlessly.
I was told in situ carcinomas do not leave the breast and take a very long time to develop if they even do develop into cancer and women have been walking around with this for a very long time and have lived to be 100 years old. It is only in the past decade or so it was able to be diagnosed. Each woman's is different. Each has to make her own decision based on mindfulness and thoughtfulness and family history, etc but I beg the medical establishment to help us work through this and no I do not want to cut my breasts off. I am tired of doctors, even one of which callously said to me, "we can just lop them both off if you want." I was horrified. Lop them both off? My God.
This has to stop. Yes, I know doctors need to cover their legal
posteriors but again, stop scaring women. This is as new to the medical establishment as it is to us. Help us to make thoughtful decisions not rash ones. Show us the research. Take the time to talk to us and do our own research. Don't go immediately to "lopping them off." I walked out of this doctor's office by the way and will not go back.
This is what I am choosing to do. It may not be right for other women.
Thanks to all who are responding to this post. I think it is a discussion women need to have.
I understand the frustration. I had a baseline mammogram May 7 with a call back the next week. I have "2 adjacent groups of microcalcifications and although they are relatively coarse, they're variable in size and shape. Many are rounded." I want to wait 6 mths to see if there are any changes. Maybe these calcifications have been there for 5 yrs. But the radiologist recommends biopsy. I have had to see several drs recently (PCP, hemotologist, ect). They all say, "I wouldn't wait 6 mths but it'll be nothing." Really? If I was wrong 80% of the time, who would trust me? I understand the whole thing about we don't know till we biopsy. (Btw, my mother has had 3 biopsies all benign. She spent weeks each time full of anxiety.) If it's likely nothing, what's the rush? Let's watch it carefully.
The comment above about how each women should decide with her healthcare team is not realistic. I've been told that whatever the radiologist says is what everyone goes with. There is no discussion about what is right for you and your situation.
I don't think most women are hysterical about this. I think radiologist are trying to do there job, but trying to not get sued. So women are put through what turns out is 80% of the time, unnecessary tests. I hope over time we can see improvement in this. If we were doing biopsies on men's parts that were 'nothing' 80% of the time there would be changes. I asked my husband if he were given those statistics would he wait and see? He didn't answer, of course. l know his answer.
I am frustrated that I am looked at like I'm doing something wrong by wanting to wait and see. Family, friends, drs all think I'm crazy for wanting to wait a couple of months. I think it's crazy to have a biopsy at this point with nothing but one mammogram to look at.
We all have different feelings about this. I understand some feel a burning desire to know for sure. I don't feel that way. I'm comfortable watching it, with the statistics on my side.
The comment above about how each women should decide with her healthcare team is not realistic. I've been told that whatever the radiologist says is what everyone goes with. There is no discussion about what is right for you and your situation.
I don't think most women are hysterical about this. I think radiologist are trying to do there job, but trying to not get sued. So women are put through what turns out is 80% of the time, unnecessary tests. I hope over time we can see improvement in this. If we were doing biopsies on men's parts that were 'nothing' 80% of the time there would be changes. I asked my husband if he were given those statistics would he wait and see? He didn't answer, of course. l know his answer.
I am frustrated that I am looked at like I'm doing something wrong by wanting to wait and see. Family, friends, drs all think I'm crazy for wanting to wait a couple of months. I think it's crazy to have a biopsy at this point with nothing but one mammogram to look at.
We all have different feelings about this. I understand some feel a burning desire to know for sure. I don't feel that way. I'm comfortable watching it, with the statistics on my side.
I would like to thank BB also for this excellent information. :)
Like you nc, I don't think we are" hysterical" when we follow our Doctor's recommendation to have a biopsy....
Very good comment.. ncmichigan!! :)
Like you nc, I don't think we are" hysterical" when we follow our Doctor's recommendation to have a biopsy....
Very good comment.. ncmichigan!! :)
My thanks to bb2222, also, for that information. Your final statement is 100% spot-on, too.
"Sensible" is open to interpretation. I have never been "hysterical" about my breast conditions either---concerned, yes, hysterical, no. My biopsies were all done for a BIRAD 4. If I had had only the "baseline" biopsy, I wouldn't know that I have LCIS and
at higher risk. I'm glad to know that. The more I learn, the better I feel, but ometimes
"a little knowledge is a dangerous thing." In the end, we make our own choices and I sincerely wish you all the best with yours.
nc
"Sensible" is open to interpretation. I have never been "hysterical" about my breast conditions either---concerned, yes, hysterical, no. My biopsies were all done for a BIRAD 4. If I had had only the "baseline" biopsy, I wouldn't know that I have LCIS and
at higher risk. I'm glad to know that. The more I learn, the better I feel, but ometimes
"a little knowledge is a dangerous thing." In the end, we make our own choices and I sincerely wish you all the best with yours.
nc
Thank you, bb2223, for this information. it is very interesting.
I myself would not know what to do as an 'outsider' and the lesion not being in MY breast.
If it was, I would listen to the recommendatiions as well as what my own body is telling me, and then I would know what to do. Kat
I myself would not know what to do as an 'outsider' and the lesion not being in MY breast.
If it was, I would listen to the recommendatiions as well as what my own body is telling me, and then I would know what to do. Kat
Your decision may be appropriate in your case, but on the other hand, a study just reported last month at the annual meeting of the American College of Radiology/American Roentgen Ray Society, held in San Diego, raises the concern that the recommendation for "short-term follow-up may not be adequate for high-risk women:
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"A short-term follow-up MRI, ultrasound and/or mammographic investigation is usually recommended for indeterminate lesions found in high-risk women. However, that may not be soon enough," study lead author Dr. Martin Korzeniowski, of McMaster University in Hamilton, Canada, said in the release.
He and his colleagues looked at 59 breast lesions in 55 women that were identified on MRI as indeterminate. Of those lesions, 22 percent turned out to be malignant on follow-up and subsequent biopsy.
"In our study, the cancer yield was substantial for indeterminate lesions identified on initial contrast-enhanced breast MRI, which suggests that those lesions should be evaluated more aggressively to exclude malignancy and increase one's chances for survival," Korzeniowski said.
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Each individual, in conjunction with her health care team, should consider carefully the best course of action based on the specifics of her particular situation.
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"A short-term follow-up MRI, ultrasound and/or mammographic investigation is usually recommended for indeterminate lesions found in high-risk women. However, that may not be soon enough," study lead author Dr. Martin Korzeniowski, of McMaster University in Hamilton, Canada, said in the release.
He and his colleagues looked at 59 breast lesions in 55 women that were identified on MRI as indeterminate. Of those lesions, 22 percent turned out to be malignant on follow-up and subsequent biopsy.
"In our study, the cancer yield was substantial for indeterminate lesions identified on initial contrast-enhanced breast MRI, which suggests that those lesions should be evaluated more aggressively to exclude malignancy and increase one's chances for survival," Korzeniowski said.
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Each individual, in conjunction with her health care team, should consider carefully the best course of action based on the specifics of her particular situation.
Dr. Christiane Northrup is speaking around the U.S. that women and men are undergoing needless surgeries for "pre-cancer" conditions...including in situ breast diseases in women that you die "with" not "from". I strongly encourage all women to watch this excellent program or read her book.
I have talked to 3 doctors that agree that microcals can go away on their own with changes in diet and treatment with certain kinds of supplements esp if these "cancers" pop up around menopause which ti me is telling. This is documented in the scientific literature.
While a baseline biopsy makes sense, if it is negative, having to get one after every single mammogram for something abnormal is excessive in my opinion.
I am in favor of giving the body the chance to heal itself and monitoring
in cases of BiRad-3's or single locations.
The bottom line is the medical establishment needs to stop scaring women because this is what many women are operating from--fear.
I for one, am going to be sensible about it. Not hysterical.
I have talked to 3 doctors that agree that microcals can go away on their own with changes in diet and treatment with certain kinds of supplements esp if these "cancers" pop up around menopause which ti me is telling. This is documented in the scientific literature.
While a baseline biopsy makes sense, if it is negative, having to get one after every single mammogram for something abnormal is excessive in my opinion.
I am in favor of giving the body the chance to heal itself and monitoring
in cases of BiRad-3's or single locations.
The bottom line is the medical establishment needs to stop scaring women because this is what many women are operating from--fear.
I for one, am going to be sensible about it. Not hysterical.
In addition to the above, tamoxifin is for er+cancer, if that is not what you have then it won't do any good. There are other studies that are under way to take meds to prevent cancer, ask your doctor if any are in your area.
I hope I don't sound harsh, because this isn't meant to be. I just felt I really had to respond
I'm sorry that many of your friends are going through biopsies, but that doesn't mean they're done needlessly. The fact that they're all benign is good news, not bad! The majority of biopsies come back benign, thank goodness, but what about the ones that don't? Would you prefer that they not be done until it's too late for treatment of the cancer that might be found in the minority of cases? I had personal experience with my
sister who was diagnosed too late at 48 and passed away before she was 51. I've had fibrocystic changes since my late 20's and I'm now 62. I've also had three biopsies offive different suspicious areas and don't regret a single one. I am not in permanent pain and I am not disfigured---just three tiny scars that only my husband ever sees. Believe me, he's grateful that he has me with the scars instead of buried with perfect breasts! (Actually, I had a scar from breastbone to below my belly button from a renal artery graft before we were even engaged, and he doesn't mind a bit.)
My last biopsy found LCIS and I am closely monitored for being high risk. I may face more biopsies and I hope and pray they are all benign. But if one isn't, I'll know that the cancer will be caught at the most highly treatable time. For me, "not knowing" is way worse than knowing and I don't believe a biopsy is ever recommended frivolously for me.
I'm sorry but I don't feel I'm a "hamster on a biopsy wheel". I feel I'm being treated by caring, compassionate professionals who have my best interests at heart. I'm given all
the information needed to make an informed decision.
You certainly have the right to make whatever choice you feel is best for you, too. I just hope that if biopsy is recommended, you'll have enough trust in your doctor to follow through. If you don't, I hope you'll at least get a second opinion and maybe even a third. If you decide to go ahead with the biopsy, I hope you're in that majority with benign results! Wishing you all the best.
nc
I'm sorry that many of your friends are going through biopsies, but that doesn't mean they're done needlessly. The fact that they're all benign is good news, not bad! The majority of biopsies come back benign, thank goodness, but what about the ones that don't? Would you prefer that they not be done until it's too late for treatment of the cancer that might be found in the minority of cases? I had personal experience with my
sister who was diagnosed too late at 48 and passed away before she was 51. I've had fibrocystic changes since my late 20's and I'm now 62. I've also had three biopsies offive different suspicious areas and don't regret a single one. I am not in permanent pain and I am not disfigured---just three tiny scars that only my husband ever sees. Believe me, he's grateful that he has me with the scars instead of buried with perfect breasts! (Actually, I had a scar from breastbone to below my belly button from a renal artery graft before we were even engaged, and he doesn't mind a bit.)
My last biopsy found LCIS and I am closely monitored for being high risk. I may face more biopsies and I hope and pray they are all benign. But if one isn't, I'll know that the cancer will be caught at the most highly treatable time. For me, "not knowing" is way worse than knowing and I don't believe a biopsy is ever recommended frivolously for me.
I'm sorry but I don't feel I'm a "hamster on a biopsy wheel". I feel I'm being treated by caring, compassionate professionals who have my best interests at heart. I'm given all
the information needed to make an informed decision.
You certainly have the right to make whatever choice you feel is best for you, too. I just hope that if biopsy is recommended, you'll have enough trust in your doctor to follow through. If you don't, I hope you'll at least get a second opinion and maybe even a third. If you decide to go ahead with the biopsy, I hope you're in that majority with benign results! Wishing you all the best.
nc
You mention the menopause connection. Most women get cancer at age 50 or older. Those breast changes need to be monitored and on occasion need to biopsied. I had regular follow ups and ended up with a cancer that doesn't show itself on mammograms and it was 10 centimeters when it was found. How many years had it been there and never biopsied in order for it to get that big? hmmmm...
There are risks to every situation, even driving down the road. I won't pooh pooh your decision to look into alternative treatments, I only suggest you don't close the door on traditional treatments. And I will share something with you that I learned after a year of cancer treatments and way too much time in the chemo room getting infusions. Each time I left I had the overwhelming feeling that cancer was the "gift" that kept on giving because I spent so much time with women who were there for their 2nd or 3rd or 4th rodeo with chemo. And I was scared because my cancer was not caught early. When I verbalized it to a friend at work she looked at me and smiled and said... For as many women as you see going through this more than once, you aren't seeing all of the rest of the women who aren't because they wouldn't have a reason to be in the chemo room. That put things into perspective for me. I have a higher risk and higher odds of recurrence or of a new cancer. But it's not written in stone either. So, your acquaintences have a biopsy history that seems high to you but how many women in your life and circle have never had an issue with this?
Never say never. Best wishes.
There are risks to every situation, even driving down the road. I won't pooh pooh your decision to look into alternative treatments, I only suggest you don't close the door on traditional treatments. And I will share something with you that I learned after a year of cancer treatments and way too much time in the chemo room getting infusions. Each time I left I had the overwhelming feeling that cancer was the "gift" that kept on giving because I spent so much time with women who were there for their 2nd or 3rd or 4th rodeo with chemo. And I was scared because my cancer was not caught early. When I verbalized it to a friend at work she looked at me and smiled and said... For as many women as you see going through this more than once, you aren't seeing all of the rest of the women who aren't because they wouldn't have a reason to be in the chemo room. That put things into perspective for me. I have a higher risk and higher odds of recurrence or of a new cancer. But it's not written in stone either. So, your acquaintences have a biopsy history that seems high to you but how many women in your life and circle have never had an issue with this?
Never say never. Best wishes.
Hi there,
I fully agree with BB...If I had a choice between worrying "what the abnormality could be" I would choose a biopsy any time over the worrying and the risk I would be taking with my life.
Breast cancer is a demon that no one knows if or when it will strike...particularly when we are aging.
Biopsies are recommended only when something appears suspicious on films,many women with a BIRADS category 3 (Probably benign finding) are not required to have a biopsy,but just close monitoring the lump or calcification.
Many women though would choose to have a biopsy for their own peace of mind.
I truly hope that you will seriously reconsider if a biopsy has been recommended by your Doctor, concerning your calcification.Like BB said " Better safe than sorry"
Wishing you all the best..and take care.
I fully agree with BB...If I had a choice between worrying "what the abnormality could be" I would choose a biopsy any time over the worrying and the risk I would be taking with my life.
Breast cancer is a demon that no one knows if or when it will strike...particularly when we are aging.
Biopsies are recommended only when something appears suspicious on films,many women with a BIRADS category 3 (Probably benign finding) are not required to have a biopsy,but just close monitoring the lump or calcification.
Many women though would choose to have a biopsy for their own peace of mind.
I truly hope that you will seriously reconsider if a biopsy has been recommended by your Doctor, concerning your calcification.Like BB said " Better safe than sorry"
Wishing you all the best..and take care.
I understand your concern and frustration, but a biopsy is not recommended for everyone with microcalcs, just those with certain patterns of microcalcs (such as clusters) that are more likely to be a response to some abnormailty. In such cases, there is no way to know for certain whether the microcalcs might be signaling an underlying malignancy without a biopsy.
Less invasive forms of biopsy are less likely to result in the "permanent pain and disfigurement" you are concerned about.
The Taxol you mentioned is a chemotherapy, which is only used to treat cancer.
You certainly have a right to reject a biopsy if one has been recommended, but with over 40,000 breast cancer deaths last year in the USA alone, most people choose to follow a "better safe than sorry" philosophy.
Best wishes...
Less invasive forms of biopsy are less likely to result in the "permanent pain and disfigurement" you are concerned about.
The Taxol you mentioned is a chemotherapy, which is only used to treat cancer.
You certainly have a right to reject a biopsy if one has been recommended, but with over 40,000 breast cancer deaths last year in the USA alone, most people choose to follow a "better safe than sorry" philosophy.
Best wishes...
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