BIRADS 2- Surgery consult

[Jenny Wren]

I had my first mammo done at age 40.  It revealed with a second mammo and US a simple cyst.  I didnt have one done last year but recently had another one done and got a call back for spot compression and US.  After the US the radiologist came in a spoke to me and told me that there is another simple cyst and nothing to worry about and apologized for having me come back again because he didnt know that I had cysts previously.  I had went to a clinic and got a voucher to pay for the recent mammos.  They sent a report to both my attending gyn/ob and also to the ob/gyn at the clinic.  I received a call this morning from the clinic telling me that he wants me to see a surgeon.  I called my regular ob/gyn office and they pulled my report from the chart and told me that my dr had signed off on it and that they usually dont recommend a surgery consult unless its a BIRAD 4 score, mine is a 2.  I told the nurse what the radiologist said and she can not see a reason why they would want me to see a surgeon.  She told me that surgeons dont normally do aspiration unless its large and painful, which mine is not.  Mine is 10x6x8 mm.  I am lost and confused.  The nurse told me to not schedule a mammo next time within the week prior to or during my period.  Both times I had it done it was within days before my period started.  She also stated that this dr wanting me to see a surgeon is very busy with his own practice plus working for this clinic.  What should I do.  I am in no pain.  Thank you!

[japdip]

I think you are very wise NOT to go along with the Surgical consult ... I'm not sure why either unless this is somewhat of a routine and a case of being too busy to read the fine print. I would make you wonder why but I'm pretty sure this was some sort of error on someone's part. Sometimes Clinics will set a routine for no reason at all and this also could be the case. Do keep up with your routine yearly Mammograms and monthly self exams and at least yearly Physician visits which should also include a breast exam.  Best wishes .....

[Jenny Wren]

Thank you for your response zouzi.  I just got a letter in the mail three days ago stating that my mammogram is normal and to follow up in one year with mammo.  The radiologist told me that day that it was a simple cyst, the same as the other one is that was found two years ago.  I think I will call the clinic tomorrow and ask why I am being referred because my own gyn/ob office is baffled too.  Thank you kindly.

[zouzi]

Hi,
You are right that biopsies are always required when BIRADS score 4 are assigned on mammograms,ultrasound and MRI reports.
Category 2 means that the findings are benign, that your breasts are the same size and shape and the tissue looks normal. Any cysts, fibroadenomas,or other masses don't look suspicious.
Simple cysts are fluid filled sacs that do not need any treatment,because they are related to the increasing hormonal fluctuation and are harmless.
I don't understand why you would need to see a surgeon,unless the radiologist is not sure if it's a simple or complicated cyst (fluid with debris) which is almost always benign but would need to be further investigated.If I were you,I would call the clinic to find out why you need to consult a surgeon.
The nurse is right that cysts tend to enlarge before menstruation and it's best to always have mammograms and ultrasounds tests after your period ends.
Avoiding foods and beverages containing caffeine, such as coffee, tea, chocolate and soft drinks, can decrease water retention and may help shrink the cysts and alleviate discomfort if you have breast pain.
Please let us know how things are proceeding.
Wishing you all the best...