Breast Nodule not seen but "believed" to be OK???

I am 48 yo disabled by a chronic immune disorder, overweight and menopausal (i have a medical background but not in oncology or radiology)

I do have bilateral breast tenderness (my period has become very irregular once or twice only this year so I always feel like I'm getting it)
Breast exam, by a breast surgeon my gyn sent me to after nodules were seen, was nrl

I had a mammogram in 3/08 that found two nodules.
A  6mm nodule in the 12:00 left breast- at the time of the exam the radiologist
said it was so small it was hard to tell but she thought she saw a "notch of lucency"-
on her report she states she did see "a notch of lucency"
And in th UOQ far posteriolly lobulated and well circumscribed 3-4 mm nodule.

Niether nodule could be seen on sonogram.

The radiologist reported they were believed to be benign intramammary lymph nodes but should be followed in 6 months for stability.

I repeated the mammography 9/08

The radiologist only reported on one nodule. Was completely mute on the second.
I only found this out after I received a copy of my mammogram report.
The breast surgeon had said that everything was stable.

This second nodule is very close to the chest wall
and very small so I thought perhaps the area wasn't fully visualized and I might need more films.

I called the radiology dept (the surgeon, understandably, is only in the office two days a week. It is almost impossible to speak with him -it took three weeks just to hear from him in 3/08 that he didn't think I needed a biopsy- that's why I called myself) and asked to speak with the radiologist.
This seemed to annoy everyone
at the radiology dept. (the secretaries) which did surprise me
but I persisted and asked them just to please ask if the radiologist would review the films.
(I was later told by another staff member that it is not unusual for patients to call and request a reread by the chief radiologist. So I am really confused)

My surgeon calls me and says indeed "two views" appear to have missed the area but on one view the radiologist "thinks" the area is visualized but the lymph node has disappeared. When I asked if this was a common behavior of lymph nodes he said he "guessed so."

He felt that repeat films were unnecessary which didn't sound right to me.
(If the films were so unnecessary why did I repeat them at all?)
He said "well if the nodule can't be seen any longer on the mammogram why repeat it".
I said, from what he said, the area was not fully visualized so shouldn't we try to get more films

I asked about an MRI and he sternly said -do you want to pay $2,500 for an MRI?
I said that I thought perhaps another type of imaging study could see the area with less difficulty...
but since this was his field of expertise I was simply asking him if it made any sense.

I'm repeating the films

If areas are not properly visualized is it routine to just move on? (just get my annual exam in 6 months)
Am I completely in the wrong here or do I need new doctors?
This was a totally confusing and upsetting experience!
I have lost a lot of trust in these physicians but since this is new to me
perhaps this is routine and just seems wrong to me...

I live in Queens NY.

[blueskyabq]

May be you can ask if special mammogram with magnification view will have better views and diagnosis for your situation?  

You are right, it is very difficult to talk to Drs, even you found out what they said to you was different than what the final report said. Try your best, we do need informed decisions.

Good luck!

[japdip]

Some of it sounds like normal procedure and some doesn't .... specifically the "guessed so" part. I see no reason not to have the MRI ... yes, they are expensive but so are all the repeat tests. The first thing I think I would do is get a second opinion and take all your reports and films with you. From what you said, none of the Dr.s sound too sure of anything. Definitely time for that second opinon.