Cyst/Lump

[Dinah]

I'm 45 years old and have yearly mammograms.  My mother died of breast cancer when she was 65, so I check myself often.  A few years ago I discovered a lump, which the doctor told me was nothing.  Mammograms always come back negative.  However, this lump swelled up and became painful (about the size of a silver dollar).  My doctor ordered an ultrasound, which showed a tiny cyst, about the size of a pencil eraser.  My general practicioner sent me to a surgeon, saying it had to be removed.  The surgeon says he wants to do a needle biopsy, but it may not show anything.  How can a cyst so small cause a lump so large?  And why do I want to have a needle biopsy if the results are so iffy?

Doctors confuse me.  Can you help?

Dinah

[CCF-RN,MSN-rf]

Dear Dinah:  A needle biopsy can be done on any lump that can be felt.  The down side of a needle biopsy is that it only examines that tissue that is within the needle, leaving surrounding tissue unexamined.  However, this procedure is much less invasive than an excisional biopsy or lumpectomy.  Nevertheless, if the consensus is that the lump should be removed anyway, it is reasonable to do this without the needle biopsy.  Apparently, neither the mammogram nor the ultrasound showed anything that is highly suspicious.  Your general practitioner may be suggesting removal solely based on your history.  As medicine is not a perfect science, you are likely to get differing opinions from different experts.  If you are worried about this lump, ask the doctor to remove it, if only for your peace of mind.

[Dinah]

Just wanted to let you know that I talked to my GP, and she first asked if I wanted to see another surgeon.  Me, being a sissy, said no, so she agreed to have another mammogram and another sonogram in three to six months.  So I guess I'll cancel the appointment for the needle biopsy.

Thank you for the information.