Excisional Biopsy

I have had a lump for about two years.  My gynecologist ordered mammograms and sonograms every six months.  They have always come back negative and I was told to do nothing except continue the six month testing.  In passing, I mentioned this to my family doctor (I was there for a sinus infection!) and she had a cow.  She could not believe I was told to ignore a breast lump for two years.  She referred me to a breast surgeon.  The surgeon was concerned and has scheduled an excisional biopsy for next Friday.  My lump is about the size of a walnut and has NEVER shown on a mammogram or sonogram.  However, it is easily felt.

Here are my questions:
1.  Why would my gynecologist advise me to ignore this for two years.  I am angry!
2.  What exactly is the difference between excisional biopsy and lumpectomy?
3.  I was told my lump never showed on a mammogram or sonogram because my breasts are very dense.  Knowing that, how should I check for lumps in the future?
4.  The breast surgeon told me that family history for breast cancer primarily runs through the FATHER's side.  How strong is that correlation?  I have quite a bit of breast cancer of my father's side but my mother's side has none.

Thanks!

[CCF-RN,MSN-rf]

Dear Clairinmd:  An excisional biopsy and a lumpectomy are very similar.  An excisional biopsy will take out only the lump for the purpose of biopsy.  A lumpectomy essentially does the same thing, although, when it is known to be malignant, the margins are more important and so a bit more tissue may be removed.  Dense breast tissue can make interpretation of mammograms more difficult.  Usually a combination of mammography, ultrasound, and clinical breast examination will detect most problems in women of average risk.  Breast cancer can be inherited through either side of the family.  If either side carries the gene, there is a possibility of this being passed along.  Most breast cancer is not inherited.

[Angel83]

I am TERRIFIED, can someone PLEASE provide me with some information on what to expect with an excisional Biopsy. Is this an outpatient thing, will it require being asleep? I am SCARED and need some assistance. Thank you very much for all your help.

Sincerely,
Angel