Yesterday I had follow up mammogram as my regular screening mammogram showed a suspicious spot. After more views it was determined that they wanted me to have an ultrasound. It showed up there as well and it is a solid node not fluid filled. When asked if it looked like is was benign, the radiologist said that he could not be sure as its size concerned him as it is taller (9.7mm) than it is wide (7.7mm). They suggested having a biopsy to be sure. I am just wondering if when I have the biopsy if it should just be removed altogether whether it is benign or not. What do people usually do? I think that I would worry about it turning into something else if it was left in there. Can anyone share their thoughts with me? Thank you.
The usual protocol for this is to have a needle biopsy, but it is also perfectly reasonable to pursue a complete surgical excision of the nodule if you and your surgeon are amenable to it. Just remember that surgical excision has its risks and side effects, depending on the amount of tissue to be removed, but these complications can be minimized depending on the expertise of your doctor/surgeon.
Regarding the probability of malignancy, it is indeed very hard to tell through ultrasound. The mammogram reporting in terms of BIRADS can help us with determining this probability. The BIRADS score is a standardized reporting system and I think you should ask your radiologist about this (http://biradsclass.blogspot.com).
The question of removal versus biopsy only would be one to ask your Surgeon. I'm guessing you either have an appointment with a Breast Surgeon or will make one soon. He/She will review your films and advise as to the type of biopsy and also if total removal of the nodule would be appropriate at that time. A biopsy is the ONLY way to differentiate between malignant and benign. Regards..
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