VERY STRANGE DISEASE

[Jannoona]

I was just wondering how is breast FNAB performed. I did one last year, where the Dr. laid me down on a table and inserted the needle deep inside the nipple right in the middle!!! It was very paiful. I was told later by my doctor that they should have not touched the nipple, they could have inserted the needle by the side of the nipple after having held the lump and made it's location clear for biopsy. I was just wondering, so why did the pathologist get deep underneeth my nipple although the lump is palpable on the side, is that OK. Would be any means this could have changed the reading of the results? It is an exact year till now, and my nipple did not heal from the sore and redish head, would the biospy had an impact on the infection? I had passed through all excams and having had all sorts of treatments my nipple did not heal, yet it did not develop or go worse.

[BhumikaMD]

Hi,

This may be possible. Both biopsies may have different results. This is du to the fact that different diseases cause changes at various levels of the body. Thus while the skin biopsy may be normal, the breast biopsy may identify lesions.

A skin biopsy aims to get a section of the skin only, while a breast biopsy has a deeper intervention of the breast tissue.

Hope this helped.

Glad to be of help.

[Jannoona]

Can I just know one last thing please, what are the differences between a breast biospy and a skin biopsy. Would a breast biopsy give a different result than a skin boipsy? In other words: If a lump was suspected and after doing U/S, mamo a FNAB would be final to rule out. If it came clean, would still a skin biopsy have the possibility of giving a different result, specially speaking if both biopsies are taken from the nipple.
I do appreciate your thprough advise.

Thanks

[BhumikaMD]

Hi,

In case of skin lesions a clinical examination is a must - a picture or website information can be grossly misleading.

It would be best to try and compare your skin lesions with any pictures available at any of the sites.

Let your dermatologist or skin specialist decide about the further course of management including whether a biopsy is required or not after a confirmed diagnosis.

Let us know about how you are doing and if you have any other doubts.

Regards.

[Jannoona]

Thanks. I want to know web sites in which I can find photos and explanation about all types of rare uncommon or unusual diseases that affect the nipple only. apart from Paget's, infection, aczema. Do you have a web site that covers my interest? I want to compare what I have with what is there in the medical directories and relate to it? How can I assure myself that I do not have paget's since this has been a year till now? Shall I do a skin biopsy, is the skin biopsy always made to rule paget's or is it done for other reasons?

[BhumikaMD]

Hi,

I think it would be good to take a course of antibiotics as advised by your dermatologist.

If it is an infection - it would heal with the appropriate medications.

It is also good to know that all the investigations have come out good.

Let us know about how you are doing and if you have any other doubts.

Regards.

[Jannoona]

I did reconsult a surgeon wrt my breast which was clinically diagnosed as a fibroadenosis in both breasts. My ultra sound and mamo came clean too. 1 surgeon out of 8 was suspicouse of Paget's disease. The FNAB and US and mamo are clean. I dermatologist advised this is a nipple infection and gave me treatment, which I yet did not use.

I can not recall any history of injury on the site before or after the biopsy.
I did a clinical evaluation one month ago with a surgeon who saw me twice before and after my period and his assessment came as clean (fibroadenosis) and said this is not paget's as it does not have it's look or symptoms.

[BhumikaMD]

Hi,

You should reconsult with a breast specialist and get a clinical examination got done.

No definite comments can be made as of now, but you are probably right about the nipple sore not healing dueto the biopsy and that an alternative site through the breast skin would have been an option.

What does your ultrasound and mammogram reports say?

Is there any history of trauma or injury a the site after the biopsy?

Do not neglect this, and get an urgent clinical evaluation.

Keep us posted if you have any doubts and also about how you are doing.

Hope this helps.

Regards.