Why are they not doing the biopsy??

[Carol221]

I  had a mammogram done on July 29, 2008 and an ultrasound on Aug. 28. 08.......

These were the results I received:

RIGHT BREAST ULTRASOUND: HX: (Abnormal mammogram, right periareolar lesion). Was then sent for an ultrasound. Now ultrasound results say: right breast ultrasound demonstrates right supraareolar cyst measuring 0.8x 0.3 x 1.5cm. This is believed to correspond with mammogram. Additionally, there is a hypoechoic lesion right breast 12 o'clock position measuring 0.5 x 0.22 x 0.54cm. This smaller region is not a cyst. Right axillary lymph nodes measure 0.7 x 0. 9cm

IMPRESSION: RIGHT PERIAREOLAR CYST BELIEVED TO CORRESPOND WITH DOMINANT MAMMOGRAPHIC LESION. ADDITIONALLY, THERE IS SMALL HYPOECHOIC RIGHT BREAST LESION AT 12 O'CLOCK POSITION. CLOSE INTERVAL FOLLOW-UP FOUR MONTHS OR ULTRASOUND. GUIDED BIOPSY RECOMMENDED

Thank you for any help you can offer me.

Yesterday, Sept.24th, 08' I had my appt. with the surgeon for my procedure.He wound up aspirating the cyst, but for some reason they had a difficult time finding the small hypoechoic lesion, that I mentioned to you previously. They were doing the ultrasound so long, and even used 2 different types of transducers, & between the technician, the RN, & the surgeon, they really could not seem to locate it, and even when they think they saw it, it was so small, he decided not to do a biopsy.He said I cannot do a biopsy in a location which was at a (12 o'clock position) that is so tiny and hard to even find. He said I should just get a follow -up ultrasound in 4 months and I have an appt. to see him Next Tues. the 30th for the results of the cyst aspiration. So I am relieved sort of, but at the same time, concerned that the biopsy was not done,and maybe I am being too paranoid. and tell me if you feel I am. I guess I feel if I had the biopsy I would get a more definitive answer than I have now. Hopefully all will be ok on Tues. & he will give me a more clearer answer on tues. Do I have reason to be concerned or should I ask the surgeon to do further testing like an MRI or, tell him I really would like the biopsy done. I have very bad anxiety and take meds for it. I just don't think I cannot wait 4 months for this to be resolved. Any input on this would be appreciated.

[Cleveland Clinic]

Dear Carol221, It is difficult not to be able to get a definite answer when going through a procedure.  Decisions on whether to pursue further investigation or another attempt at biopsy at this time will be based on risk and benefits to the patient, degree of suspicion as well as whether or not what is done at this time would yield information to clarify the situation.  Have the discussion with the surgeon on Tuesday and ask questions and voice your concerns based on the new information that he has with the aspiration results.  It may be helpful to make a list of your questions and concerns so you don’t forget to bring them up.  It may also be helpful to bring someone with you to this appointment who can listen with you, and also help with making sure your concerns are addressed.  

[madgeOwens]

Hi Carol,
I have had cysts aspirated a few times, and had lumps here and there and was diagnosed with fibrocystic disease.  So I know what it is to have these things and to worry about what it all means.  Try not to worry about it too much, most of the time these things are nothing.  He can tell you more on the 30th. Be sure and write all your concerns and questions on a paper and take it with you to ask your questions.  Let me know how it turns out.  Take a deep breath and relax, its usually really nothing. You have to trust your doctor also at some point that he knows what he/she is doing....I think they do. Take care. Madge