I am 63 yrs old, never had a mammogram. Found a 1" lump in top center left breast about 7 months ago (was in denial til now) had a breast exam with famiy dr who scheduled the mam. Also had an ultrasound. Radiologist found calcifications in addition to lump and scheduled a biopsy. My reg. dr. sent me to see a gen surgeon because he thought I would want the lump removed regardless of results. The surgeon says she believes it is cancer and immediately started talking about mastectomy. She has now canceled my biopsy appointment and scheduled a breadt mri. and then wants the biopsy after that. I am scared to death - how important is to have the mri before the biopsy (which the surgeon insists on). It has been 9 days of worry. Help!
I imagine the surgeon wants to have as clear a picture as possible of the proposed operative area. An MRI can be very useful, as it can "see through" tissue, esp. dense tissue, to show more about what might be going on. It might also give an idea as to whether any of the axillary lymph nodes appear abnornal in size or shape.
However, if you did not feel comfortable with the general surgeon, you could ask your doctor for a referral to a breast specialist.
If you are mostly worried about the delay in the biopsy because "it's been 9 days," this is not an unusual period of time to wait. (It often takes longer than that to get an appt. with a surgeon and get a biopsy scheduled.)
You did not mention the BI-RADS Category Score (which gives an estimation of the degree of suspicion of a finding) for you mammogram. If the score was high (a BI-Rads 5), that may have been a factor in the surgeon's already discussing treatment options such as mastectomy.
But keep in mind, the only way to be completely sure whether a finding is malignant or not is from the pathologist's report after examining tissue from a biopsy.
Please post again if you have additional concerns, or to update us regarding how things are going, by adding comments to this same thread. (We can better help you if all of your information is in one place.)
Thank you for your reply and concern - it is really just what I need right now. I was not given the BI-RAD score from the radiologist or the surgeon so I don't know if it was high or not. Since I started this screening process here I was planning on following through here and then, depending on the results of the biopsy, I was considering having any surgery done at a hospital in a larger city that specializes in breast cancer.
My next question-is it always necessary to have a breast MRI before a hollow core biopsy that would leave markers. The surgeon seems to believe that this is the only way to go and I'm not sure. I had planned on having the biopsy today but it has been canceled until I have a MRI. The not-knowing if this is cancer or not is the scariest part of this entire thing!
Whether to have an MRI is probably a matter of the radiologist's or surgeon's preferred way of operating.
Someone close to me had a core biopsy done by the radiologist, and when the results came back as BC, she was referred to a breast surgeon for removal of her tumor. The surgeon wanted her to have an MRI (along with many other tests, as part of staging) but she was unable to have an MRI d/t her physical disabilities preventing her from getting into the position required for the MRI. She went on to have a lumpectomy, chemo, and radiation, and to date, 3 years out, is doing well. Yay! :-)
I hope that, if you ARE dx with BC, things go as well for you!
p.s. Given your expressed desire to have the biopsy done as soon as possible, and then go to a larger city for treatment if you are dx with BC, I think it would be quite reasonable to contact your doctor and tell him you prefer to proceed, without further delay, with the original plan to have the core biopsy performed by the radiologist. And also, that you want to seek out a surgeon specializing in breast surgery at a hospital in that larger city if the results are positive.
This is your case, and you have a right to handle it in the way that feels best for you.
After a stereotatic and a core biopsy I just found out that I have papillary carcenoma and DCIS. I have an appointment next week with a breast surgeon where I will find out what treatments along with surgery, are best for me. From what I was told (just a brief phone conversation) papillary carcenoma is very rare but also slow-growing and very treatable. Do both of these types of cancer usually happen together or are they 2 separate issues? Also it is possilbe to have a lumpectory and then radiation and hormone treatment or is the usual course of treatment mastectomy, then radiation. I also think she said that they do not think this has spread to lymph nodes. Do you know anyone who has had this type of cancer? Hearing that I have cancer is was a shock and I may have not clearly heard everything that was told to me so are there any questions that I should call back with?
The breast surgeon will likely be able to give you information about whether these are two separate issues, or related, in your particular case.
DCIS is a common, very early stage of cancer (by some it even considered "precancer"), while as you mentioned, papillary carcinoma is quite rare. Here is a link to a previous thread regarding papillary carcinoma, which confirms the information you were given about it:
Mastectomy is usually required only if atypical cells, or malignant cells, are widely dispersed in the breast, or if the woman has smaller breasts and the amount of tissue that would have to be removed in a lumpectomy would result in unacceptable cosmetic results. Otherwise, the choice between mastectomy and lumpectomy is usually a matter of pt. preference. Lumpectomy with radiation has been found in many research studies to be as effective (or even more effective, in some cases) than mastectomy in terms of long-term prognosis. Surgery and radiation are local txs, that deal with any atypical or malignant cells in the affected breast.
Chemo is usually required only if the cancer cells are very aggressive (Grade 3), the cancer is large, and, esp., if there is lymph node involvement. Chemo is a systemic tx, that is intended to kill any malignant cells, including "microinvasions" (tiny groups of cells too small to be detected) that may have gotten loose in the body through the blood or lymph systems.
Unless there are certain burning questions that are making you very anxious, rather than call back, I think you'd probably do better to make a list of any questions you have, and take them with you to the consultation with the breast surgeon next week. It is often helpful to take someone and/or a recording device with you, because is difficult to hear and absorb everything in such a stressful situation...
Please keep us posted on how things are going--we care!
Hello Blue Butterfly
Just wanted to let you know that I had the lumpectomy and sentinel node biopsy 2 days ago after first having pre-op bracket localization and nuclear sentinel node mapping. I came home the same day and am actually feeling quite well. I did not speak to the surgeon after the surgery but she told my family that everything went well. She was able to remove both the DCIS and the papillary carcinoma in 2.5 inch incision because they were actually quite close together. She did say that she removed 2 lymph nodes instead of the one that was planned but did not give a reason why. She also said something about a pathology report in connection with the lymph nodes but I thought with a sentinel node biopsy they would be able to tell if there is cancer in the first lymph node while I was still in surgery. The incision for the node removal is about 2.5 inches rather than the 1 inch that was originally explained to me. Do you think this is anything to worry about (that the cancer was in the first node)? I have an appointment with the dr. next wed after she receives the pathology report.
I'm glad to hear you are feeling well follwing your lumpectomy!
Here is a brief description of the Sentinel Node Procedure: "The surgeon will use a hand-held probe to find the lymph nodes that contain the most radioactive dye. In that location, your surgeon will make a small curved incision, and look for the lymph nodes that have been stained with blue dye. Only one to three nodes will be removed, unless many more are stained. These nodes are sent to the pathology department, where they are examined for metastasis and micrometatasis."
As you can see, even though it is called "Sentinel Node," it is not uncommon to remove 2 or even 3nodes. Therefore, I would suggest that you not upset yourself by trying to "mind-read" what this might possibly mean about your results, and wait as calmly as possible (not easy, I know!) for the actual results next week.
I'll be thinking of you and hoping for a negative report.
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