digital mammogram results concerning

Hi- New to this forum and finding it very helpful. Just had a digital mammogram and ultrasound 2 days ago. Radiologist told me I needed a fine needle biopsy asap. She literally squeezed me in at end of day. She told me she was "very concerned", and the digital mammogram saved my life. I was so nervous that I did not ask many questions. She saw a mass 2 cm and told me she was very certain that it was malignant and if it wasn't, she wanted me to have it removed. Tomorrow is Thanksgiving, and I will not get the results until at least Monday. I am 56, post menopausal, have fibrocystic, lumpy breasts and have always had 6 month follow-ups b/c of past calcifications and had a sterio... 2 years ago that showed benign results, First mammography with a digital machine, and the radiologist said many times that this saved my life. I found her very dramatic, and wondering if she could be exaggerating her concern. I called the center today to ask for the bi-rad score that I learned about on this board. Guess I have a lot more to learn. Any other questions I should ask if they call back? I thought I could put this aside for the weekend, but I find myself getting more anxious.
    Thanks, viddie

[CCF-RN,MSN-rf]

Dear viddie:  Results of a mammogram can look more or
less suspicious based on certain characteristics.
These characteristics help the radiologist to assign a
BIRAD score which then guides the recommendations.
The only way to know "for sure" if something is
malignant is with biospy.  The question to ask may be
"If the abnormality appears this concerning, would an
excisional biopsy (remove the lump) be appropriate as
a first step.  This would be best to discuss with the
surgeon who, after reviewing the mammogram and
ultrasound, can make a good recommendation.

[viddie]

just spoke to radiologist and she said my bi-rad score was a 4c or 5. How do they know that? Can they be sure?  She said it is an irregular mass and highly suspicious. If she is right, she is an excellent diagnostician. She said it could not have been seen on a regular mammography. I had a physical last month and also had a gynacology appointment last month and both doctors did not feel it.

[Bunny711]

I beleive they score it by indtereminent, not really knowing, suspicious.

Wow, you've kept up on it, when you mean mass, is it a lump, or calcifications? meaning clustered cells?

I would most definitely speak to my doctor, don't worry about this if you've been tetsted regularly, and it just showed up.  I would speak with my doctor.

Try to take is easy and enjoy the holiday, I realize its easier said then done.

Did you use the same radiologist office as always?  I'm just wondering why this radiologists was so alarming.

[Bunny711]

Hi:

Where you had the calcification biopsy, is it the same breast where they found the mass?

Did you ask if they can see anything from your prior tests.  I would most definitely cosult a breast surgeon since they would be doing the needle biopsy.  

Just from my expereince, i went right in and did an excusional open biopsy for clustered calcifications, in an area that was impossible to do needle or sterotactice.  With that being said, I wanted this cluster of bad cells out whether it tested benign or not, and thats what the surgeon did.  Well mine is benign for now.  I will start 6 months mammo's now. I am 40, had first baseline at 35, thenm 38 and now, they saw the changes on the mammography.  My maternal grandmother had breast cancer 40 + years ago.  Yuo may want to get a second opinion also.  I am blabbering away.  You situation sounds a bit confusing as you know.

[viddie]

Dear Bunny,
  It is a lump  with irregular borders and it was next to the area of calcifications where they did a steriotac-- a few years ago. It was also a different diagnostic center. I switched centers because I heard they had a digital mammography machines, and since I have fibocystic breasts, I thought it was a good idea. I had all my records sent over and the radiologist assured me she examined them thoroughly. She was very thorough.

[cyn17]

It sounds like you're in excellent hands. They may have been so alarming based solely on the appearance of your tumor...some are shaped in a way that they can only be cancer. Of course a biopsy will provide the definitive answer. I know two women (my mother was one of them) who were told their tumors were likely cancer before even having the biopsy. The really good news is, if this is cancer, you have caught it early. Keep us posted on your results. You're in our prayers!

[Bunny711]

You are in excellent hands.  I was just wondering.....as cynn said, if this is worst case, its still early.

Have a Happy Thanksgiving try to anyway.

[viddie]

Hi again,
  Thanks for your posts. When I said to her that it is good that you caught it early and asked it that meant that it would be in the very early stages, she said not necessarily because some breast cancers grow very quickly, in two to three months, so until she has the results of the biopsy, hopefully Monday, she cannot tell if it is an early stage. I will hope for the best though. My mom was diagnosed with pancreatic cancer after an ERCP and before the biopsy results, a procedure similar to mammography. The Doc was quite certain the results would show a malignancy. They were negative and she does not have cancer. So, I made an appointment to see a surgeon next week, but this weekend, at least, I will hope that she is wrong. By the way, there is no history of breast cancer in both sides of my family.

[Montana girl 06]

I have found radiologists tend to alarm me and surgeons put things in better perspective and calm me down when I have suspicious reports. The irregular shape of your mass is alarming, but even birad 5's turn out benign at times. Waiting for results is miserable. I will keep you in my prayers.

[Mrs. R]

Did you have pain and is that why you went to the doctor?  Or, was it just a regular 6-monthly check up?

[viddie]

Hi,
  It was a 6 month followup. My breast is a little sore now because of the biopsy. I didn't feel the lump before, but after my breast subsides from the biopsy, I will try to look for it. The radiologist said she felt it, but neither my gynocologist nor my primary care noticed it when examined in September. It has to be new. Thanks to all how who responded and have a Great Thanksgiving.

[who_dis]

I think it was inexcusable for her to have alarmed you in such an extreme way, right before a holiday weekend where you now have this hanging over your head for many days.  

Even if it is suspicious or highly suspicious, you do not deserve to have people throwing around the phrase that digital mammography saved your life.  That's a completely loaded statement to have made before a diagnosis is even made.  Sounds more like a sales pitch than a compassionate statement.

I had a small tumor that was detected 13 years ago by regular mammography.  It was too small even to be palpated.  Cancers can behave very differently, and each persons body can influence it to an extent, too.  Mine was diagnosed when I was 35.  I had no malignant nodes, and have done very well for many, many years now.  Totally inexcusable for her to tell you that "some cancers progress rapidly".  Well, some do.  BUT YOU DO NOT EVEN KNOW IF YOU HAVE ANY CANCER, let alone a rapidly advancing one!  The doctor handled it very poorly with you, in my opinion.  Yes, you needed a biopsy.  But this could have been discussed rationally and calmly without the hue and cry of "life saving emergency".  

I wish you the best, and I can't tell you not to worry now.  I know and feel your worry and agony over this.  Try your best to focus on your holiday, pamper yourself, and in general be kind to yourself.  Please post your results, if you feel up to it.

We care!  Many of us have been there.  The day I was diagnosed was burned in my memory forever.

[vermontgirlII]

I agree, I think it was inexcusable and very unproffesional for her to be so alarming.  She is jumping to conclusions all over the place, and since you went ahead and had the biopsy, she didn't need to scare you into doing that procedure.  I understand your worry.  I am waiting to have a biopsy next Thursday, then it will be another few days and a weekend before I find out the results.  Easier said then done, but try to keep yourself busy and not think too much about it.  Yeah, right.

[viddie]

Just found out---I have  IDC, grade 2- no other info- different radiologist- the original radiologist is at convention--very nice and caring- both were. I have an appt with a surgeon on Wednesday and an MRI scheduled for Thursday. He told me that I would get more information once I had the MRI and the sentinal lobe dissection. I feel numb. Now I have to call several friends and family. Not in the mood, but I promised I would let them know. Maybe they will cheer me up. Is there any other questions I can ask my primary care Doctor if he calls me back about the biopsy results.

[viddie]

Just found out---I have  IDC, grade 2- no other info- different radiologist- the original radiologist is at convention--very nice and caring- both were. I have an appt with a surgeon on Wednesday and an MRI scheduled for Thursday. He told me that I would get more information once I had the MRI and the sentinal lobe dissection. I feel numb. Now I have to call several friends and family. Not in the mood, but I promised I would let them know. Maybe they will cheer me up. Is there any other questions I can ask my primary care Doctor if he calls me back about the biopsy results.

[cyn17]

We are here for you with our thoughts and prayers. Keep us posted as to your treatment. I wish you all the best!

[Montana girl 06]

Sorry to hear about your diagnosis. I hope you get a great team that helps you understand your results and future treatment.

[vermontgirlII]

I am so sorry to hear about the diagnosis.  I have an old friend who was diagnosed with brain cancer, and she wrote that after she got the news, she screamed and cried and took as much time as she needed to let those emotions out, and after she did, she felt she could get on with the process of getting better.  It sounds like good advice to me, but do whatever works for you.   I found a good website at www.imaginis.com or org ?? that has tons of information about bc.  It explains the terms and diagnosis that the doctors will tell you, which, I know for me, is like a foreign language.  Good luck with this.

[who_is_this]

I'm so sorry to hear this.  (I'm who_dis above, new name).

My cancer was also intraductal carcinoma with microinvasion.  I was diagnosed 13 years ago, early like you.  I had no positive nodes and elected a mastectomy for various reasons.  I wish you all the best, and know our thoughts are with you.

[boninclyde]

Though I haven't posted you I have been watching you post. I am so sorry about your diagnosis. Please keep us updated. It helps us all to know we are not alone. What are your next steps?

[viddie]

Hi,
  Thank you all for responding. I saw the surgeon on Wednesday and I am scheduled for surgery on Monday, Dec. 11. I had a breast MRI on Thursday, and when they see the results, they will come up with a plan and present it to me. If the MRI shows no other tumors, my surgeon suggests that I have a lumpectomy. Judging from the films so far, he is optimistic  that he can get it all. He will also do a sentinel lobe dissection the morning of surgery, and only then will he know if it has spread to my lymph nodes.
The surgeon has been highly recommended by quite a few people, so I am quite confident and comfortable that he knows what he is talking about. Also, on  Wednesday mornings, there is a tumor board, consisting of several breast surgeons, several oncologists and radiologists and they discuss all cases that are due for surgery.  
So far things have gone smoothly. I am hoping no surprises pop up on the MRI. Thanks again for caring.

[Montana girl 06]

I'll pray that nothing else shows up. I'm glad you have a good surgeon.

[boninclyde]

Your breat center sounds so much like mine. One day a week everyone, surgeons, doctors, nurses, radiologist and pathologist get together, reviewed the films, path reports, biopies and talked about the cases and surgeries for the week. So I felt like I had 20 doctors. My particular surgeon studies with ACS,  TNCI and teaches at colleges and hospitals all over the world. He does not take on many sugeries anymore so I was really lucky to get in with him. This sounds like a great center and you are in good hands. Do you  mind if I ask what city you are in?

[viddie]

Hi,
  I live on Cape Cod. We are close to Boston- Dana Farber is located in Boston- I thought of going there- around 1 1/2 hours away, but unfortunately,  there is a lot of cancer on Cape Cod- including breast cancer-  As a result, the doctors here have had a lot of experience. I have heard excellent stories and decided that I feel confident staying here. They have a great Cancer Center and an Oncologist from Dana Farber comes to the Cape every Wednesday and is a team member of the Tumor Board who reviews the cases. When my husband fought (and won) pancreatic cancer 3 years ago, we did make the trek to Boston for his whipple surgery, and chemo and radiation every day for 6 weeks. That was different- pancreatic cancer is relatively rare and the doctors here virtually had no experience with it. That was well worth the trips. I feel confident I am making the right decision for me.

[vermontgirlII]

Hi, It sounds like you  are in excellent hands.  I am praying for you.