fat necrosis

I had a mammogram and a sonogram a few days ago. The radiologist recommends a follow up mammogram and sonogram in 6 months. My gynecologist recommends a biopsy asap. Should I be concerned? I have no health insurance, does anyone know how I could get help with this? I live in the MD/DC area.


This discussion is related to Fat Necrosis.

[PaulMD]

Hi there.

To give us a clue on what your radiologist thinks, it is best to ask him or her about the BIRADS classification of your mammogram.  This is a standardized reporting scheme for mammograms that will give us the idea if the lesion detected is benign or malignant.  This would give the probability of more serious conditions and direct future actions such as pursuing a biopsy (http://biradsclass.blogspot.com).

If the BIRADS classification is about 4 and above, then I would agree with a definitive biopsy procedure to rule out the possibility of malignancy.

Regards and God bless.

[izmelori]

The BI-RADS is Category 3: probably benign.

I wasn't really concerned until my doctor called and said I should see a surgeon. Is she just being overly cautious?

I have no health insurance, does anyone know how I could get help with this? I live in the MD/DC area.

[mamaboulet]

I'm not sure why this is labeled fat necrosis, but a BIRADS 3 rating often results in a wait and see, with possibly a 6 month follow-up, not necessarily a biopsy. I would definitely ask your doctor why she thinks it should be biopsied. Did your doctor mention fat necrosis? Fat necrosis is a benign condition, supposedly produced by trauma to the breast, considered somewhat rare (except in cosmetic surgery circles apparently). I don't believe it is as rare as indicated. I had a classic late stage fat necrosis lesion that was BIRADS 5 scary on the mammo and US. Early stage fat necrosis tends to be a smooth nodule, but late stage fat necrosis often evolves into a spiculated lesion with microcalcifications. And yes, I had to research full-on medical papers with pictures to find that information. It is not readily available. Perhaps if more radiologists read the same medical papers I did, then my radiologist wouldn't have freaked out and not even MENTIONED the possibility of fat necrosis when he saw my films.

[izmelori]

This is what the report says:

1 lumps at 2:00 measuring 1.3 cm and another at close proximity at 2:00 measuring 5.2 mm. The sonographic findings in combination with the vague density seen on mammography are suggestive of some response to injury, perhaps small hematomas or more likely areas of fat necrosis.

IMPRESSION: Probably benign findings in the right breast as described. Recommended follow up mammogram and sonogram in 6 months.

BI-RADS Category 3: probably benign.

Now this doesn't sound very scarey at all to me. But the doctor calls and tells me I need to see a surgeon for biopsies.
My problem: I have no health insurance. So I need to know if the biopsies are really necessary, and if so is there anywhere I can get financial help with this.