BIOPSY ON COMPLEX NODULE ? - BIRAD 2?

[Roxlin]

Hello.  On my very first mammo. and ultrasound (dense breast), I was told that I had a well-circumscribed hypoechoic nodule, and the told me to come back in six months. They radiologist said that it was probably benign and rated it a Birads 3.  I went back a few weeks ago and the size was the same but the shape was CLEARLY different - It was weird looking on the ultrasound.  The tech took it in to the radiologist and came back in a few minutes telling me that it was basically the same. I was like, huh??  I got the report a few days later for a second opinion and she called it a lobulated complex nodule, and she rated it a Birads 2 !- like she knew that this complex nodule is benign with no tissue samples!  OK, so how is the nodule the same if at first it was oval a nd now it's complex and weird looking?  I am 42 years old - my sister DIED of ovarian cancer at 42 ( aunt died also of ovarian cancer).  They told her that she did not have cancer.  Am I over reacting? Am I doing the right thing to get this biopsied at one of the top name breast centers even thought they are giving me a hard time about not covering this place on insurance?  I'm in a fight.

Roxlin

[Roxlin]

I had the core needle biopsy done  on 4/28/08- it came back with benign results - however, when they were locating that nodule for the biopsy, they came across another smaller nodule that was missed by the first ultrasound screening.  They did a fine needle aspiration on that one - it came back with atypical cells.  Now they want to do a vacuum assisted core biopsy for that one, so that they can get definitive results.  If they find alot more atypical cells, they with have to do an open excisional biopsy.  I go for this vac. biopsy on this coming Monday - 5/12/08.

[BhumikaMD]

Hi,

How are you doing now?

Has a biopsy been done? What does your breast specialist advise?

Let us know about the latest and post us.

Regards.

[Roxlin]

Hi.  I appreciate your responses because I've really needed to talk more about all this.  The waiting is making me a bit crazed; I'm distracting myself with my kids (teenagers).  My teenage daughter is almost 16, and she's been coming to me lately saying that she has all these lumps in her breast.  I've done research, and I know that alot of this is normal and hormonal.  BUT she came to me the other day practically in tears, because apparently, they are extremely lumpy.  She said they almost feel like bones.  She's like this can't be normal, and I was trying to reassure her.  It was a really big lump - and apparently there are more - one side is definately bigger than the other.  I didn't make a big deal about it, but I called the doctor, and I made an appointment.  maybe just fibroadenomas - hopefully not those phyllodes tumors.!  We women sometimes have to deal with alot.

Can you let me know how your test go in a few weeks.  I'm here if you need to vent.  Take care and God bless.

Roxlin

[omasgrandsons]

the same thing happen to me last year.  I went to the bc specialist and delivered my films to them, their radiologist viewed them, i had the mri and no masses.  the specialist wanted to see me in nov. for another mammo, and insurance wouldn't pay, since they didn't pay for the mri, i couldn't afford to pay for a mammo.  i asked the specialist if i could wait till jan because then the insurance would pay.  no problem.  in jan I went for the mammo and their tech wanted my films and I told her i delivered them to the specialist last june.  she took new films and the radiologist viewed and told the specialist that i had microcals in a small cluster and milk of calcium, waiting to see old films to make a comparison.  I told the specialist that i delivered the films to them last year and they said they would track them down.  after 2 weeks no films, so the radiologist's report stated no change from previous films, recheck in 3 months.  clinical exam - lumpy breasts not to be concerned but specialist couldn't understand why the radiologist would say no change when they can't find my old films.  The specialist told me they would use these as my baseline and he wants a repeat in 3 months.  It is coming up in 3 weeks, starting to worry but not obsess over it.  Insurance companies run our lives, we no longer have a choice as who we can see and what test we really need to have.  I wish you the best of luck and God Bless.  Take care of your self and do what YOU feel you need to do.
omasgrandangels

[Roxlin]

Hi

I am trying to get another opinion from breast specialists at a breast center, but my insurance covers some of the doctors, but not the radiology part - which would include where they do the breast biopsies.  I do need new films because the center where I want to go is very thorough - I don't trust my second set of ultrasound films. I didn't feel as though the tech was thorough enough or got enough photos - apparently the breast center felt the same way because they wanted more films.  Then to top it off, I sent my left side mammos and ultrasound to the breast center, but the first imaging place I went to lost the right side mammos.  Boy, I'm losing trust in these people by the minute.  My OB and Primary care dr. are now thinking that I should get a biopsy - I guess the question now, is where.  I do want to go to these specific breast specialists because of their reputation.  A lady at the breast center is trying to work with my dr.'s office, so that they can contact my insurance about me coming there - we'll see...

Roxlin

[Roxlin]

Hello,

Thank you for your response.

The first report - 6 months ago - states a well-circumscribed hypoechoic solid nodule - some through transmission - measuring 1.4x 1.1x 0.7 - thought to be a fibroadenoma. Birads 3 rating

The second report - just recently had - states that it is a benign appearing complex nodule - no interval growth - most likely representing an atypical fibroadenoma - mild degree of lobulation.  Birads 2 rating

It's strange to me because there was no mention of lobulation in first report and did not appear like that when I looked at the film, it just looked like an oval/rounded shape.  Now on this report and film, the shape is lobulated - very much so when I looked on the ultrasound screen and films - there was also no mention of it being complex in the the first report.  

I have done some research, and almost everything that I have read about complex nodules/ atypical fibroadenomas states that they should at least be considered for biopsy - especially when you get into your 40's on up - that's why I was confused as to why she would rate it as a Birads2. !

My OB/GYN  and my primary care physician do think that I should have a biopsy - especially because of family history and the link of breast and ovarian cancer.  

[BhumikaMD]

Hi,

You should try and talk to your doctor about any doubts that you have and also if a biopsy is required. It would be best to consult another breast specialist for a second opinion if you are not convinced about your management.

Let us know about the exact reports if possible.

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

Regards.

[omasgrandsons]

I feel you need to do what is best for you physically and mentally.  If you feel like you need a second opinion get one, don't let anyone stop you.  A biopsy, I am chicken so if my second opinion told me not too worry and come back for a recheck in a few months, then I would probably feel a little at ease.  I just do a lot of research with what I was informed on last April that I have, even though they told me not too worry, I did get a second opinion at a Breast Cancer Center because I have had at least 3 aunts on my father's side die of bc and 2 on my mom's.  The specialist is keeping an eye on my condition with mammo every three to six months to see if any changes.  I still worry all the time, but I do feel more at ease.  Take care and good luck.
omasgrandangels