what is better for a biopsy Birads 4a

[charlotte19]

Hi i was wondering which is better between mri , mamo  or ultra sound can an ultra sound see calcs also what does an excisional biopsy intail. Is it ok to just do mamo follow ups instead of a biopsy what are the risk i have been diaognois with slight ploemorphism morphology microcalifications birads 4a suspicious.  
I am asking as i had a steriotactic on the 15th of sept 08 but the P.A. Missed my calcs now they are saying that i need to have an excisional biopsy ok i am scared as i do not do well with surgery can i just follow these what are the chances of these calcs being cancer there is no breast cancer in my family i do know we  have brain tumor cancer which is what my dad passed away from, can someone give me some kind of advice i am going to see a completely different doctor now i have to pay out of pocket which i really can not afford. due to my ins only pays for one consult a year does anyone know how i can get my ins. to pay for my second consult i am sorry if i have a lot of questons i am scared i just want to put this all behind me i am depressed please help i feel like i am trapped in a circle and there is no getting out any advice on my questons would be so nice right now thank you  

[Ray515]

Hi Charlotte-
I had a wire guided excisional biopsy last March.  It really wasn't very difficult at all to recover from.  It was an outpatient procedure and I didn't even have to have general anesthesia.  I went home an hour after the procedure and took it easy for two days.  By day three I was back on the treadmill.  I really barely noticed the incision and had almost no pain.  They sent me home with a prescription pain med but I only used Tylenol on the first day.  The worst part for me was before the surgery in the mammogram room where the radiologist inserted the wire to guide the surgeon to the correct place in my breast.  Again, there was no pain as the breast had been numbed but it took about half an hour and I was squished in the mammo machine the whole time.  I was able to sit in a wheelchair though.  The actual surgery and recovery wasn't bad.  I told my husband that I had headaches that hurt worse than the incision.

It is very important that you find out whether you are dealing with cancer or not.  An excisional biopsy will give you a definite answer.  Good luck.  Go get your answer.

[PaulMD]

Hi there.

I believe that a BIRADS 4a mammogram should entail further tests, and a negative stereotactic biopsy may not be sufficient as this may really miss the pathologic structures.  I would agree with the plan to have excisional biopsy done as this would entail removal of the entire lump and therefore examine the lump thoroughly.  This way, the entire nodule can be examined and nothing is missed.  I believe that pursuing the biopsy is a better option than doing all other imaging tests such as the MRI which cannot really settle anything.  Regards and God bless.