Avatar universal

biopsy after follow up mammogram and ultrasound

My mom went for her yearly Mammogram last week and came back with a dense area and they wanted her to follow up with another Mammogram of that location and an ultrasound. The follow up Mammogram today still showed the spot and during the Ultrasound he said he believe it's a cyst and it doesn't have characteristics of anything bad looking but also doesn't have characteristics of something just being benign, it's basically stuck in the middle. So they ordered a biopsy and suppose to meet with the Dr. tomorrow to schedule it with the surgeon and determine what type of biopsy should be done. They said the surgeon will also look at the images and films to help determine if he thinks its anything more worrisome.

It's very nerve racking and I feel so horrible for my mom and I just wanted to know if anyone else had this type of experience or if its common for a Ultrasound not to be able to tell if it's a Cyst or not. From things I've read is an Ultrasound is what's used to pick up a Solid or a Liquid filled mass but this came out undetermined.

Any advise is appreciated.
19 Responses
25201 tn?1255580836
This recommendation is what one would call "Good" Medical practice. Ultrasound can determine at times more accurately than a Mammogram alone the true nature of an abnormal finding. As the Dr indicated this is likely to be a cyst but he/she is not 100% positive; thus the recommendation for a biopsy of some type. Evidently this area has some characteristics that leave a question as to exactly what it represents. Many times a biopsy is needed to be absolutely certain that the area in question is benign so relax and feel assured that your Mom is receiving the very best care; not leaving anything to chance.  Kindest regards to you both.
587083 tn?1327120262
When Mammograms or Ultrasounds images are uncertain, then the best option is to proceed with a biopsy, because this is the only way to obtain a correct diagnosis. What your Mom has could very well be a cyst as the Radiologist suggested or perhaps it could be a complex cyst containing debris that has been noted on ultrasound.
I surely understand you worrying about your Mom being referred to a breast Surgeon and go through a biopsy, but try to stay calm and keep in mind that the majority of breast cysts, even complex ones that are biopsied, result in benign findings.
Hoping that everything will turn out just fine for your Mom.
Best wishes to both of you..
Avatar universal
Thank you so much for fast responses, it really helps getting any additional information <3
Avatar universal
Sorry not trying to hound if this changes anything but just wanted to clarify after talking with Mom again since her mind was cloudy at the time that it was actually during the Mammogram he believed it was a Cyst but wanted to follow through with Ultrasound which brought up the uncertainty on the characteristics of the mass where its not matching anything bad but not matching anything good which is where we're stuck in the middle, just hope to hear more tomorrow.
Thanks again
587083 tn?1327120262
Thanks for the clarification. But I am afraid this doesn't change much. All I can say is when images on either Mammogram or Ultrasound are not clear enough to determine the nature of a lump, it is not at all unusual that a Radiologist recommends a biopsy procedure. Most often a biopsy results in benign findings and I hope the same for your Mother.
Please let us know how things are proceeding and the best of . luck to your Mom. :)
Avatar universal
thank you :)
Avatar universal
Spoke with the Surgeon this morning and he also believes that he doesn't think it's anything but to be safe and for peace of mind to have a biopsy instead of  the watching and waiting.
They are gonna do a Needle Ultrasound Biopsy on Thursday, he said it's only the size of a pea, he couldn't feel it in it's location since its so small. He said if they can't get enough cells or can't obtain any then they will have to do a wire biopsy since he said when it's so small they have a hard time hitting it and if they can hit it they will probably take out most of it with the needle. He thinks it could be a fibroid? She thinks that's the term he used. If they can obtain the sample it will take 2-3 days for results.
Thanks for listening.
587083 tn?1327120262
Thanks for the update.
A fibroid is a "benign" growth in the breast that is solid and usually painless or only slightly tender..So if this is what your Mom has, please let her know that she shouldn't worry because these tumors are benign,but of course a biopsy would be the best course course of action to make sure and have peace of mind.
All the best to you both..
Avatar universal
Thanks for that info Zouzi. I'm really hoping it's just that.

I was also wondering due to the size of the mass, pea size, they didn't' really specify if they will do a fine or core needle biopsy. Do they generally do fine when they think its only a cyst? I wasn't sure if there is a way they decide or not.
587083 tn?1327120262
You are welcome! :)
I would think that they would do an ultrasound-guided biopsy using a very thin needle (after using a local anesthetic). If the lump is a cyst, the needle will take out fluid. If the lump is solid, the needle will take a sample of tissue to be examined under the microscope. However the Surgeon may decide which type of biopsy is best for your Mom. Both types of biopsies, FNA and Core biopsy are simple procedures, and the whole process from start to finish usually takes no more than 10 to 15 minutes.
I hope this helps….

Avatar universal
Yes that helps! I appreciate that. I was just wanting to make sure they do the most accurate type to not miss anything. If they end up just pulling out liquid can they tell it was probably a cyst or do other things contain just liquid?
587083 tn?1327120262
Hi again,
Well, a simple cyst is just a lump filled with fluid. A complicated cyst is also filled with fluid but mixed with old blood and sometimes just debris. These cysts are almost always benign.
A simple Fibroadenoma is a benign solid tumor and is made of glandular and fibrous breast tissue and contains no fluid.
Another type is a complex fibroadenoma, that contains other components such as fluid and calcifications (calcium deposits).
Please don’t worry, the Surgeon will decide which type of biopsy is best for your mom and I am sure nothing will be missed.
When you and you Mom will meet with the Surgeon, make sure to ask all the questions you have asked here to obtain the most accurate information.
Take care now…
Avatar universal
We got a report sent to our online portal and just wanted to list what they noted to see if anyone had any incite on this?

Ultrasound imaging left breast shows 4 x 6 mm complex hypoechoic nodule corresponding to patient's mammographic abnormality. As discussed with the patient this nodule is indeterminate in its appearance. Recommend consideration for biopsy.

1. A 4 x 6 mm complex nodule central left breast corresponding to
mammographic abnormality. Recommend consideration for biopsy.  
***** Final *****  
587083 tn?1327120262
According to the report this could very well be a tiny Complicated or a Complex Cyst; but as I mentioned in my previous post, since the Ultrasound image is uncertain, a biopsy is definitely required to obtain an accurate conclusion. It’s really impossible for any one of us to know for sure what this little lump really represents until a biopsy is performed. I am really sorry if cannot be more helpful to you…But I am hopeful that your Mom’s biopsy report will disclose benign findings.
Avatar universal
My mom had her Biopsy today and the Radiologist said she had the best scenario he would have wanted to see during the procedure. He completely drained nodule which turned out to be a Cyst, he got all clear liquid which is what he wanted to see. They did 3 follow up tests and could not locate any remains of the Cyst on another Mammogram and Ultrasounds. They will still send in for a report but he said he can't imagine it coming back as anything bad. So there first thought of it being a Cyst ended up being true. This really took a huge lift of stress off of us.

Thanks again for all the support and a special thanks to Zouzi for following up with so much useful information that really helped me understand this.
587083 tn?1327120262
Thanks for the update and CONGRATULATIONS to your Mom!
You made my day with this wonderful good news!
The Cyst was obviously a "simple Cyst" since it contained clear fluid and has virtually no chance of containing malignancy.
Wishing you and your Mom health and happiness. :)
Avatar universal
Thank you :)!!
Avatar universal
I wish you the best as well :)
Just wanted to put a final comment, the Biopsy report came back good!! She will do follow up in 6 months.
Thanks all for your support!
587083 tn?1327120262
Thank you so much for the update!
We are so happy to hear that the final Path report stated benign findings :)
All the best to you and your Mom....
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