Mammo results question - UPDATE #9

[mom2boys]

Received a letter from the radiology lab indicating

Your recent breast imaging examination dated xx/xx/xxshowed an area that we belive is BENIGN (NOT CANCER)

. THe letter goes on to state that I should have a follow-up in 6 months to confirm this area has not changed The next paragraph then touts the importance of early detection of cancer & not all cancers are found through mammography.... SO I have a huge mixed message - got this problem, bury my head in the sand for exactly 6 months and IF it is something it has had 6 months to grow
I made an appt with my GYN for Monday to discuss these results. Maybe I'm overreacting. I don't think so. ANyway, what should I be asking her? Should I insist on additional testing? a lumpectomy? what?

 

[Christine]

but, I would not let it wait.

Last year, I had a mammogram that showed a lump. I was then referred to ultrasound and the radiologist told me himself that he was certain that it was a fibroadenoma. BUT...he said that you can NEVER, EVER get a determination on a solid lump from any radiology report (mammogram/ultrasound). So, even though the radiologist was "heavy" on the words "probably benign" he also recommended that I go have a biopsy of it.

As it turned out, it truly was benign, but I don't think I would have wanted to let it go.

So, I think I would try to get a copy of that report and figure out if the lump is solid or liquid. A liquid lump, I believe is 99.9999% not cancerous, and you "can" watch them.

I guess I'm really shocked that they did not recommend a follow up ultrasound to see exactly what it was made of.

I think going to your GYN is a good idea; however, I don't think I would let anyone put me off for six months.

Insist on an ultrasound. If that comes back "weird" get a referral to a breast surgeon. I think you're in Maryland, right? If so, I can tell you some good ones.

 

[dianeschlicht]

When I had a questionable result, the doctor ordered an ultrasound immediately. I would definitely call and ask about that.

 

[Christine]

Yeah, I wanted to add (prompted by dianes post) that when my screening mammogram came back "funny" the radiology center called me back and told me it was funny, that they wanted to do a diagnostic mammogram and possibly and ultrasound. All this they did on their own--not my doctor.

It just seems odd to me that they would not push for further testing. In this day and age, they usually overreact to stuff. I'd love to know what the report says.

 

[HOGFAN]

As a mammographer of 20 years, I think I can help you out.
As a general rule, mammograms are "overread" , too much litigation out there.
Mammograms are like fingerprints, everyones are different, they are the hardest exams a radiologist has to interpret(also the least reimbursed, but thats another story) . The example I often give: If you had 100 women in a room and took pictures of their big toes, everyones big toe looks the same. But take a picture of everyones mammogram, you got 100 DIFFERENT pictures.
If it was your first mammogram, 6 months will just confirm your breast pattern(which is unique to you)

If its not your first, dont panic, it could be a new nodule that looks benign(like a lymph node) but want to get a short term look at it. Or it could be a very slight increase(or new) calcification(BTW: EVERYONE has calcification of some sort)
Mammograms are hormone,diet, and stress driven also. If you went just before your period, had some extra caffeine days prior, or are lately under alot of stress, your mammogram can look different from before.

Believe me, if they thought you really had something going on, they would have called you back for extra stuff immedietly. And sometimes you need that time frame to see if something really IS changing.
Try not to worry, but I would be okay with it.

 

[AMcaptured]

I have had similar results and asked for an ultrasound for confirmation of "benign" dx also.

Good Luck, I know how much anxiety it can cause.

 

[mom2boys]

I had a baseline 8 years ago and a regular mammo 2 yrs ago. The lab may or may not have the baseline, but they definitely have the one from two yrs ago. I am thinking it is either caffine or scar tissue from a twenty yr old injury.

 

[NHAnn]

Re-read HOGFAN's post carefully. I would ask what specifically is seen in the "area". As HOGFAN pointed out, it could be calcifications or something else (nodule, cyst, etc). If it's calcifications, an ultrasound is useless as it can't "see" them. An ultrasound can determine if a lump/abnormality seen on mammogram or felt in examination is fluid filled, like a benign cyst. If the ultrsound shows a solid abnormality, it could still be benign, like a fibroadenoma. A solid abnormality could be cancer--or it could be a benign condition like a fibroadenoma. 80-85% of calcifications are benign. A cluster of them can be a possible indication of cancer....very early cancer. If they appear to have increased in number and look more suspicious after the 6 months, the only way to determine if it's cancer is biopsy. Typically nowadays the biopsies are less invasive. A lumpectomy would be a done as a possible treatment ONLY after a biopsy indicated cancer. But don't even "go there", even hypothetically at this point. Ask for a copy of the radiolgists report. Talk to your GYN. If it's calcifications, the six months wait (or denail ) is extremely likely to end in celebration of good news. If it's another type of abnormality, you might want further testing like ultrasound.
Sorry if that's TMI or scarey. There's LOTS of user-friendly info here breastcancer.org
And lots of helpful DIS-ladies here...for questions or support DIS Breast Cancer Survivors
Sigh...I swear there has GOT to be a better way to test and diagnose
Be postive and optimistic...if the very unlikely event that there IS something , you've caught it very very early and it's not only treatable but in many cases curable.

 

[mom2boys]

Saw my Doc today. The report they sent her is MUCH more detailed than the info they sent me. Apparently the cause for concern is that I'm asymetrical (sp?) and the lab failed to compare the current results to the results from 2004 -claimed there were no prior results. Same lab, so there was no excuse for this. I called the lab & politely but firmly requested that they review my results in comparison to the 2004 results & issue a report in light of that info. The tech who answered was great - couldn't explain why there was no comparison but was able to find it. She was going to read the results herself when we got off the phone.

 

[Daxx]

Had my very first mammo. in August 2005. While I was still there, Radiologist requested a magnified mammo of a particular area where they spotted calcifications. Had the magnified mammo and radiologist said they were calcifications ... small, and 1% chance of cancer or could be pre-cancer but more than likely were benign. Radiologist offered the option of a biopsy (stereotactic core needle) or wait the 6 mos. to see if there were changes in the area. I cannot sit on something like this and "ride it out" for 6 mos so I requested the biopsy. Thankfully, it came back benign. I still have to go back in March for a "review" to see how things are. But, I can rest assure that what it was ended up being benign. I know I'd be a wreck if I just had to wait the 6 months ... but that is me.

Thankfully, you have another mamm. to compare it to and you're smart to check w/your GYN to see what his/her thoughts are.

BTW -- my biopsy was not bad at all. I had imagined it to be much worse than it actually was!

Good luck and keep us posted! P&PD to you!

Warmly,
Daxx's Wife

 

[staceyfe]

The tech who answered was great - couldn't explain why there was no comparison but was able to find it. She was going to read the results herself when we got off the phone.

Huh? A tech will re-read your mammo? I am a mammo tech, ultrasound tech, and biopsy tech at a highly respected facility and I feel that a radiologist (doctor who specializes in xray/ultrasound, etc.) should compare prior films to current ones. If you are asymetrical, you are probably fine, but at our facility we would definitely call you back in immediately for repeat views and cone compression views, and perhaps an ultrasound, depending on what the repeat films look like. If everything were ok, then and only then would we recommend a six month follow up. It has been my experience that some facilities are not quite as cautious or aggressive as we are, but why take the chance? You are proably fine, but having a tech re-read is just ridiculous.