QuestionQUESTION: Hi-I'm 39 year's old & had a regular mammogram that I was called back on. I then did the digital imaging-more involved than first one-then I was asked to do an ultrasound. Results from first mammogram showed 2 nodules-9mm within posterior left breast and 6 mm nodule more anterior. Second mammogram corresponded with the first. Ultrasound states there are cysts at 2:00 and 9:00. Uncertain if this is what they saw on mammogram-reccomend ultrasound guided aspiration and post mammogram to see if nodules disappeared. Same reccomended for 2nd cyst.the BIRAD score was 4. My PCP said they would not do a biopsy on this because likely just a cyst. From what I have read-wouldnt it be standard procedure to check these for cancer? Should I be looking for a specific type of person to perform this procedure-ex. Breast surgeon? At the hospital, I am not sure who they assign to do the procedures. This is scheduled for next week-so any immediate help would be appreciated.
Thank you
ANSWER: If the biopsies are done as ultrasound guided needle biopsies - SHOULD be done! - then they are probably done in the diagnostic radiology department. The biopsies are then evaluated by pathologists. It SHOULD be standard procedure, especially since your radiologist has recommended it!
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QUESTION: Thank you for your response. The order from the PCP is for an ultrasound guided aspiration. This was also the reccomendation from the radiologist report. However, the BIRAD rating was 4--based on that wouldn't it be standard to do a biopsy on the cyst aspiration? I would like this done either way--how can I get this done? Would I ask the PCP (despite their belief it is just a cyst) or would I ask the radiologist or person performing the procedure?
Thank you again for your assistance
ANSWER: A BIRAD 4 lesion SHOULD be checked with a biopsy! You should ask for those biopsies (including the cysts, easily found by ultrasound) in the radiology department. That is what I believe but I'm a Swede living in Sweden and therefore unfamiliar with local procedures where you are.
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QUESTION: Thank you for your reply. I did the procedure yesterday which was the cyst aspiration. They did not biopsy the fluid--and said it was clear; therefore, not indicated. There were 2 nodules seen on the mammogram and 2 cysts seen on the ultrasound. The thought was that once the 2 cysts were aspirated....the nodules would disappear. I did a mammogram right after the aspiration---and one of the two nodules was still there. They followed with an ultrasound...and did not find a cyst or anything they felt was of concern. I spoke to the radiologist who stated that I could just follow up in 6 months with another mammogram to see what if anything has changed. She stated that she did not see a tumor or anything that was of concern to her--but needed to speak to the MD that did the actual procedure.
She did state that I could get an MRI to more clearly discern the mass. So, I am not really sure what to do at this point. Clearly there is still something there...but they said that is probably normal?? I guess I am not sure how they know that? It is seen on the mammogram and not the ultrasound....is it more likely that tumors are picked up by mammogram than ultrasound? So that if something was seen on the mammogram....I don't understand why we are not trying to find out what it actually is?
I don't want to be paranoid but am concerned about waiting another 6 months if it is something else?
What do you think?
Thank you in advance for your reply.
AnswerIf something is still seen and it is not known what it is I think it is better to have it checked directly with a needle biopsy to see what it is instead of waiting 6 months! X-ray mammography & ultrasound scanning are 2 very different methods. Each of them are good for specific (different) things so one is not better than the other. It is best to use them together! it is the same with MRI. So INSIST on a needle biopsy!
