QuestionI'm 41 and a "thickening" was found in my left breast between 6-8 o'clock during my mammogram last week. Today I had a follow-up ultrasound, during which the tech said she was sure it was a cyst - she showed me that the area was dark and defined (sort of an oval). But the consulting doctor at the radiology center came in ten minutes later and said it was definitely NOT a cyst and they don't know what it is. My doctor got the report and told me to see a surgeon for biopsy. I can't feel this lump at all, though they say it's 3 cm, which sounds big to me.
Naturally I'm very scared - if the "mass" is black on ultrasound, as it appeared to my eye, doesn't that indicate fluid, and doesn't that indicate cyst? Could the tech really be that sure and that wrong? The fact that my OB/GYN wanted me to see a surgeon once she saw the report, and the fact that the surgeon got me in within a week (instead of the 2 month wait they indicated prior to getting the report), also scares me.
It all scares me. My mother and sister have a history of fibrocystic breasts, I've been taking birth control pills for PCOS for the past two months and they've given me very tender breasts, vague nasuea and other hormonal symptoms. Also, I nursed my two children - now 17 and 7 - for a total of three years and did get mastitis in this left breast twice.
Does any of this additional information point toward "probably nothing to worry about"? And if it is the worst, does 3 cm mean it's advanced?
AnswerAs I have not examined you, reviewed the medical record, lab tests, or imaging, what follows is offered for information purposes only and does not constitute treatment. I always suggest a thorough examination by a health care professional before embarking on a course of treatment.
While technicians are very good at ascertaining how to perform a diagnostic test, leave the diagnosis up to the experts- the radiologist and surgeon. They are the professionals with twelve years of post-graduate study and the board certifications. If I had fifty cents for every time a technician or nurse made a diagnosis and was only marginally correct or outright wrong, I would be rich. They simply have too little information and function in a very narrow niche of medicine.
Let us return to the big picture. You need to see the breast surgeon for an evaluation where your entire medical history and physical examination will be reviewed. At that time, the surgeon will review the results of your imaging study and a decision will be made as to the appropriateness of a breast biopsy. Complex cysts are just that, complex. They may have fluid in them and contain varying amounts of cellular matter, debris, and scar tissue. You point out a family history of fibrocystic disease and a personal history of mastitis. These make your examination difficult and referral to an expert is indicated.
As to the timeliness of referral, the standing policy in my office has always been to accept breast referrals expeditiously because these patients were all "worried." Every patient was "convinced," she either had breast cancer or there was nothing to worry about because some ancillary health professional (in your case a technician) had jumped to a diagnosis. Either way the situation is scaring the crap out her.
My input is to follow your physician's advice. Second, I would report the technician who "diagnosed," you as this is wholly inappropriate.
