QuestionQUESTION: I'm confused and would appreciate clarification. I had a stereotactic biopsy. There were two areas they were to biopsy. The first was an area of microcalcifications. That went fine thank God, and the results were "no malignancy".
The other sample they were to take was a retroareolar/central breast nodule that could be seen on the CC view. They said it may be localized within the 12 o'clock position but it was obscured by overlying fibroglandular tissue. The second look ultrasound failed to demonstrate the presence of a cyst. They assumed the area was solid.
When it came time for the biopsy of that area they could not detect it on the mammogram, so no sample was taken. I went back for a 3 month follow-up mammogram The doctor wrote the following:
"Vague nodule is identified at the site fo previous nodularity. No suspicious persistent nodularity is seen on today's study although the nodule still is seen on the medial breast. This is likely a nodular parenchymal pattern. Patient should return in 3/08 for bilateral mammogram and ultrasound."
That's 8 months away and corresponds with my annual exam. The Bi-rads category was 2: Benign findings.
My questions are:
1. what is this nodular area and what does all this mean?
2. Am I at higher risk for cancer because of it?
3. Why did she order an ultrasound in addition to the mammogram?
4. What is different that indicates I don't need the biopsy now?
Thanks so much for your help!
ANSWER: Were you evaluated by a surgeon experienced in breast cancer diagnosis and treatment? If not you should seek out a second opinion.
---------- FOLLOW-UP ----------
QUESTION: The doctor who wrote the report is a doctor who interprets the mammogram/ultrasound tests and also performs the biopsies at the hospital where I get my mammos. I actually had the surgery by another surgeon so that I could get the biopsy done sooner. I will be seeing him next week.
I was able to speak with the doctor who wrote the report today. She said that because the stereotactic is dimensional, if a nodule disappears on the sterotactic it means that it's a benign glandular tissue. She said these tend to blend in and won't be seen on the stereotactic pictures.
Does this make sense to you? Do you feel it's benign and normal? She said that women do develop these things as a normal part of aging. She said if I'm nervous I can have an MRI, which I would do with no question, however I'm concerned about the contrast (I've been diagnosed as multiple chemical sensitivites, allergies, restrictive airway disease, etc. I'm concerned about a reaction even without iodine in the contrast. I also have a very severe neck and back problem which will make the MRI painful. My neck has been significantly worse since the stereotactic procedure.
I'm very grateful for your opinion.
AnswerTo resolve the issue, the safest course is to have the MRI. The contrast agent, gadolinium, is very safe. Reactions to the agent are incredibly rare and mostly confined to itching when they occur. Your physicians are trying to settle the issue for you. Every test has limitations and you have encountered the limitations of a minimally invasive procedure such as stereotactic biopsy. Sometimes, when the breast is compressed the architecture changes and the area of interest disappears. This usually means the area of concern is benign. You want a certainty not possible from a single test. This is why the MRI was suggested and it is a good choice.
