Wednesday, June 22, 2011 overanxious asks

Q: When to seek a biopsy for a thickened area?

Hi,

I am 42 years old and my nurse practitioner found a small thickened area in my right breast, below the nipple at 6 o'clock. I have had irregular periods and she suggested it might be from hormone irregularities. I had a diagnostic mammogram yesterday which was compared to my mammogram done 2 years prior. I was sent home with a piece of paper checked "no evidence of cancer". I did not see or talk to the radiologist. I can still feel the thickened area - particularly when standing up, less if I lay down. Should I seek out additional tests and a biopsy? Why would the radiologist choose not to screen with ultrasound? I googled thickened area and got scared to death- lots of reports of horrible cancers missed on mammograms. I am ridiculously anxious and made an appointment with the nurse practitioner tomorrow. Is there anything specific I can/should ask her? Some family history - maternal grandmother, and two aunts on my Dad's side.

Thanks!

- A
- A
- A

Answers (2)

PJ Hamel, Health Guide

6/22/11 1:10pm

Hi - I'd explain to the nurse practitioner that, due to a family history of breast cancer, you're super-vigilant about any kind of lump, and you'd like to know exactly what this thickening is. Chances are it's nothing to worry about, as the mammogram results showed. But there's nothing wrong with finding out exactly what it is - for your own peace of mind.

An ultrasound would determine pretty definitively if the thickened area is a cyst. If it's not, an MRI would be the next step, prior to biopsy. Unfortunately, all of these tests are expensive; and MRI has a very high false-positive rate - that is, about 50% of the time an MRI will see something "suspicious" (requiring a biopsy) when it's actually just fibrocystic change, or some other natural feature of your breast. Thus, doctors are sometimes reluctant to order tests, especially when, in the case of MRI leading to biopsy, they may cause physical damage.

So, it's up to you how hard you want to push this. You said you're over-anxious; and you know yourself better than anyone. So advocate for yourself tomorrow, telling the nurse practitioner that you won't feel OK until you find out exactly what's causing this breast change. Best of luck to you - PJH

overanxious

6/22/11 3:02pm

Thanks for the quick answer. Can a biopsy leave scar tissue that could be problematic for future breast cancer imaging?

PJ Hamel, Health Guide

6/22/11 3:15pm

Yes, although since they know where the biopsy was done, they can factor that into future readings. Still, the less you operate on your breasts, the better/easier it is to read mammograms. Take care- PJH

Phyllis Johnson, Health Guide

6/22/11 7:03pm

A thickened area does need to be watched closely, but it doesn't necessarily indicate cancer. An ultrasound could be a good follow-up test. A fine needle biopsy would not leave much scarring, so that might be an option. Talk about all your options with the nurse practitioner and then make the best decision possible. Let us know what you find out.

Q: When to seek a biopsy for a thickened area?

Related Questions

Ask a Question