In Jan. 2008, at age 45, I was dx'd with IDC, stage 1, ER+/PR+, HER2 -ve bc. I had lumpectomy for a 5mm. tumor, no nodes involved (0/3 on SLNB) and clear margins. I had a course of radiation tx and then started on Tamoxifen. My Oncotype Dx recurrence score was 7, putting me at relatively low risk for recurrence over 10 yrs. provided I take Tamoxifen for 5 yrs. I've tolerated the Tamoxifen seemingly well - relatively few side effects --- some hot flashes but otherwise okay. My 1 yr. follow-up mammo was fine (i.e., totally clear) but the breast MRI showed something "somewhat suspicious" near the top clip of the lumpectomy site. The radiologist's report classified this finding as BI-RADS 4A which, according to what I've researched on Google scholar, suggests that it may be fat necrosis or some odd scar tissue etc., with a relatively low chance of malignancy. I had an MRI-guided core biopsy last wk. (not a fun procedure) and am nervously awaiting the results. I'm praying it's benign and just fat/scar tissue, but if it's not, what are my options for intervention? If it's really tiny (which it is), can I have another lumpectomy with perhaps Mammosite-type radiation, or would I have to have more radical surgery and chemo? Do you know of any statistics on how likely BC is to recur within 6 mos. of finishing tx? Thanks so much for any help you can offer!
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Lyn, you had a really "good" initial diagnosis - VERY small tumor, no nodes, and your treatment was right on course. Low Oncotype, which means cancer wasn't at all aggressive. I'd bet this is just what the doctor says; scar tissue and/or necrosis. Understand that MRIs are notorious for picking up "false positives" - things that mammograms can't see, but that also aren't anything to do with cancer. Rather than borrow trouble, why not wait till you get the results before you start planning on cancer treatment? There's every chance this is NOT cancer. But if it is — yes, you can have another lumpectomy, and I'd assume you could have MammoSite; but you might want a mastectomy, just to put an end to your worries. Good luck - PJH
dr. report before biopsy- bi-rads cat4, what does this mean?
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