can doctors tell by mammos

CAchick said:

Mine was fast, too
Hi Lynn,
I had a bad mammo report (routine mammo after a checkup) that I received on a Wednesday, with the news that I was set up to see a surgeon on Friday. Had a lumpectomy the next Friday, and received my cancer diagnosis the next Tuesday. (That was two years ago this month).
Pretty quick...From OK to Cancer in two weeks...
Sybil

Found my lump
and saw my GP on Monday. While I was there she called the surgeon and made an appointment for the next day. I thought we were scheduling a biopsy but he did a needle biopsy in his office, scheduled a mammo, a PET scan, and an MRI. By Friday I had an appontment to have a port put in and an appoitment with an oncologist. Saw the onc on TUesday and started chemo on THursday. It was a whirlwind! But then I didn't have any time to sit and brood or worry - things moved too fast for that.

Interesting Question
I had my regular mammo on 3/17/09 (yay St. Patrick's day), was called back on 3/20/09 for another look. They told me there was a question which had happened before and they knew I worked and had an early appt that would work for me -- I like a total dummy fell for it and had no clue. I had my biopsy on 4/1/09, although everyone who saw the mammo told me "they knew" got the results on 4/2/09 via phone from my gyno. Lumpectomy on 4/22/09 and started chemo 5/23/09.

My tumor was IDC stage 3a, 6.5cm. I'm sure at the time it didn't feel very quick, but looking back it really was and I'm sure it was because of the size and stage.

Also my attitude helped, I think. The first time I met my onc, after his explanation of procedures and treatments when he asked if I had questions, all I wanted to know was if they had a chair open that day, I was ready.

marge

mammo and US
Lynn,
Ultrasound has become very proficient at determining the nature of a mass. Mammo's still require some additional testing. When I had mine I wanted to have the lumpectomy right away and not bother with the biopsy. The radiologist wanted the biopsy since it could be scheduled sooner. The advantage for me was that they found another mass during the ultrasound for the biopsy. I also had chemo prior to the mastectomy. My MO used the masses to be sure the chemo was working. (it was)
Every doctor is different. If they are thinking lumpectomy then chemo or just lumpectomy, the excisional biopsy could be right.
When ever you have questions, ask the doctors too. They are usually happy to explain.

Cindy

PS - Our departments goal is lump to biopsy in 2 weeks or less. We are an accredited Breast Care Center.

Feeling a lump is not always accurate.
October 20, 2010 I saw a family dr. for a breakfast sausage link sized lump in my breast. He felt it and told me not to worry because cancerous lumps have fingers that jutt out and aren't round and smooth like mine. Boy was he wrong. I had already scheduled myself a mammogram for November 1, 2010 (one radiologist was on vacation and couldn't get me in sooner). Mammogram was suspicious, so good thing they had already scheduled for an ultra sound, too. Ultra sound was suspcious as well, so radiologist did a ultrasound guided core biopsy. Biopsy results came back two types of precancer, but the lump was too large that she didn't trust that I didn't have cancer in it somewhere and recommended (but she also said, and this is a Harvard graduate...that the surgeon would not take the whole lump out, leaving some of the precancer behind, the surgeon would just take out the really bad looking parts so my breast wouldn't be disfigured. Holy cow was I in a tizzy, why in the world would the surgeon go in to take "some" out, and like the biopsy sample, how would she "know" she got all the cancer...) November 9,2010 saw the surgeon, guess I was lucky that I made the appt in November, couldn't get into see her sooner either and receptionist wouldn't let me see someone quicker. Lumpectomy was November 26, 2010 (no one told me to eat a LIGHT meal before sugery and no alcohol and it was scheduled the day after Thanksgiving!). This crap and that crap happened, plastic surgeon was fired, oncologists were fired and finally had my double mastectomy 1/11/11. Turns out DCIS, since it grows in the milk ducts is round and smooth.

Lynn Smith said:

Gee this answer was fast
Georgia,Thank you for your response.

That was fast.I always got things done fast years ago(over 40 years) after a lump being found but not now.Seems the wait time is longer than I want.My doctor wants to do a consultation then excisional biopsy instead of a needle biopsy.The tumor is very small and he always thinks the lumpectomy and biopsy should be done at the same time. Not just a biopsy but both procdecures.Also take tissue samples/biopsies of surrounding tissue. Clear margins etc.So skipping the needle biopsy and going straight to the lumpectomy and checking margins etc.

The group I see are breast surgeons. Also trauma doctors. Very well known. I've been with the group for over 40 years.But things seem different than years ago.But then we didn't have all these tests and mammos.

Lynn Smith

After my mammogram showed
After my mammogram showed something suspicious, my doctor ordered a core needle biopsy in a couple of days which showed I had bc. So, it was fast.

Lynn Smith said:

Seems some get in sooner than others
I see some are in getting everything done within a couple weeks and some over a month.I guess it depends on doctors schedules, if the lump is small or large and consulting.

I read things about excisional biopsies.It all goes including tissue around the growth at the same time.Just this waiting drives a person nuts.

The radiology doctor said I have 2 cysts plus one he isn't sure of.Why He wanted to do the needle biopsy but my surgeon wants to go straight to doing it all since the tumor or cyst is so small.He felt the same way with my DCIS.Then though a needle biopsy was done but he would've preferred a lumpectomy/biopsy at the same time.I read where your breast can be I guess distorted with a excisional.Who cares.I guess doctors don't want you to be shocked and why the consultation.Also going over my mammo/ultrasound probably too. I have no scars really from my first surgeries with DCIS since it was in the nipple area but will have one with this.

The radiology doctor said he thinks it is a cyst or even a possibly benign tumor.But biopsy is the only way knowing.

Lynn Smith

not just the outside
Every time you have surgery on the breast you can create scar tissue inside the breast which makes reading the mammos more challenging. It also changes the look of the breast tissue. That may be why the rad wants the core biopsy. He may be leaning towards benign and not want to have you go through surgery?
As far as the difference in cue times for diagnosis and treatment, it depends on if you have a cancer treatment center, or a large hospital or if you are in a rural area. Fortunately in the Bay Area here, things move quickly.

All the best!
Cindy

e_hope said:

short
My wait was very short. I had my mammo on a Thurs (basically told then it was cancer) Saw surgeon on Tues (appt with surgeon was scheduled prior to having the mammo by my PCP) and had a biopsy wed and was confirmed on Monday

Some of these cancers seem
Some of these cancers seem really tough to diagnose. I saw my oncologist almost two months ago for my leukemia, mentioned the change I found in my breast. He did a manual exam and said he didnt think it was cancer but to rule it out sent me across the road to a nationally reknowned breast cancer center. There I had three mammograms, two ultra sounds and two manual exams. The radiologist said she didnt think it was cancer and told me I have very messy breasts. But she ordered a breast MRI to rule it out. That came up suspicious so a MRI guided breast biopsy was ordered. And here we are. I thank goodness even though really great doctors doubted it was cancer they were persistent in being sure. Now its been three surgeon appointments and my pre op next week. Surgery for a bi lateral is finally scheduled for August tenth a little over two months since I found the lump. WAY TO LONG. My brain is threatening to melt down from the stress. The tenth cant come fast enough...and is coming to fast. Jayne

CypressCynthia said:

My opinion and experience
Sometimes it is obvious and sometimes it is not. In my case, the radiologist read my mammogram as probable carcinoma. In my sister Jeannie's case (she felt a lump), nothing suspicious was seen on mammogram, but her biopsy was DCIS (ductal carcinoma in sito). In my sister Wendy's case, she went in complaining of a right-sided lump and her mammogram came back suspicious for carcinoma of the LEFT breast.

In the 2 cases where the radiologists were suspicious, they were correct, but, in Jeannie's case, they missed a very, very small lesion.

All tests, xrays, scans, etc. are simply tools and none of them are absolutely reliable. Reliability increases with repeated and comparative testing. Also, as some have pointed out, some breasts are easier to read by mammograms, etc. than others: increased density, multiple benign cysts, scarring, etc.--all can make it harder to read. A biopsy is the "gold standard" because it allows physicians to examine the tissue itself.

CC thank you once again for
CC thank you once again for your informative description.