What to ask when nurse calls with biopsy results?
I had a biopsy done last Thursday and expect a call from the nurse early this week about the results. The diagnostic mammogram states in pertinent part "...clustered small amorphous calcifications spanning 2.3 cm are seen...." These are increased in number since the previous diagnostic image of October 2015, hence the recommendation of biopsy. No mass was detected in either breast. The BI RADS classification is 4B- Suspicious Finding; Intermediate Probability.
I don't imagine the nurse tells you more than basics of diagnosis reading from the report and maybe s/he tells you they've set up a surgical consult with Dr. X, if the results indicate that surgery is recommended. What was your experience? What questions should I ask the nurse, if any? At what point do you ask for a second opinion? I am currently in treatment for a second recurrence of endometrial cancer so I want to be diligent in getting second opinions.
Thanks for any advice. Best wishes, Oldbeauty
Comments
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Thanks for the feedback
I happened to be at my endocrinologist this morning and she told me the biopsy results were "fibrocystic changes" which she said is benign. Then the nurse at the breast center called and gave me the same info with the addition of repeat mammo in one year (not 6 months). I will be able to pull the path report in about two days from my online interface which I hope has more info. Fibrocystic changes can still indicate early DCIS and I want more info. They took 6 specimens of which 4 contained the microcalcifications. So, I expect there to be 4-6 slides with descriptive analysis of more than just "fibrocystic changes." From my reading, there should be analysis of whether the cells are "proliferative" or "non-proliferative" and if "proliferative" should be further defined as "atypical" or "without atypia." So, I will wait til I can pull the report and take it from there. Thanks again for your input. Best wishes, Oldbeauty
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Of coursetufi000 said:Duh
TALK TO YOUR ONCOLOGIST!!!!!
I just logged on to my online medical file and see that the "fibrocystic changes" remark is in the addendum to my biopsy procedure report entered by the diagnostic radiologist who presumably has access to the pathology report, which I do not have yet. So I will pursue getting the path report and follow up with the appropriate Doc, whether that be my PCP or my gyne oncologist. But rest assured I won't stop until I am satisfied that I have a complete picture. Thanks and best wishes. Oldbeauty
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Get a definite diagnosisoldbeauty said:Thanks for the feedback
I happened to be at my endocrinologist this morning and she told me the biopsy results were "fibrocystic changes" which she said is benign. Then the nurse at the breast center called and gave me the same info with the addition of repeat mammo in one year (not 6 months). I will be able to pull the path report in about two days from my online interface which I hope has more info. Fibrocystic changes can still indicate early DCIS and I want more info. They took 6 specimens of which 4 contained the microcalcifications. So, I expect there to be 4-6 slides with descriptive analysis of more than just "fibrocystic changes." From my reading, there should be analysis of whether the cells are "proliferative" or "non-proliferative" and if "proliferative" should be further defined as "atypical" or "without atypia." So, I will wait til I can pull the report and take it from there. Thanks again for your input. Best wishes, Oldbeauty
oldbeauty,
First of all, you need an ultrasound of that breast. An MRI isn't as good at showing the whole picture. At least it wasn't for me. And if you have dense breasts, ( like me), it's even harder to see what's really going on. My mammogram showed many microcalcifications and I had a follow- up MRI which showed several areas that were stated in the radiology report as " Most probably benign." I then went back for yearly mammos for another 4 years with the results being "normal mammogram, no indication of cancer." Well, at my next mammo, the Radiologist spoke to me and said that my microcalcifications were now showing a "particular pattern" which was of concern and that I should have a breast biopsy. I did. Bingo! Lobular Breast Cancer right where those microcalcifications were seen. Only a tiny area showed this cancer, like .5 cm. I had a lumpectomy which showed one sentinel node positive out of 7. No scans were done to see what condition the rest of my body was in. Not even any bloodwork!
I was put on Arimidex as I was EST+. Did that for 1 1/2 yrs when all of a sudden I had fractures in my ribs and spine! Original Oncologist messed up my appointment to get a bone biopsy. Then I couldn't reach him + he never called me back! I ended up seeing my Primary doctor who got me the necessary biopsy and scans which were long overdue. Bottom line: I have extensive bone metastises. Goodbye to old Onc and hello to new one who's watching me very very carefully.
Because the area of my microcalcifications was small, it was considered not a situation that needed immediate attention or further testing.Wrong! Lobular breast cancer is hard to detect anyway, and in all the time that went by, it was spreading to other parts of my body. I think the Radiologist and my old Onc were shocked. But, they were NOT thorough!
So I now live in the Stage 4 world and it's a scary place to be. It's incurable. I've been on 5 different treatment drugs so far. I hold my breath at each doctor's appointment to find out what my latest tumor markers show or what my scan results are.
My advice: Get the necessary tests to get to the bottom of those microcalcifications. Don't settle for " It's most likely benign or fibrocystic changes." And definitely DO NOT wait one whole year to get another mammogram! If you have dense breasts, I hope you're getting a 3-D mammogram now.
If your Birades grade was 4, that's HIGH. Mine was 3 and my Oncologist told me that they should've looked into my situation more. He said a 3 deserved more inspection. Believe it or not, knowing my mother and sister both had had breast cancer, I had originally been put on a " Watch List." After my MRI, they took me off this list and treated me as if I had no history of breast cancer in my family.
Just be on top of things, if you aren't sure you're being handled carefully, go for a 2nd opinion, for sure! Bring your mammograms and have your lab slides sent to the 2nd opinion facility. I did. It's very reassuring to do this and insurance encourages it. I've even gone for another opinion while still keeping my good Oncologist. He also encourages more opinions.
Anyway, I wish you much good luck in pursuing your breast health. Hopefully, all is well. Take care. Kats2
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KatsKats2 said:Get a definite diagnosis
oldbeauty,
First of all, you need an ultrasound of that breast. An MRI isn't as good at showing the whole picture. At least it wasn't for me. And if you have dense breasts, ( like me), it's even harder to see what's really going on. My mammogram showed many microcalcifications and I had a follow- up MRI which showed several areas that were stated in the radiology report as " Most probably benign." I then went back for yearly mammos for another 4 years with the results being "normal mammogram, no indication of cancer." Well, at my next mammo, the Radiologist spoke to me and said that my microcalcifications were now showing a "particular pattern" which was of concern and that I should have a breast biopsy. I did. Bingo! Lobular Breast Cancer right where those microcalcifications were seen. Only a tiny area showed this cancer, like .5 cm. I had a lumpectomy which showed one sentinel node positive out of 7. No scans were done to see what condition the rest of my body was in. Not even any bloodwork!
I was put on Arimidex as I was EST+. Did that for 1 1/2 yrs when all of a sudden I had fractures in my ribs and spine! Original Oncologist messed up my appointment to get a bone biopsy. Then I couldn't reach him + he never called me back! I ended up seeing my Primary doctor who got me the necessary biopsy and scans which were long overdue. Bottom line: I have extensive bone metastises. Goodbye to old Onc and hello to new one who's watching me very very carefully.
Because the area of my microcalcifications was small, it was considered not a situation that needed immediate attention or further testing.Wrong! Lobular breast cancer is hard to detect anyway, and in all the time that went by, it was spreading to other parts of my body. I think the Radiologist and my old Onc were shocked. But, they were NOT thorough!
So I now live in the Stage 4 world and it's a scary place to be. It's incurable. I've been on 5 different treatment drugs so far. I hold my breath at each doctor's appointment to find out what my latest tumor markers show or what my scan results are.
My advice: Get the necessary tests to get to the bottom of those microcalcifications. Don't settle for " It's most likely benign or fibrocystic changes." And definitely DO NOT wait one whole year to get another mammogram! If you have dense breasts, I hope you're getting a 3-D mammogram now.
If your Birades grade was 4, that's HIGH. Mine was 3 and my Oncologist told me that they should've looked into my situation more. He said a 3 deserved more inspection. Believe it or not, knowing my mother and sister both had had breast cancer, I had originally been put on a " Watch List." After my MRI, they took me off this list and treated me as if I had no history of breast cancer in my family.
Just be on top of things, if you aren't sure you're being handled carefully, go for a 2nd opinion, for sure! Bring your mammograms and have your lab slides sent to the 2nd opinion facility. I did. It's very reassuring to do this and insurance encourages it. I've even gone for another opinion while still keeping my good Oncologist. He also encourages more opinions.
Anyway, I wish you much good luck in pursuing your breast health. Hopefully, all is well. Take care. Kats2
That is very good advice. What happened to you never, ever should have happened. I am so sorry that those doctors failed to properly diagnose you! There are some people, if not most, who just trust the doctors and don't question them. It sounds like you are in good hands now!
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Glad you're perseveringHapB said:Kats
That is very good advice. What happened to you never, ever should have happened. I am so sorry that those doctors failed to properly diagnose you! There are some people, if not most, who just trust the doctors and don't question them. It sounds like you are in good hands now!
Old beauty,
I'm glad you're pursuing your biopsy results. I hope that your Gyn doctor and PCP will not just side with the Radiologist and your Oncologist. That's why I think an "outside' opinion at a well- known Cancer Center would be beneficial.
Do you know that before I went for my second opinion, the Radiologist at my hospital had written down "Ductal Carcinona with some Lobular features" in the biopsy report? Well, when the consulting lab re-analyzed my slides, they found STRICTLY Lobular Carcinona!
God knows how my treatment plan would have been with this wrong diagnosis of my breast cancer type! I'm SO glad that my slides were reviewed by other radiologists at the 2nd Cancer Center!
This is food for thought. Good luck with your decisions. Kats2
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Thank you, Kats2Kats2 said:Get a definite diagnosis
oldbeauty,
First of all, you need an ultrasound of that breast. An MRI isn't as good at showing the whole picture. At least it wasn't for me. And if you have dense breasts, ( like me), it's even harder to see what's really going on. My mammogram showed many microcalcifications and I had a follow- up MRI which showed several areas that were stated in the radiology report as " Most probably benign." I then went back for yearly mammos for another 4 years with the results being "normal mammogram, no indication of cancer." Well, at my next mammo, the Radiologist spoke to me and said that my microcalcifications were now showing a "particular pattern" which was of concern and that I should have a breast biopsy. I did. Bingo! Lobular Breast Cancer right where those microcalcifications were seen. Only a tiny area showed this cancer, like .5 cm. I had a lumpectomy which showed one sentinel node positive out of 7. No scans were done to see what condition the rest of my body was in. Not even any bloodwork!
I was put on Arimidex as I was EST+. Did that for 1 1/2 yrs when all of a sudden I had fractures in my ribs and spine! Original Oncologist messed up my appointment to get a bone biopsy. Then I couldn't reach him + he never called me back! I ended up seeing my Primary doctor who got me the necessary biopsy and scans which were long overdue. Bottom line: I have extensive bone metastises. Goodbye to old Onc and hello to new one who's watching me very very carefully.
Because the area of my microcalcifications was small, it was considered not a situation that needed immediate attention or further testing.Wrong! Lobular breast cancer is hard to detect anyway, and in all the time that went by, it was spreading to other parts of my body. I think the Radiologist and my old Onc were shocked. But, they were NOT thorough!
So I now live in the Stage 4 world and it's a scary place to be. It's incurable. I've been on 5 different treatment drugs so far. I hold my breath at each doctor's appointment to find out what my latest tumor markers show or what my scan results are.
My advice: Get the necessary tests to get to the bottom of those microcalcifications. Don't settle for " It's most likely benign or fibrocystic changes." And definitely DO NOT wait one whole year to get another mammogram! If you have dense breasts, I hope you're getting a 3-D mammogram now.
If your Birades grade was 4, that's HIGH. Mine was 3 and my Oncologist told me that they should've looked into my situation more. He said a 3 deserved more inspection. Believe it or not, knowing my mother and sister both had had breast cancer, I had originally been put on a " Watch List." After my MRI, they took me off this list and treated me as if I had no history of breast cancer in my family.
Just be on top of things, if you aren't sure you're being handled carefully, go for a 2nd opinion, for sure! Bring your mammograms and have your lab slides sent to the 2nd opinion facility. I did. It's very reassuring to do this and insurance encourages it. I've even gone for another opinion while still keeping my good Oncologist. He also encourages more opinions.
Anyway, I wish you much good luck in pursuing your breast health. Hopefully, all is well. Take care. Kats2
Thanks for sharing your story. I have put in a request for my path report and I have asked my PCP to pursue as well and review and get back to me. I am currently in treatment for recurrent endometrial cancer and I finished my last chemo yesterday. In September, I will have a PET/CT from mid-thigh to skull base to evaluate my treatment (which has been going well for shrinking the lung nodules that appeared) and to investigate a new soft tissue lesion in my right adnexal area just discovered. I do have dense breasts and when I had a PET/CT in January 2015 some mild pick up in breasts and stomach was further evaluated. I had a 3D mammo then followed by u/s and consensus was no issue. Now that I am an active recurrent patient maybe the call back for a 3D mammo last month was out of an abundance of caution; I did ask the radiologist to also do an u/s which she did and which she said also showed no masses and gave no further insight into the microcalcifications. She seemed to me to be mainly attentive to the linear pattern of the increased microcalcifications from 2 years ago. Hence the 4B BI RADS classification and the biopsy. I certainly want to know how concern translated into "nothingburger" and want the path report and I expect to seek second opinion in any event. It is good that I'm getting the PET/CT, I think. Thanks again for sharing your story. I am so sorry it turned into such a nightmare and I hope you are faring well. Best wishes, Oldbeauty
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All of this borders on the rediculous. Nurses are not permitted to give diagnoses nor probable possibilites
While we all care about your issue, NONE of us are qualied nor permiited here to suggest the possible resulte. The WORST thing is for you to make assumptions from what the nurses say, reading reports, or most imprtant the internet junk.
If they haven't given you an oncologist, insist on an opinion from one.
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Thank you, tufi000, for your considerationtufi000 said:All of this borders on the rediculous. Nurses are not permitted to give diagnoses nor probable possibilites
While we all care about your issue, NONE of us are qualied nor permiited here to suggest the possible resulte. The WORST thing is for you to make assumptions from what the nurses say, reading reports, or most imprtant the internet junk.
If they haven't given you an oncologist, insist on an opinion from one.
I appreciate your time and concern. I have an oncologist but it is a gyne oncologist who is treating me for my second recurrence of endometrial cancer. It was my PCP who wrote the script for the screening mammo which turned into a 3D screening and an ultrasound and then biopsy. I am expecting to have a copy of the actual pathology report in a day or two and I have asked my referring physician to follow up on this and report back to me. I don't really expect anything from my gyne onco unless I have another primary cancer to report to him but I am keeping him informed. Once I get and review the pathology report I will consider a second opinion. Don't worry, I am not going to blithely accept a second-hand reading of the path report from a nurse or even the diagnostic radiologist. Thanks again. Best wishes, Oldbeauty
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HugKats2 said:Get a definite diagnosis
oldbeauty,
First of all, you need an ultrasound of that breast. An MRI isn't as good at showing the whole picture. At least it wasn't for me. And if you have dense breasts, ( like me), it's even harder to see what's really going on. My mammogram showed many microcalcifications and I had a follow- up MRI which showed several areas that were stated in the radiology report as " Most probably benign." I then went back for yearly mammos for another 4 years with the results being "normal mammogram, no indication of cancer." Well, at my next mammo, the Radiologist spoke to me and said that my microcalcifications were now showing a "particular pattern" which was of concern and that I should have a breast biopsy. I did. Bingo! Lobular Breast Cancer right where those microcalcifications were seen. Only a tiny area showed this cancer, like .5 cm. I had a lumpectomy which showed one sentinel node positive out of 7. No scans were done to see what condition the rest of my body was in. Not even any bloodwork!
I was put on Arimidex as I was EST+. Did that for 1 1/2 yrs when all of a sudden I had fractures in my ribs and spine! Original Oncologist messed up my appointment to get a bone biopsy. Then I couldn't reach him + he never called me back! I ended up seeing my Primary doctor who got me the necessary biopsy and scans which were long overdue. Bottom line: I have extensive bone metastises. Goodbye to old Onc and hello to new one who's watching me very very carefully.
Because the area of my microcalcifications was small, it was considered not a situation that needed immediate attention or further testing.Wrong! Lobular breast cancer is hard to detect anyway, and in all the time that went by, it was spreading to other parts of my body. I think the Radiologist and my old Onc were shocked. But, they were NOT thorough!
So I now live in the Stage 4 world and it's a scary place to be. It's incurable. I've been on 5 different treatment drugs so far. I hold my breath at each doctor's appointment to find out what my latest tumor markers show or what my scan results are.
My advice: Get the necessary tests to get to the bottom of those microcalcifications. Don't settle for " It's most likely benign or fibrocystic changes." And definitely DO NOT wait one whole year to get another mammogram! If you have dense breasts, I hope you're getting a 3-D mammogram now.
If your Birades grade was 4, that's HIGH. Mine was 3 and my Oncologist told me that they should've looked into my situation more. He said a 3 deserved more inspection. Believe it or not, knowing my mother and sister both had had breast cancer, I had originally been put on a " Watch List." After my MRI, they took me off this list and treated me as if I had no history of breast cancer in my family.
Just be on top of things, if you aren't sure you're being handled carefully, go for a 2nd opinion, for sure! Bring your mammograms and have your lab slides sent to the 2nd opinion facility. I did. It's very reassuring to do this and insurance encourages it. I've even gone for another opinion while still keeping my good Oncologist. He also encourages more opinions.
Anyway, I wish you much good luck in pursuing your breast health. Hopefully, all is well. Take care. Kats2
Continued prayers going up for you.
Hugs,
Annie
0
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