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All TopicsForum: Waiting for Test Results → Topic: Waiting for pathology report and "hello".

Topic: Waiting for pathology report and "hello".

Forum: Waiting for Test Results — Biopsy, mammogram, CAT scan, PET scan, ultrasound, or other tests.

Posted on: Nov 29, 2012 12:21PM

kymL wrote:

Hello. I've been reading through a lot of topics and posts the past few days and really, first, just want to say thank you to all who share their experiences and feelings. Your stories are very helpful to me as I feel overwhelmed with medical issues right now, and most recently- or at least more worrisome - the prospect of breast cancer. I thought I'd wait and see but then this waiting is hard so I'm jumping in.

Very recently I found two lumps under the areola. Monday I had an ultrasound and mammogram. One lump was a lipoma-like nodule that was nothing to be concerned about. The other one, well, the US tech spent at least 20 mins on that one compared to the 3 mins she spent on the lipoma. The radiologist called my doctor and they agreed I should have a core needle biopsy, which she did immediately. She also put a titanium pin in the area and did a repeat mammogram with that in place.

So now I'm waiting. Waiting. Everything was so tense and fast on Monday and now I'm in limbo/obsesso land, scouring the internet and learning everything I can. I'm an information person. It helps me channel my anxiety. And boy, have I learned a lot!

I'm pretty tough. I have RA (diagnosed 2 yrs ago) and I was hospitalized a few times this fall for pericarditis, pneumothorax, Afib, and pleural effusion. I also had an US of my thyroid, and I've been referred to a surgeon for that. Somehow that one doesn't scare me as much -- it just adds to the overwhelm. And questions. I have prednisone-induced diabetes and I'm going to be on the heart meds through February. How does all this work? I feel like I'm falling apart!

I think that the pathology report on the breast lump isn't going to be benign. I know I could be wrong. But I just have this sinking feeling that, by the way the radiologist was so concerned, that there's something wrong. So I wait. This afternoon I'll see my rheumatologist and have him check on the computer to see if the path report is back, although I do trust my pcp to call me as soon as he gets the report, as he promised.

So hello to all of you, nice to meet you, even under the circumstances of our aquaintance. Thanks for being here. I'll post when I know something.

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Posts 1 - 12 (12 total)

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Nov 29, 2012 12:42PM skapaya wrote:

Hello KymL,

This is my 3rd time in the waiting room... in the last year. Each time I had a sinking feeling it was something scary, and so far they have all been benign.

Now let's see if I can remember this while waiting for my biopsy results after tomorrow's appointment :)

(((((((((((Sending good vibes))))))))))

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Nov 29, 2012 07:25PM kymL wrote:

Hi skapaya.

Third time this past year? Oh, my. I am curious whether they are different problems or the same? I'll take your good vibes, thanks, and send some right back to you now for this biopsy.

I don't know what to think about my situation. Instead of a pathology report, an US report, and a report of the biopsy, I have three identical reports with very uninfomative mammogram and US "findings" in which said findings are not really described in any diagnostic way.

addendum:

"The pathologic diagnosis of benign breast tissue is discordant with the imaging findings. Per Dr. [...] the patient is to followup with a surgicalconsult for an excisional biopsy of this area.  Ultrasound guided needle localization can be performed.

Then about the mass:
"
Ultrasound of the anterior 3:00 position left breast demonstrates a 1 cm hypoechoic mass corresponding to the palpable finding."

Then toward the bottom:

In the 3:00 position, there is a circumscribed mass measuring 7 mm corresponding to the palpable finding. AND:

IMPRESSION:
1. 7 mm mass anterior 3:00 position left breast in the region of palpable
concern.  Ultrasound-guided core biopsy was completed on the same date. 

So I can't say what kind of cancer the radiologist thinks she "found".

Circumscribed, hypoechoic, and between 7mm and 1cm in size.

I really think I need more information than this. Or I don't know -- is there something about the description "circumscribed, hypoechoic, and small" that nails it as a malignancy? Where is the pathologist report? It looks like they sent an overwrite on the computer reports I can access electronically at the hospital, so I have no real info.

I cried after my doctor called. I was driving. Then I swore loud in the car... then cried some more. I asked the doctor "discordant with WHAT findings?" He said, "I don't know, it doesn't really say. I'll release it and you can read what I am looking at." Then he gave me the name of a breast surgeon to call in the morning. It's been a hell of a year.
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Nov 29, 2012 08:28PM sljones wrote:

KymL,

Is that the "pathology" report that you were waiting for all this time?  you're right- it does not identify anything- It sounds like it was the doctors clinical note about the three tests (biopsy, mamo, and US) that were done.. the first part of the adendum states, "The pathologic diagnosis of benign breast tissue is discordant with the imaging findings..." This sounds like the pathology report (biopsy) found BENIGN tissue.... which could mean one of two things- either the mass you have is benign (YAY!) or the doctor didn't get a good enough sample from the biopsy, and it is a flase positive... But the fact that it says "is discordant with the image findings" means to me that the mass looks suspicious for malignancy on imaging, but the actual tissue was "benign"  which doesn't always add up- which I think is why the MD is suggesting just removing the mass by an excisional biopsy- and at least then you can have it out of you, and have the entire thing tested....

It makes me wonder what the actual patho report says- what was benign about it?  was it fatty tissue, glandular tissue, a fibrocystic mass? 

I hope you don't have to wait too much longer- I am in the same boat as you, I had a core needle biopsy three days ago, and I am told I should get the results tomorrow:

28 years old with no family history, mass  0.7 mm x 10 mm x 0.7mm Mamo/ US microcalcifications, hypoechgenic, irregular boarders.. So.. I wait.

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Nov 29, 2012 09:13PM blackcat2012 wrote:

It sounds like an inconclusive report and I would go with the recommendation of having it removed so that you know one way or the other.  Just my 2 cents, worth.

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Nov 30, 2012 11:16AM itsjustme10 wrote:

That one sentence sounds to my non-doctor ears that they didn't find what they expected in the needle, based on the shape of the mass ("discordant") , and would feel more comfortable removing the whole thing, just to make sure.  Assuming English and "Medicalese" translate to the same thing - there was a discoonect between what they see and what they found under the microscope.

If it were me, I would listen to the radiologist's recommendation and have it removed.  There's no down side to doing that, as far as I can see - even if it is benign, it doesn't belong there...

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Nov 30, 2012 11:29AM kymL wrote:

sljones, hi, and than you for your thoughtful response. I hope you get some good news today. From what I've been reading about various types of tumors, I know the irregular borders are a concern and the microcalcs may or may not be. You are young! I hope it's benign.

blackcat, you are right.

What is bothering me is lack of information. Especially because excisional biopsy is a lumpectomy, so I'm getting the same surgery I would get if it were malignant for certain, but it could be benign. And it is just under the nipple -- so does that mean that in order to get the proper borders I will lose the nipple, so instead of a lumpectomy, I'm having a mastectomy, for something that could be benign. I am also immunocompromised so do I have to do this thing inpatient? I have a lot of questions for the surgeon.

I know the wise thing to do is probably get rid of it. Better safe than sorry. I have an appt with the surgeon on Tues morning at 9:40am and it can't come soon enough. She will examine me and go over all the mammograms, etc. and cover all the possibilities. I talked to the nurse at my pcp's office about all of this including my anxiety. She's going to ask the doctor about getting me some xanax or something. At least then I can take them to sleep. And maybe take the edge off this awful sense of dread. I can't stay asleep and I'm getting cranky. :( 

Thanks so much for your responses.

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Dec 3, 2012 08:37AM skapaya wrote:

Hello KymL,

2 of the biopsies where for the same area, and the current one (results on friday) s for a different area of the same breast.

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Dec 3, 2012 10:16PM, edited Dec 3, 2012 10:18PM by kymL

Thinking of you and wishing you the best of luck, skapaya.

Maybe I'm imagining this but I feel a tiny something on the other boob now (right side). It doesn't hurt and it feels just like the lipoma on the left side, so I guess I'll just mention that to the surgeon at my appt tomorrow morning. I'm glad my husband is able to come along for the consultation. He calms me.

This lump on the left that they are worried about hurts. It's not at 3'oclock, either... it's at 5 o'clock (I wonder if they didn't just miss the real mass). And the area is weirdly lumpy and hurty now -- not just a discreet hard pea of pain. I guess there's inflammation still from the biopsy. I wonder what makes a mass hurt like this. I haven't been able to find out anything about it. Have you had pain with yours?

I'm making lists of meds, doctors, and questions then heading for bed. Will update asap.

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Dec 3, 2012 10:24PM kymL wrote:

www.ncbi.nlm.nih.gov/pmc/artic...

RE:  Discordant, it turns out, it is a meaningful category. From the intro:

"Imaging-pathology correlation is of critical importance in imaging-guided breast biopsies to detect such a possible sampling error and avoid a delay in diagnosis."

So it wasn't exactly what I had imagined. This happens very rarely. Lucky me!

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Dec 4, 2012 09:30PM kymL wrote:

Surgical consult went well. She thinks it's benign. I asked her what characteristics the mass had that led the radiologist to believe it wasn't benign and she said that there really aren't any; it's just that with my age a solid mass is automatically suspicious. I actually, for the first time in a few weeks, feel like it just may be benign. I am cautiously relieved.

Surgery is scheduled for Monday the 17th. I will be getting something called a "pred pack" in the IV beforehand (bc I'm on Prednisone) but otherwise it's going to be very straight forward wire loc. biopsy with twilight sleep and go home a couple of hours after.

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Dec 5, 2012 09:56AM marie5890 wrote:

Ah Kym,

So glad that it is sounding more and more like good news. Take some of those deep breathes and  that you probably have afraid to take and...exhale... 

God Bless...

DO NOT READ ANYTHING INTO THE TECH'S EXPRESSION OR WHAT THE TECH SAYS. Jan '11 Biopsy Dx-ed a PASH tumor (rare, but benign tumor)....All I ask is for peace and serenity to the depths of my soul. Makes the rest of life more live-able.

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Dec 5, 2012 02:09PM skapaya wrote:

I'm a big fam of the twilight sleep. Sleep in general is awesome.