All Topics → Forum: Not Diagnosed but Worried → Topic: Radiologist and Surgeon Disagree
Posted on: May 22, 2012 01:50 PM, edited May 22, 2012 01:56 PM by LisaDVM
LisaDVM wrote:
Hey -
Was wondering if anyone can help me sort this out. I had a baseline mamogram done when I was 40. It showed 2 small masses in my left breast and 3 in my right. Went for ultra sound and the radiologist and surgeon agreed at the time that 4 of the masses looked like fibroadenomas and one on the left breast looked like a complex cyst. recommendation was to mammogram and us sound them every 6 months for 2 years.
fast forward 2 years. I am on the last us and mammogram. Everything has been stable so far. On this last mammo I knew something was off as they did 6 additional views of left breast. Then they us. Radiologist comes in and said that complex cyst seemed a little more prominant, but had not changed in size much beyond what could be explained thru error, and wants me to start the every 6 months for 2 years cycle over again. OK nothing to worry about.
Go see surgeon. She starts doing her own u/s. I question this as this is not the norm. She says cyst has changed from a regular to irregular shape and she was trying to see if she could locate it. It has not grown but the shape has her concerned. She says she wants to take it out, but it is deep, and if she could not locate it she would have to have radiologist place wire. She said in the past they have talked patients out of biopsy for small lesions such as mine and she does not want them to do that with me.
So would you follow radiologist or breast surgeons recomendations? Have any of you had a cyst change shape before? Should I be worried?
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May 22, 2012 01:55 PM mckenna wrote:
get another opinion. it can't hurt and two might agree then you might find it easier to decide. i had to have a wire placed for my lumpectomy and i can honestly say i felt no pain. not even the needle they used to numb the area, it was very uneventful (comparatively speaking). i know that is not everyone's experience but it was mine. good luck
May 22, 2012 02:08 PM Sommer43 wrote:
It's a tricky question for me too. Surgeon (in UK, called, consultants) or the clinical director of breast screening, who is the radiologist. He has said the same to me the three times I have seen him. Two other consultants have said two other different opinions on my problems. He's the one who remains solid throughout the whole process for me.
I haven't had a cyst change shape, but my radiologist took the decision not to wire insert me, on the morning of surgery, after the consultant had ordered wire insertion.
May 22, 2012 02:15 PM, edited May 22, 2012 02:16 PM by dlb823
If the surgeon is truly a breast (only) surgeon who specializes in diseases of the breast (vs. a general surgeon who includes breast surgery within their specialties) then IMO her opinion would trump that of a radiologist. I say that because it's well known that radiology is open to interpretation -- in other words, two rads might look at the same image but come to different conclusions about it.
I agree with getting a second opinion, possibly at a major medical center, if you haven't already, where both a new radiologist and breast surgeon could look at your images. Here's a list of NCI-designated cancer centers, where I would absolutely trust their opinion on whether or not a biopsy is warranted: cancercenters.cancer.gov/cance...
Good luck! Deanna
May 24, 2012 09:15 AM LisaDVM wrote:
Well I decided to go ahead with the biopsy. I have done 2 years of the every 6 month mammogram thing and just want an answer now. I am tired of watch and see. I am also the sigle mother of a 13 year old whose father left never to be seen again when the baby was under 1 year. AS my sister told me I owe it to my daughter to get this taken care of ASAP since I am the only parent my girl has.
Has anyone heard of a complex cyst changing shape and still be b9?
May 26, 2012 01:22 PM amanda1116 wrote:
May I tell you that my radiologist, one of the top in the country, says exactly the same thing as your sister when I carry on about having a yearly MRI. I say noooo I don't want to to this (I have had four resulting in 3 biopsies, all B9 but completely emotionally draining) She said, and I quote: "You have a 15 year old daughter so suck it up and deal, Amanda" And she is right.
May 26, 2012 04:28 PM Luvflsun wrote:
My breast specialist at Mayo and radiologist agreed and my surgeon did not. It is so frustrating. I, too had to make a decision and it is very difficult with conflicting information. I had needle core biopsy and the bs and radiologist wanted lumpectomy. Said the needle biopsy would not be enough information because the lump is too large. Now I am having lumpectomy a year and several months later, then after healing and finding out it is not cancer (I hope) as they say it is not, then I have to undergo reconstruction. This is odd with the mixed advice and a tremendous amount to go through with mixed signals. I feel for you. I would say get another opinion but I just feel have the biopsy and piece of mind.
I don't understand why I'm going under if it is not cancer. It makes no sense. See my post if you can and offer advice I am lost on this one. The first bs and radiologist wanted it out within 30 to 60 days and now the bs doesn't feel that way anymore and the surgeon who did not see what they saw in the beginning now does and would excise it if it were her body....it's like a big joke and nobody remembers how they felt yesterday regarding such a serious issue....let's just fly by the seat of our pants. Ugh I hope the best for you, this is tough, everyone wants to say stay positive and that is true but let's be real. This stuff is tough when we have to make decisions as mothers that will affect the rest of our/their lives.
I've gone through stages where I feel a radiologist is the one to follow as they are trained to look, detect cancer PERIOD THAT IS their job, while a surgeon is trained in that but also much more to it obviously. But I am told at Mayo the surgeon trumps them all. Ugh
May 29, 2012 01:15 PM pinkangels wrote:
Ten years ago at the age of 34, I found a lump in the upper outer quadrant of my left breast. I waited 3 months before going to see my nurse practitioner. When I finally saw her, she felt it and ordered a mammogram right away. I had the mammogram and an ultrasound a few days later. They assured me that it was just a cyst. They showed me the film and I could see a dark pocket that they said was filled with fluid. They weren't really concerned but scheduled me to have it drained a month later. They said I would be able to watch on the screen as they aspirated the fluid out of it and that I would see it shrink. The day of the aspiration the radiologist made 3 attempts to get fluid from this so called cyst with no luck. He ended up doing core needle biopsy and assured me that I should not be worried. Said he did this every day and this did not appear to be anything cancerous, was probably a fibroadenoma or a benign phyllodes tumor, not to worry.
Four days later I got the call that it was a very aggressive invasive ductal carcinoma and I was scheduled for surgery a few days later.
Now 10 years later I have found a lump that feels just like the other one, but in the other breast, almost directly behind the nipple. I was scheduled for my annual screening mammogram the following day. They did it as a diagnostic mammogram which showed nothing. Followed by and ultrasound which also showed absolutely nothing. It's been a couple months and I saw my nurse practitioner for my annual pap and such and she could feel this lump and said I should not trust the negative mammogram and ultrasound. I saw the surgeon who did my previous surgery and he has scheduled me for a biopsy next week. He thinks it's probably benign, but given my history and how I was told last time that it was probably nothing, he agrees we should get it out and see.
Don't let anyone tell you it is nothing. Hopefully it will be benign, but they don't know until they remove it. You know your body better than anyone else and when something doesn't seem right, trust your instincts. Get it removed and if it's benign at least you'll have peace of mind.
May 29, 2012 08:24 PM CoolBreeze wrote:
I am a cyst-maker, which is why when I got the real lump, the cancer, I didn't worry. FYI, it felt VERY different than the cysts but I attributed it to aging. "Oh, this lump is harder because I'm getting older and hormones are changing." Wrong!
But, that doesn't help you - I did have a cyst "change shape" once. I put that in quotes because it only appeared to change shape. In fact, another had grown underneath, which gave an irregular appearance on the sonogram and mammogram.
The one thing I've learned, having Stage IV cancer, is just how inexact a science this is. They have these expensive, million dollar pieces of equipment and they often still can't say with certainty what something is. Right now, I have one doctor telling me that cancer is growing back in my liver while another is telling me it's surgical scarriing. I go to UCSF, a major cancer center, have a famous surgeon - even they don't know for sure. We think they should be able to know but it's not like that.
So, all that is to say, is that the only way they are 100% is surgically. I'm not telling you what to do because time will tell too. If it's cancer, it will make itself known. Getting it checked every six months is a good plan and if you have a cyst farm, like me, you probably just have another cyst. But, a cyst draining or lumpectomy is a simple procedure.
Either way, don't ignore it. That's what I did and look at me now. Only you can know which one will make you more comfortable. Which one will keep you from worrying the most? Do that one.
May 29, 2012 08:59 PM minkarejn wrote:
A radiologist can't see cells on any of their tests. Only a pathologist can and that can only be done if the surgeon takes it out. I've played this game with a radiologist here and it's a game you don't want to play.
May 30, 2012 05:49 AM Shayne wrote:
i had 3 cysts......all regular in shape. Was assured they were cysts. One wasnt. I also have an 11 yo daughter - all my decisions are based on being around for her. Dont mess around. Keep us posted - wishing you the best possible news!
May 31, 2012 08:04 PM, edited May 31, 2012 08:05 PM by LisaDVM
Thank you all for your words of wisedom. Biopsy scheduled for June 7. My daughter gets out of school on the 6th. She wants to be there, but that is the same hospital she where she watched her grandfather die. I am nervous about her getting emotional there. WWYD?
Could also use some prayers. It is hard keeping up a brave front for her when inside I am shaking.
May 31, 2012 08:08 PM susan_02143 wrote:
How old is the daughter? That matters.
*susan*
May 31, 2012 08:13 PM LisaDVM wrote:
She is 13. Grandpa died 2 years ago. She was holding his hand and he died. When he died white foam came out of his mouth and ran down his chin. Needless to say she was a bit hysterical at the time.
May 31, 2012 08:19 PM susan_02143 wrote:
I think 13 is too young to be this involved with your medical procedures. 13 is still so very young. She should still be enjoying the ends of her childhood, not sitting in a waiting room while you have a biopsy. Let her stay home, and then go for a special mother-daughter ice cream after it is over. Thank her for coming to have a post procedure ice cream with you. She will understand that you feel supported without actually having to step into the hospital.
But, I kept the gory details from my 17 year old. So maybe my viewpoint is different than yours.
Good luck navigating these choices.
*susan*
May 31, 2012 09:25 PM Shayne wrote:
She's already involved. My daughter is 11. I see the worry on her face. You know what is right mama......talk to your daughter.
May 31, 2012 09:35 PM Luvflsun wrote:
Praying for your biopsy. My surgery is the 13th and it's very tough. I would not involve your daughter. With that said, my kids have to go with me because mine is out of town BUT the word Cancer is not mentioned and they will be able to be outside doing kids stuff because it is at that type of facility. I would not take her to the hospital where she had such a traumatic experience for anything regarding a worry about her mom. Mine do coloring contests and get prizes for most creative, most colorful, etc when I wake up. Then their drawings will hang as my get well art. Unless she has to be there and there is someone to keep her assured mom is ok and turn the time into childlike activities, I would not take her. Praying God will comfort you and your daughter. Xoxo
May 31, 2012 09:57 PM Shayne wrote:
Ill keep u in my prayers mama.........keep us posted!
((((love))))