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Told "probably benign" and to come back in 6 months

Naturenut
Naturenut Member Posts: 3
edited December 2017 in Not Diagnosed But Worried

I am 35 yr old with no history of Breast cancer. My PCP suggested a baseline mammogram when I mentioned that I weaned my last baby over three years ago, yet was still not completely dried up. Had the mammo on 12/27. Got a letter to come back for more testing. Had a more advanced mammogram today where they "spot" still showed up. Immediately sent to Ultrasound. The first u/s tech could not find the "spot" and had to get another tech, who then found it right away. Both techs left and the first tech came back in with a Dr. (have no clue what kind of dr. He did not say and I did not think to ask). The tech tried to show him the spot on u/s, but once again she could not find it. The Dr. turns to me and says quote "I cannot say what it is, but it is probably benign, come back in 6 months and we will see if it grows". I told him I did not think I could handle waiting 6 months to figure out what this spot is, especially since I came in because I was having a weird issue. He told me "go home, forget about it for the next 6 months". The Dr. was really rushed and seemed like he just could not be bothered with me. 

I don't like the fact that the dr. did not even get to see the spot and that he gave me the brush off.  Both things were unacceptable to me. I plan on getting a second opinion at a place that had an actual breast health center. Should I insist on a needle biopsy?

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Comments

  • KLJ
    KLJ Member Posts: 79
    edited January 2014

    Absolutely do not listen to them. I was told the same thing. "Come back in 6 months". Fortunately I have good friends that told me to go back and insist on an MRI. On Dec. 12th I was diagnosed with breast cancer. I was told the good news was that it was only 4mm, the bad news was that it was cancer. But it is very small and would have gone untreated for 6 months longer. Do not listen to them. Better to safe than sorry!

  • melissadallas
    melissadallas Member Posts: 929
    edited January 2014

    if the spot showed on the diagnostic mammogram and they told you to come back in six months they are saying the risk of it being anything to worry about is less than 3%. Waiting is reasonable. Remember that all the women who got rechecked in six months and were put back on regular mammogram schedule are out going about their lives and not answering you on a breast cancer board.

  • mdg
    mdg Member Posts: 1,468
    edited January 2014

    I would push for another test.  I was told to wait 6 months and when I did go back in 6 months it was BC.  THe odds are in your favor - must lumps are benign.  I would see another doctor.


  • marie5890
    marie5890 Member Posts: 111
    edited January 2014

    Go and get that second opinion and see what they say. If they also say wait 6 months, and you are not comfortable with that, tell them that. 

  • sheila888
    sheila888 Member Posts: 9,611
    edited January 2014

    Naturenut ....There is no such thing as PROBABLY BENIGN

    Either it is or is not when it comes to Cancer

    I was also asked to wait 6 months but didn't...It was Benign and i had a peace of mind

    This time when I went to Biopsy we all knew it was bad

    If you're not comfortable with the DR's decision please get a second opinion

    Good Luck

  • FocusGirl
    FocusGirl Member Posts: 2
    edited January 2014

    In all likelihood it is probably benign but that being said I would not wait 6 months.  I would insist on a MRI to be sure.  My surgeon sent me for a MRI after a mammogram and ultrasound failed to diagnose a lump that could be felt.  It turned out I had cancer in both breasts.  Some cancers are "occult" and can't be seen by standard detection methods.   Best of luck to you.

  • Bad_At_Usernames
    Bad_At_Usernames Member Posts: 241
    edited January 2014

    I think you should push for an MRI.

    Personally, if I had waited six months...I'm quite sure I would've been diagnosed at Stage IV.

  • beesie.is.out-of-office
    beesie.is.out-of-office Member Posts: 1,435
    edited January 2014

    This is a breast cancer discussion board, and sometimes it's hard for those of us responding here to look beyond the fact that we have been diagnosed with breast cancer.  The fact is that most women who have a call-back or suspicious imaging or even a biopsy turn out to not have breast cancer.   

    A "Probably Benign" finding is an official term that means that the radiologist assesses there to be a less than 2% chance of cancer. 

    BI-RADS 3

    Probably Benign Finding - Initial Short-Interval Follow-Up Suggested:


    A finding placed in this category should have less than a
    2% risk of malignancy.

    It is not expected to change over the follow-up interval, but the radiologist would prefer to
    establish its stability.

    Lesions appropriately placed in this category include:

    • Nonpalpable, circumscribed mass on a baseline
      mammogram (unless it can be shown to be a cyst, an intramammary lymph
      node, or another benign finding),
    • Focal asymmetry which becomes less dense on spot compression view
    • Cluster of punctate calcifications

    Follow up at 6, 12 and 24 months showed no change. Final assessment was changed to a Category 2.

    The initial short-term follow-up is a unilateral
    mammogram at 6 months, then a bilateral follow-up examination at 12
    months and 24 months after the initial examination.

    If the findings shows no change in the follow up the final assessment is
    changed to BI-RADS 2 (benign) and no futher follow up is needed.

    Introduction to the Breast Imaging Reporting and Data System   

    I've had lots of BIRADs 3 "Probably Benign" findings over the years, and lots of 6 months follow-ups.  I have never been diagnosed with breast cancer as a outcome in any of those situations.  This is true of the vast majority of women who get a BIRADs 3 rating. 

    I agree with Marie's recommendation that you get the second opinion - probably the best idea is to see a specialist, a breast surgeon.  If the second opinion agrees with the BIRADs 3 "Probably Benign" assessment, then that should reassure you that your risk is very low and it is preferable to wait 6 months rather than undergo a unnecessary biopsy.  On the other hand, if the second opinion disagrees and suggests more testing or a biopsy now, then you can do that.

  • Bad_At_Usernames
    Bad_At_Usernames Member Posts: 241
    edited January 2014

    Bessie--is there any harm in doing an MRI or needle biopsy if the chances are overwhelmingly that it will be benign? I know surgical biopsies carry a risk of scar tissue hiding future findings. Is there a similar risk with needle biopsy? Are there any risks associated with MRI?

    I'm not trying to be snarky in any way, I'm honestly curious!

  • wyo
    wyo Member Posts: 165
    edited January 2014

    hi - I thought about what you wrote bad at and really had to think about it- MRIs and needle biopsy while different types of diagnostics do carry risks albeit small.  I will be interested to hear what Beesie has to say because I believe if there were clinical benefit and diagnosis coming from the tests we could justify doing them and the risk/benefit is acceptable.  

    Doing a biopsy for peace of mind on tissue you don't believe has pathology does not seem like "good medicine" or ethical as I think it over. 

  • Momof4blessings
    Momof4blessings Member Posts: 1
    edited January 2014

    I would go to a breast specialist atleast. I had an ultrasound 4 months ago was told to wait and see and when I went back the radiologist thought it was the same but wanted a biopsy and the breast specialist said it did change by 1 mm and I needed a biopsy. If I would have had it 4 months ago I wouldn't have all this stress now- plus I'm pregnant so that makes it even more stressful. Biopsy Friday- :/ so even though it's probably nothing just so you don't have to stress Again in 6 months I would ask for a biopsy 

  • beesie.is.out-of-office
    beesie.is.out-of-office Member Posts: 1,435
    edited January 2014

    kayb, I agree.  Doctors really need to explain "Probably Benign" a lot better.

    MRIs are not used for screening because of all the false positives.  That's the risk with having an unnecessary MRI.  Personally I had that experience last year when I had a mets scare because of something that showed up on my MRI, not in my breast but elsewhere. Someone on the board who was recently diagnosed has had to undergo significant additional testing because of something that showed up on her breast MRI, again it was something outside of the breast. Lots of women end up even more scared and having unnecessary biopsies because of these false positives.  So yes, there are times when an MRI is recommended and it can be helpful and reassuring but often the result is just the opposite - more confusion, more fear and more unnecessary biopsies. 

    As for needle biopsies, they don't present the same risks as surgical biopsies, but scar tissue or calcifications or fat necrosis can develop (less likely, of course) and there can be bruising and hematomas and other side effects from the biopsy itself.

  • ALittleBitBritish
    ALittleBitBritish Member Posts: 415
    edited January 2014

    I was told to follow up in 6 months on BIRAD 4 'suspicious'. 

    So I waited 7 months not thinking I could have anything going on, cancer was the last thing on my mind. My hubby was deployed so I was pretty occupied with that. I had DCIS/LCIS in the suspicious breast. They didn't see the ILC and IDC in the other...They found that after my lumpectomy when I pushed for an MRI, as my insurance wouldn't agree to mammogram my other 'non-suspicious' breast for the 6 month follow up.

    One thing I learnt is be your own advocate and if you are worried, do something about it.

    I would request to see a breast surgeon and have their opinion. A specialist who knows what they are talking about.

    I am hoping for you it is absolutely nothing to worry about, but peace of mind is worth a whole lot.

  • Naturenut
    Naturenut Member Posts: 3
    edited January 2014

    Finally talked to my family dr's office. The report they got had the "probably benign" label with the options of either waiting the 6 months or being referred to a surgeon for a possible biopsy. I chose to be referred on. I requested to be referred to someone who specializes in the breast area and at one of the bigger hospitals in the area, not the tiny country one I was originally sent to.

  • Naturenut
    Naturenut Member Posts: 3
    edited January 2014

    But now I am confused on how to know if the surgeon is any good. Is there a list or website that list recommended breast surgeons in your are.?

  • beesie.is.out-of-office
    beesie.is.out-of-office Member Posts: 1,435
    edited January 2014

    Naturenut, that's good.  See a breast surgeon, and see what he or she has to say.  A breast specialist might suggest a biopsy now, or perhaps an MRI, or perhaps he/she will feel that it is best to wait.  

    I think ultimately we have to find a doctor (or doctors) that we trust and then go with what the doctor recommends. They are the experts.  That doesn't mean that we should agree with every doctor we talk to, or follow the advice of every doctor who advises us - getting 2nd or 3nd opinions can be very helpful and can lead to different recommendations.  It also doesn't mean that we shouldn't ask about things, such as "would it be helpful to have to an MRI?" or "does it make more sense to have a biopsy now?".  Where I personally draw the line, however, is that I don't think it's appropriate to tell a doctor how to do his or his job; in other words, I don't think it's right to insist on a test or procedure that the doctor doesn't feel is necessary or appropriate.  But that's where a second opinion comes into play - if you are concerned with what's been recommended, or if you feel that a particular test or procedure might be appropriate and your doctor doesn't agree, ask another doctor.  None of this is black and white and often two doctors will approach things differently. Then you get to choose which approach you feel is better for you. But if you do have two doctors who agree, then it probably makes sense to take their advice.

    Good luck with the second opinion. Hopefully it eases your mind, whatever is recommended.

  • april485
    april485 Member Posts: 1,983
    edited January 2014

    I had a birads 3 finding in July of 2012 for micro-calcs, come back in 6 months. I was not comfortable with that so did what Beesie suggested. I got a second opinion from a breast surgeon at a nationally ranked cancer center. The agreed with the first radiologist. Watch and wait. So, in January of 2013 at the 6 month mark, I went in for the diagnostic mammo and it had multiplied times 4 and had a birads 4 rating so I had a stereotactic biopsy where they found the DCIS. I waited like they wanted me to, sweating it the whole time and I knew something was amiss right from the get go. I would get that second opinion and do whatever makes you comfortable. Praying you have a good outcome.

  • Joakes77
    Joakes77 Member Posts: 2
    edited August 2017

    Hello all!

    My partner has yearly mammogram and was called back for diagnostic. Had diagnostic and ultrasound. Found small lesion. Scheduled for a biopsy. Upon review of area with ultrasound, techs AND doctor spent 30 minutes moving lump and compressing it. Doctor, who is described as a Bulldog, recommended wait 6 month and then come back. Biopsy deemed unnecessary.???

    WHY wouldn't they just do a friggin biopsy when she was there and already for one. We have been freaking out for over a week waiting for this.

    Any advice would be appreciated.

    Thanks

  • MTwoman
    MTwoman Member Posts: 228
    edited August 2017

    Hey Joakes, this thread hasn't been active in over 3 years, so you might not get much feedback here.

    so sorry you are having continued anxiety over your partners diagnostic process! So the Bulldog gave his opinion that a biopsy wasn't necessary. Each of the experts (radiologist, breast surgeon, plastic surgeon etc) has their own area of expertise. The radiologist felt that the "small lesion" should be looked at and potentially biopsied by a breast surgeon. The "bulldog" felt that the area was less concerning (they "wait and see" with findings that meet the criteria of having a 2% or less chance of being bc). Btw, what type of doctor was the "bulldog"?

    While I'm sure it is very frustrating, the specialist needs to feel as if an invasive procedure is warranted or it is unethical for them to do it, as there are associated risks (albeit small). I'm not sure why the PCP's office is going to refer her to a breast surgeon, but I'd call and ask them that before the weekend so you can both feel more comfortable with what is going on. Hoping you get some answers before the weekend!

  • Joakes77
    Joakes77 Member Posts: 2
    edited August 2017

    MT Woman,

    Thanks so much for your reply!! Sorry, I don't follow threads very well. 😵

    The doctor was at the breast center where all of the other mammograms were done, but that's all I know. SHE was pretty confident that we/they were looking at a "squishable, " well-defined lump of fat. She said tumors of the malignant nature "don't do that." Since my partner has large breasts, she said that sometimes lesions appear similar to tumors. Of course, I am paraphrasing, but I might want to urge her to get a second opinion. We have had it rough. I'm sure you understand. It must be difficult to keep answering questions about this subject matter.

    She called the doctor and asked for further explanation of the referral. They have yet to call back, but she WILL call back tomorrow am.

    Thanks so much!!!

  • MTwoman
    MTwoman Member Posts: 228
    edited August 2017

    She should most definitely call back tomorrow, just so that she (and you) have clarity before the weekend. I was just wondering about the type of doc the bulldog was, as it wouldn't make much sense to refer your partner to a breast surgeon if she'd just seen one. (unless there is some reason to be seeking a second opinion, and then that should have been stated. i.e. that it was a second and the reason a second is recommended).

  • green71364
    green71364 Member Posts: 9
    edited November 2017

    On Aug. 1st. of 2017, I felt sore in the armpit and found swollen nodes. Saw gyno and he couldnt feel them, but schedukled me for CAD mammogram, since at 63, I have very dense breast tissue. and ultrasound of nodes. Results as of Aug. 24th finding, benign reactive axillary nodes and benign mammogram BI- RADs 2. Saw surgeon and his recommendation was a 3 month ultrasound of nodes and take ibuprofen for pain, which hasnt stopped yet!. Saw my g,p. for still swollen node pain and on Oct. 20, had another ultrasound which deemed nodes larger. Dr. scheduled me for an MRI on OCT 24th, and to see another surgeon after results. MRI showed nodes still deemed benign by ultrasound and MRI findings, still swollen and painful, though, but a potential abnormality in the breast! So now scheduled for MRI guided biopsy Nov. 8th. Trying to be positive as I was initially having just swollen reactive armpit nodes! And now it is a breast issue where I thought the CAD mammogram had deemed it benign! What is going on! Anxiety is killing me!

  • shazelwo
    shazelwo Member Posts: 4
    edited November 2017

    Ive been on 6 month watch and wait for a year. Just had my 3rd mammo in that year (1st one 10/2016, 2nd 5/2017- biopsy pash tumor, 3rd 11/2/2017 -increased microcalcifiactions cluster biopsy AGAIN :( scheduled for 11/13) its kinda a tough spot I usually do pretty good til its test time again and im struck with this fear that this time they might find something since I am screened so much I feel like I must be higher risk. Its a lonely place the 2 people i chose to lean on have brushed me off every single time. I feel like I have a right to feel concerned but every where I turn it seems I dont have that right at all. :( ugh.

  • MTwoman
    MTwoman Member Posts: 228
    edited November 2017

    green71364, so sorry that you're here worried about your breast health! Do you have a copy of your imaging report that describes the "potential abnormality"? If not, I would recommend that you get a copy. There is information included in that report (including a BIRADS score) that will help us to help you better understand what is going on. If you copy the wording here, we'll be glad to "translate" any confusing sections.

  • green71364
    green71364 Member Posts: 9
    edited November 2017

    Getting ready to go for biopsy. Anxious as all get out! BIRADS 4 score. Just called surgeons office! :(


  • MTwoman
    MTwoman Member Posts: 228
    edited November 2017

    sorry green, I had hoped it would show clearly b9 features. It may help you to know that 70-80% of biopsies come back with b9 results. I know it doesn't eradicate the anxiety, but do try to just take one step at a time. Best wishes for b9 findings!

  • green71364
    green71364 Member Posts: 9
    edited November 2017

    Thank you so much! MRI biopsy was not painful at all! Radiologist was same one who scored my CAD mammogram BIRADS 2 on August 24th! I asked why I went from benign 2 score to birads -4 in two months time! He said sometimes with dense breast tissue you just cant get flat enough to see everything. Also said this could be benign. Hoping and praying! Still have swollen axillary nodes that ultrasound and MRI deemed benign. After biopsy of breast result, might have biopsy of nodes depending on findings. Thanks again!

  • moo-moo23
    moo-moo23 Member Posts: 1
    edited June 2018

    Beesie Thank you for posting that! I️ found a lump in my right breast and had a diagnostic mammogram and ultrasound on Thursday. When finished the nurse came in and gave me a paper that said it was “probably benign” but to follow up with the breast clinic this Wednesday and get another ultrasound in 1 month. I️ stood there speechless thinking what the heck is “probably benign”! I️ personally think it is a terrible term but thankful that I️ do get a follow up so soon. Still nervous. I’m 32 with implants. No history of bc in family. Any comments would Ben greatly appreciated

  • MTwoman
    MTwoman Member Posts: 228
    edited November 2017

    moo-moo, "probably benign" is a BIRADS category for findings that have certain characteristics. "The positive predictive value (PPV) or the chance of having a real breast cancer is very low for BI-RADS category 3 lesions. In addition there has been a decrease in PPV for BIRADS category 3 in recent years. So, with advances in both research and experience, specialists consider the PPV of a category, breast lesions 3 as less than 1%." (read more about the BIRADS scoring system here: http://breast-cancer.ca/bi-rads/)

  • green71364
    green71364 Member Posts: 9
    edited November 2017

    Yay for benign breast findings with BIRADS 4 rating! Still have swollen lymph nodes which I have had for 4 months now. Not growing, but not going away either. This is what I addressed in the first place, on Aug. 1st,2017, and I still dont know much more than they appear benign reactive on ultrasound and 2 MRI findings. Wish I could just let it go at that but they still ache! No call from surgeons office for re evaluation or follow-up ultrasound yet and it has been 2 weeks!