BIRADS category 3.. To biopsy or not?
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Wrenn:
Definitely working on not being so anxious. The nurse in me is always expecting theirs the since that's what I deal with every day at work. Thanks for your advice. I've started some deep breathing and meditation to help me relax... Biopsy is this Wednesday
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Mine was actually an excisional biopsy (practically a lumpectomy) and they didn't leave a marker. However, if I had originally gone to the Conprehensive Cancer Center (CCC) they told me that theywould have done a core biopsy and put a marker. Unfortunately, I chose to do the initial biopsy by a local rural doc and he didn't really follow the right protocol. If I had to do anything over again, I would have gone straight to the CCC from the get-go!
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Oh ok. The radiologist actually called me this morning and spoke with me just to ease my anxiety about the whole ordeal. He explained that the use of a titanium marker is just a safety measure and it's so small I won't even know it's there. I'm just so anxious about the whole thing and the fear of the unknown. But, I've been reading a lot about the category of BIRADS 3 and it looks like most come back benign. So, I'm trying to take deep breaths and relax and pray that all comes back in my favor.
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It true...MOST do come back benign!
My friend had some biopsies where they placed titanium markers and she doesn't feel them or even know they're there
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I don't like the idea of the markers being left in there. I think even that would drive me nuts! If the doctor originally recommended a repeat US in 6 months with my BIRADS 3 category that it would be safe to forgo the biopsy Wednesday and just come back after 6 months time to have the US repeated? I'm confused about what to do. On one hand I'd like to know whether this lump is benign or not and on the other hand I really don't want the titanium marker left inside... Decisions.. Decisions.
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Hi Melly81 - just want to share my experience and hope it helps a little. I had my first mammogram a year ago at age 61. I had bilateral faint calcifications and a nodule in one breast. A diagnostic mammogram and us was ordered. Us ruled out concerns about the nodule. Calcifications looked the same in both breasts, but they were starting to form a line in one breast. I was birads 3. Out of an abundance of caution, my radiologist ordered a biopsy (not urgently - 6 weeks out) - and also because it was my first mammogram. I was/am birads 3. Even though calcs were starting to form a line, Biopsy came back completely benign - no atypical cells- fibrocystic changes only. I was not given the option of waiting 6 months. Post biopsy, I am still being monitored every 6 months for 2 years with diagnostic mammograms and us - even on the breast that had the benign biopsy. I'm told that it is their protocol to monitor all calcifications every 6 months for 2 years. I go to a breast imaging center for excellence, where all radiologistsare fellow trained. Best wishes for your biopsy this week and keep us posted.
Frankie
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I'm 34 with no history of BC in the family. The only way I even found this "lump" was because I was searching for something. Both breasts appear to be lumpy in my opinion. So I'm on the fence about having the biopsy done Wednesday. Do you have a titanium clip left inside your breast Frankie? That alone, scares me. I'm the worst worrier there is
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I do have a titanium clip. What concerns you about the clip? It was painless when they put it in and I can't feel it at all.
My situation was a little easier than yours in that I was not given a choice about the biopsy.
Even with the benign biopsy and 2 6 month follow ups that are okay, anxiety is always with me. I have another year of monitoring. I don't know ifthe anxiety will ever go away.
Frankie
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They are the size of a grain of rice. You can't feel them and it identifies that the area has already been biopsied on future imaging. A lot more desirable than having to rebiopsy an area in the future because it isn't marked that it has already been checked.
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Hi Frankie...
I just get anxious about the clip being left there. I don't want to have a reaction to it, I don't want it to become infected and I just don't like the idea of having inside me. I'm just weird like that. Why weren't you given a choice? My lump is 9x9x7 mm in size. All of yours came back benign?
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You don't have reactions to them. Titanium is the same metal used in hip replacements, etc.
Do you want to keep having to rebiopsy the same spot over the years because you won't let them mark it?
I think all these posts are just feeding your anxiety.
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I did not have a lump. I had calcifications in both breasts that looked the same. But the calcifications in one breast were starting to form a line and that can be a sign of early breast cancer. The only way to know if the ones forming a line was an early breast cancer was a biopsy. Prior to the biopsy, the radiologist told me that in her heart of hearts she didn't think it was anything, but only a biopsy would reassure her that it was nothing worrisome. I wasn't given the option to wait 6 months and yes mine was benign. The calcs in the other breast have been stable for a year and remain birads 3.
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Nobody has reactions to titanium--it is non-magnetic and won’t set off an airport metal detector. Not only that, it’s the metal they use for eyeglass frames for people allergic to the nickel in stainless steel (or even 14K gold). It has to stay in there so they’ll know where to look next time you get a mammo or ultrasound...or in the very, very, VERY unlikely chance you’d need a lumpectomy, where to find the tumor on mammo & ultrasound.
Take a deep breath. Several deep breaths. At first I thought you were unnecessarily anxious, but that there’s no real harm in getting the biopsy done in order to keep you from worrying for 6 months. But now you’re worrying about something as trivial and harmless as the titanium clip! I hate to make you even more anxious, but once the biopsy comes back benign and you’re advised to re-check in another 6-12 months, I suspect you will keep worrying (“what if the pathologist was wrong, what if they missed the part of the tumor that might have cancer, etc. etc.”). If you mistrust a benign biopsy result and insist on excision, you will worry yourself sick waiting for those results--and if they’re benign, you’ll probably still be waiting for the other shoe to drop. Trust me, it never ends--no matter the results.
Look, the fact is that life’ll kill ya. (I stole that from Warren Zevon). You could get hit by a bus. You could get shot as an innocent bystander in a gang-banger drive-by. You could choke on something with nobody to Heimlich you. You could get stung by a swarm of bees, carried away by a tornado, struck by lightning, catch a drug-resistant bug, You could fall down a flight of stairs and fracture your skull or spine. But no sane person twists their guts into knots worrying about those things. The chance your biopsy comes back anything other than benign is almost as remote--and the chance of anything going wrong by getting a titanium clip is nonexistent.
Being in the health professions carries the real danger of white-coat hypochondria. In my husband’s second year of medical school, he and all his classmates kept imagining the sound of hoofbeats and went looking for zebras--and were convinced they had symptoms of every disease they studied. It was ridiculous, and they eventually got back to reality and on with their lives. An example is one day years ago when I was going for my physical and booster shots. Before my primary care doc came in, the resident assigned to take my vitals & basic h & p looked at my toes and said they looked sort of purple--and asked me, “There’s a disease called lupus, you’re the right age for the highest risk of it, and I think you should ask your doctor to order an l.e. prep test.” My doc came in, I told her what the resident said. She looked at the thermostat in the room--it read 61 degrees. “Your toes are purple because you’re cold. I’m cold. But we won’t be for long,” she said, as she adjusted the air conditioner control. The she mentioned hoofbeats & zebras. (You can probably guess I never got lupus).
There are SO many REAL dangers in life to worry about--and eventually (unless you’re suddenly struck dead in your prime by a meteorite or runaway train), you will be old enough to encounter them. Then you will look back and beat yourself up for wasting the best and healthiest years of your life worrying unnexessarily.
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Melly,
What area of nursing is your expertise? I'm thinking you can drawn on the factual information (Ie your medical hat) to help with anxiety?
Im surprised that you are concerned about the titanium marker. I take it, in your area of nursing, you have not heard about this?
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Actually, most of the responses on here are making me realize how irrational my anxiety sounds to someone other than myself. I have been able to think my way through this all and am starting to realize that I do tend to think catastrophically about everything. I'm an experienced RN who cares for women to have undergone extensive mastectomies, and skin flaps, tissue expander placement and replacements so that is where my mind automatically went when the radiologist did not give me the automatic "you're all good it's just normal dense breast tissue" following the breast ultrasound. No, I was not aware of the titanium markers, and yes it makes me a little nervous. That nervousness I am sure it not a big deal to some, but to someone who suffers from health anxiety it is something that will be on my mind for a long time. However, I am thinking about listening to the radiologist's original rec of waiting the 6 months and having a repeat ultrasound. I thank you all for your responses and experiences. It's not an easy thing to deal with regardless of what the outcome is. It's the fear of the unknown and uncertainty in life that is scary. Thanks again...
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Hi Melly,
I have almost never heard of the markers causing a problem, although one person thought they were, so she actually had them removed surgically. I have markers in both breasts and have no had difficulty with them whatsoever. The main issue is, can you deal with the anxiety if you have to wait six months for follow-up imaging? It's up to you; of course, but maybe you could opt to wait, and get some kind of counseling in the interim to help you get through the time period. It is true that biopsies can cause scar tissue to form, making imaging more difficult. I did have a situation where the radiologist would have waited, but the surgeon wanted to biopsy. This was in the untreated breast, but I guess the surgeon thought I was at greater risk of having DCIS or atypia in the other breast. It was only a few months after I completed treatment on the other breast, so I went with it. If I hadn't seen the surgeon, I would have, most likely, waited. They converted the BIRADS to a 4 so that they could do the biopsy...result...completely benign.
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If you are having a fine needle biopsy (FNA) I am doubting whether a titanium marker would be placed. The needle used for FNA doesn't have the capability of introducing the marker into the area due to the slenderness of the needle. It is a different type of biopsy than a hollow core through which the marker is usually deposited. I have had numerous US guided FNA over many years prior to breast cancer diagnosis and never had clip placement until having a US guided hollow core biopsy done. If you are concerned about clip placement I would ask again whether it is done with FNA type biopsy - the radiologist may have assumed you were doing a different type of biopsy or generally answering clip placement questions.
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THey put me at a birads 3 with hypoechoic and lobulated nodule showing on my ultrasound should I push for more testing or wait the 6 months? This forum seems like a very helpful place where I'm hoping I can get a little clarification and reassurance. I am new to these boards and am waiting to go do my genetic testing in mid may (the first opening they had). every woman in my family has had breast ovarian and cervical cancer several times and some with a combination all before menopause as well as my aunt 48yrs old and cousin at 20 yrs old testing positive for brca1 gene and my sister 36 yrs old for colorectal cancer, so needless to say im 35 yrs old and worried due to multiple breast changes this year I have a lot of pain in my nipple almost like a hot iron going throught to my back and constant pain under both my arms. I had an ultrasound done a few weeks ago but haven't been able to relax since. i feel like somethings wrong and now i have to wait 6 months for ultrasound and until may for genetic testing. Any help you could give me with interpreting my ultrasound results would be awesome.
Multiple hypoechoic masses bilaterally measuring approx. 9mm in greatest dimension in right and left breast, appearance most consistent with simple and mildly complex cysts well as intramammary lymph nodes. most suspicious appearing nodule occurs in the 10 oclock position of the right breast 1cm from the nipple and measures 6x3mm in size. repeat bilateral u/s recommended in 6 months to confirm stability with particular emphasis on lobulated nodule in the 10 oclock position of the right breast approx. 1cm from the nipple. birads category 3 probably benign findings
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