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Can anyone who's had a breast ultrasound give me some info?

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freakedout2
freakedout2 Member Posts: 7
edited January 2021 in Not Diagnosed But Worried

This is probably a stupid question. I'm being sent for a breast ultrasound to evaluate some breast changes/symptoms. I've had about a hundred transvaginal ultrasounds in my day, and at least a half dozen thyroid ones, but this is new to me. What's the process like? How long does it generally take? What can and can't they tell from an ultrasound?

Also, I had a skin punch biopsy done to see if they can figure out why I keep getting skin infections (I'm concerned about IBC or IDC at this point but we'll see I guess); would that be able to rule out/detect IBC?

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  • trishyla
    trishyla Member Posts: 698
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    It's an incredibly simple, quick, non invasive procedure, far less uncomfortable than a transvaginal US.

    I changed into a spa type robe, bra off, pants on, then was taken to the US room. I laid down on the table and the tech opened the robe, applied the gel, rolled the wand around for a couple of minutes, then it was done. It took about 10 minutes total.

    Mine was read immediately by the radiologist and I had a biopsy right then. That part sucked.

    Good luck. I hope it turns out to be nothing.

    Trish

  • sasamat
    sasamat Member Posts: 43
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    I've had a few breast / axilla ultrasounds, for various reasons. First, an enormous ping-pong-ball-sized armpit lump that emerged suddenly during pregnancy. That turned out to be accessory breast tissue responding to hormonal surges the same way as breasts do. Then I've had ultrasound to follow up an abnormal screening mammogram. That turned out to be a lymph node inside my breast. I've paid privately for an ultrasound for same accessory breast tissue that bugs me constantly (I'm in Canada, so it's unusual to go outside the public system). More recently, I've had bilateral ultrasound to also follow up an abnormal screening mammogram. But in this case, I've also had stereotactic core biopsies showing atypical ductal hyperplasia and I'm preparing for surgical excision in about 2 weeks. I get the results from that ultrasound tomorrow.

    The general setup for my breast ultrasounds has always been like Trishyla says. (I've also had lots of the other kind, since I've had twins. It's lovely you don't have to prepare a full bladder for breast ultrasound!)

    My first 2 ultrasounds were quite short and chatty (armpit during pregnancy lump and lymph node in breast). The radiologist explained exactly what they were seeing and what they thought in real time. I left knowing what the result was.

    My last 2 ultrasounds lasted longer and I dealt mostly with a tech, who is not in a position to say what they are seeing. Even last week's ultrasound, where the radiologist eventually got called in, she wasn't willing to say anything. She was clearly taking specific images and annotating them for later interpretation. These both took longer (20-45 mins) and are more nerve-wracking, because I am constantly trying interpret everyone's facial expressions. These are harder for me, because you have to wait 'til later to learn the findings.

  • mountainmia
    mountainmia Member Posts: 857
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    I've had 3 breast ultrasounds and a "whole breast ultrasound," which is a different process. I would say each of the regular ones took longer than Trishyla is describing. The first one was the diagnostic one for my IDC and DCIS diagnosis. The tech spent quite a bit of time with me before calling the radiologist in, who also looked at the images while the tech was viewing the spot. Some images were saved with measurements, too. They were able to do the biopsy right then, rather than scheduling another appointment, which was great from a timing standpoint.

    The US is not generally painful, but if your breast is tender then it might be uncomfortable at moments.


  • threetree
    threetree Member Posts: 1,371
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    I had a breast ultrasound in the ER, as I had gone there with chest pains that turned out to be related to my tumor (it was large and causing pressure in my chest). It didn't take all that long, but I don't remember just how many minutes. I had my pants on and a hospital gown. It didn't hurt at all. The tech didn't say anything of course, but I got the results when I left the ER. If the test is done in the ER you get the results right away and don't have to wait, but I know your situation is different and your US is scheduled. The results just referred to "a mass" and gave some size measurements, but it did not actually go into whether it was cancer or not. I had the biopsy later in a surgeon's office.

    It would have to be much, much simpler and easier than a transvaginal US. A doctor wanted me to get one of those a few years back and I declined, it just sounded awful and I didn't think I could do it. I'm also used to actual doctors performing procedures "down there" and didn't at all like the idea of "just a tech" doing it.

    Good luck - it shouldn't be a difficult time at all and I really hope the results are not a big deal.

  • alicebastable
    alicebastable Member Posts: 1,945
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    The techs who perform trans-vaginal ultrasounds are more highly trained in that procedure than a doctor would be. I had several of them about twelve years ago, all done by technicians. I'm not sure I'd trust a doctor to do one correctly, because it's not their specialty.

  • beesie.is.out-of-office
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    Ditto what AliceBastable said. Recently we've had a couple of women on this site who went to breast surgeons for their screening mammos and biopsies, and ended up needing to do it all again with radiology techs and a Radiologist. I would expect the same would be true with any type of ultrasound - personally I want the people trained for the procedure to do it, not someone who does it as a sideline. When I had a transvaginal ultrasound, my doctor sent me to a screening center where a trained tech did it and a trained Radiologist reviewed the imaging.

    freakedout, to your question, it is my understanding that a punch biopsy is the best way to diagnose IBC and therefore a negative punch biopsy should rule out IBC. As for what they can tell from an ultrasound, ultrasounds are best at identifying whether a mass is solid or fluid or a combination of both. A completely fluid filled mass is a cyst, and those are benign. A solid mass may be a fibroadenoma - also benign and ultrasounds are sometimes good at picking up the specific characteristics. Often it's the combination of a mammogram and ultrasound that helps the Radiologist assess whether a biopsy is required. Each screening modality 'sees' into the breast differently, and combining how something looks on a mammogram (or if it shows up at all) and how something looks on an ultrasound (or if it shows up at all) gives the Radiologist enough information to determine whether something is benign or highly likely to be benign, or whether it's uncertain and requires a biopsy. Have you had a mammogram?

    A couple of other things. Whether you get the results on the spot and speak to the Radiologist depends on whether this has been scheduled as a screening ultrasound or diagnostic ultrasound. Screening ultrasounds usually are not read on the spot, but diagnostic ultrasounds usually are. A Diagnostic ultrasound is usually done as a call-back after a screening mammogram has shown something, or sometimes is scheduled if there is obviously a mass or distortion in the breast that requires investigation. Even if the ultrasound is read on the spot and you do get to speak to the Radiologist, it is extremely unusual to be sent for a biopsy on the spot, so don't expect that this will happen. It's not impossible (to MountainMia's example) but very unlikely.

    When is your ultrasound scheduled?

  • threetree
    threetree Member Posts: 1,371
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    Nice to hear the better thoughts about technicians and ultrasounds. The first ultrasound I ever had was in the 1980's when I was expecting my second child. In that case the doctor/radiologist was in the room with a technician and was directing and explaining the whole procedure. Ever since then, I've only had a technician do an ultrasound with no doctor and I came to the conclusion that they had turned it all over to technicians as a cost cutting procedure, much like the way ARNP's and PA's now do some of what doctors used to do. I would think that a gynecologist could/would be well trained in how to do a transvaginal US, but who knows? I think I'm just getting real old fashioned and it's all been ingrained from the old days when the actual doctors did most everything. I was also raised in a family that said to never go to osteopaths and chiropractors, only MD's. That said, I've seen osteopaths at clinics who have been just fine and there are many things for which I feel totally comfortable with a nurse practitioner, and in fact prefer them over doctors. Can't say that so much with PA's though. I do believe that a well trained technician would be better at a particular task than many doctors.

  • melissadallas
    melissadallas Member Posts: 929
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    I was pawned off on the nurse practitioner and never saw the gynecologist when I was having severe bleeding and “perimenopausal” problems five years before I developed massive ascites with my twenty two pound ovarian tumor and almost died She put me on birth control pills, which likely made it worse. Do I think the doctor might have caught something the NP missed? Yes, at least I hope so, and I know the (likely already large) tumor was the problem.

    Do I mind seeing the NP for minor stuff? No.

  • freakedout2
    freakedout2 Member Posts: 7
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    Thanks everyone for your input. I'll be having it done at NYU, which has never led me wrong with any imaging tests, so whatever happens I'm sure it will be done competently. I haven't scheduled it yet; I figure I might as well wait two more days for the biopsy result in case that affects what I need to do. I'm extremely anxious because of my symptoms (especially the ones that seem to match the "unmentioned" symptoms people here have described, like excessive sweating, intense sugar cravings and high blood sugar), but I guess I'll find out within the month. Never thought I'd be worried about breast cancer at 37, but I guess no one does.

    FWIW my experiences with ultrasound techs and doctors have been more or less comparable. My gyn does his own ultrasounds in-house, which is tremendously convenient when you need one every three months. The only downside is he likes to give little guided tours of my insides while I'm just thinking "Yeah, super, please hurry it up."

    Melissa, holy crap, 22 pounds?? Here I thought my 11 cm endometrioma/16 cm fibroid were big! I felt so good unloading that fibroid and all the endometriosis the surgeon took out while she was there; I can't imagine what it felt like post-surgery to not have that monster in there anymore!

  • threetree
    threetree Member Posts: 1,371
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    After reading Beesie's post I can add that the breast ultrasound I got did say that it was a solid mass and not a cyst; no fluid, so I can underscore her comments there. Also, it was able to note that the mass that was seen was right at the same spot where I had had a benign fibroadenoma way back when I was 19 (I had thought what I was experiencing a couple of years ago was related to that old fibroadenoma and assumed it was benign at the time). I had told the staff there that I thought it might be a change in an old fibroadenoma site and I was actually quite surprised that the radiologist could still see, all those years later, that same spot in the same place as my new troubles, so a breast ultrasound is apparently very sensitive to certain features, so would be well worth getting since it is painless, fairly quick, and can provide a lot of good info.

  • melissadallas
    melissadallas Member Posts: 929
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    What do you mean by the “unmentioned” symptoms people here have described? Sweating, sugar cravings and high blood sugar are a lot more likely to have nothing whatsoever to do with cancer. The majority of folks post here are ultimately NOT diagnosed with breast cancer. If I saw those symptoms I would assume perimenopause and/or obesity way before I thought it had anything whatsoever to do with breast cancer.

    Yeah, my tumor tool up my entire abdomen and was compressing my heart and kings. I also got bonus pulmonary embolisms...

  • mountainmia
    mountainmia Member Posts: 857
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    Right, Beesie. The fact that I had my biopsy immediately was a fluke, because they happened to have an open slot right then. I think generally at my hospital it would be a few days wait.

  • bcincolorado
    bcincolorado Member Posts: 4,700
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    When I had my mamo this year on my "non-cancer" side that is still me after several takes of the mamo and with dense tissues and my history they did an u/s right away. I was in a breast center though and they specialize in this there. They read right away and even had radiologist come talk to us to reassure us of the suspicous area they are watching.

  • alicebastable
    alicebastable Member Posts: 1,945
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    I had my biopsy right after the ultrasound, but that might be the way our breast center schedules things. The appointment was for "Ultrasound and possible biopsy" at the same appointment. I had the u/s, the radiologist was called in to review it, then they added a nurse to the crowd and I got biopsied by the radiologist, all on the same table/bed/whatever. Very nice and efficent.


  • trishyla
    trishyla Member Posts: 698
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    The reason my US was so quick, and why I was given an immediate biopsy was because the US tech knew right away that what she was seeing was very likely cancer. She took a couple of snap shots and sent them directly to the Chief Radiologist. He came in, checked the live ultrasound and told me I needed a biopsy, sooner rather than later. He was right. Triple negative cancer in my right breast.

    I saw the Breast Surgeon two days later. When she did her exam, she found more lumps in my left breast. Sent me back to the Breast Center that day. Repeat of my first visit, including the Chief Radiologist. This time he found two tumors, both turned out to be hormone positive.

    I'm glad I was able to get immediate biopsies. It would have been harder for me to wait.

  • freakedout2
    freakedout2 Member Posts: 7
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    Saw my GYN today and was told to get a mammogram as well, which makes sense but isn't something I'm looking forward to. Trying to get everything scheduled now. GYN said he couldn't feel anything and nothing was jumping out at him visually which I guess is positive (though I know plenty of people have bc with no palpable lump). Really hoping to get this over and done with quickly. Scared of answers but not knowing is also crappy.

  • mountainmia
    mountainmia Member Posts: 857
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    It totally makes sense to have the mammogram, too. The two types of scans provide different information, and together will help guide what happens next. Thanks for letting us know.

  • freakedout2
    freakedout2 Member Posts: 7
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    I was able to get them scheduled both for the 4th, so at least I can combine the two into one trip. My anxiety is through the roof; I know my issues could be caused by a number of things, but I'm finding it hard to stay positive.

  • blue22
    blue22 Member Posts: 172
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    Hi freaked out,

    What symptoms have you had that make you think you have IBC?

    I had a mammogram and ultrasound back to back. The ultrasound was easy. It was late in the day and they took a lot of time. By the time they were done with the ultrasound the FNA biopsy clinic down the hall was closed for the day and they told me to come back first thing in the morning. They also told me that even without a biopsy they were sure I had cancer.

    When do you get your punch biopsy results back?

    I hope you do not have cancer and it is just nothing - which is much more likely!

    Take Care,

    Blue

  • freakedout2
    freakedout2 Member Posts: 7
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    Thankfully (and a little unfortunately since I have recurrent skin abscesses on that side and I'd like to know why!) the punch biopsy came back clear

    Another question:

    The other day when I met with my GYN I had a difficult time expressing one of the things that's making me think I have something sinister going on. I don't think I was able to say it in a way that actually got across what I was trying to say. Since I'll likely seek out a second opinion regardless of the outcome of my imaging tests, I was wondering if there was a better way I could explain myself.

    Basically, my nipple retracts when I lie on my back with the breast upright (if I just lie back without holding it up, everything just kinda flops to the side). But it appears to sink into the breast more than be pulled. I have what seems like loose skin in the area (I've gained, lost, gained, lost etc a lot of weight over the years so there's a little bit of loose skin on my breasts), and if I pull that back to tighten the skin like it would be when the breast is hanging, it no longer appears sunken (just flat, but not much more than usual; it's always been on the flat side).

    Standing up, bending forward and lifting my arm make no difference I can perceive (though it's difficult since the issue is mainly when it's soft, but it tends to harden with movement, thus making it hard to tell how it acts in its "resting" state), but squeezing the breast makes it appear to pull inward a bit.

    I tried to explain this to my GYN and the poor guy just looked at me like I was speaking another language. (And I couldn't demonstrate because it was about 30 degrees in his office!) I did take a picture today in case I can't get it to repeat when I meet with either my GP or whoever I choose for a second opinion, but I'd like to be able to explain myself a little better.

    I realize this is a weird question; I just hate not being able to communicate my concerns effectively and I've been Googling forever trying to figure out the words for what I'm experiencing. But all I get are "if you experience nipple inversion or retraction, speak to your doctor." Anyway, I figured I'd ask here, not otherwise knowing where to go. Apologies for yet another stupid question.

  • mountainmia
    mountainmia Member Posts: 857
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    Okay, freakedout, it's great to hear that your skin biopsy was negative. Also your gynecologist found no palpable lump or sensation of a problem. Also you have described an "inverted" nipple, but it is only sunken when you are lying on your back, and you also note you have gained and lost weight many times so your skin and tissues are loosened by that. You have scans tomorrow, which is GREAT!! And you should get information back from them pretty quickly. If they tell you that nothing is wrong, will you believe them? No offense, but it sounds like you're looking for something to worry about.

  • blue22
    blue22 Member Posts: 172
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    Hi FreakedOut,

    That is very good news that your punch biopsy came back negative!

    I can see that the nipple issue you are experiencing is difficult to describe, and hopefully it is just nothing. Breasts change with time, and most of the time the changes are not indicative of anything serious. I can tell you that when my nipple changed you could see the difference no matter what position I was in. Eventually the difference was quite obvious.


  • freakedout2
    freakedout2 Member Posts: 7
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    No offense taken; I'm a worrier. Honestly I just don't have a high opinion of my current GP and until I find someone I do think is good, I'm hesitant to just take his word for anything.

  • freakedout2
    freakedout2 Member Posts: 7
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    My results were normal. Thank you everyone who helped me. Wishing you all the best in the future.

  • minustwo
    minustwo Member Posts: 13,119
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    Congrats. Thanks for posting your normal results.