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Birads 4c after normal screening mammogram

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tntnsd
tntnsd Member Posts: 124
edited February 2021 in Not Diagnosed But Worried

I am 49 years old. Last month I felt a lump on my left breast. I scheduled a screening mammogram, and also my primary doctor to check it out. When I saw my doctor, the mm result has not been backed yet, but with exam, she felt the lump too, concern enough that she ordered ultrasound and dx mammogram for me. While waiting for that, my result from screening came back, normal with birad score of 2. I went ahead with the ultrasound and dx mammogram; I can tell that the result is not good from the look of ultrasound technician. The radiologist came back and told me that they found 3 small solid masses, together their size about 3.6 cm. They will née to order me a biopsy. The birad score from dx mammogram and ultrasound is no 4c. That makes me worry sick.

I am scheduled to have biopsy done Dec 29; it is hard and nervous for me right now. I read the stats and it said with 4c, it is more than 50% chance that it is cancer.

I don't know anyone in my family had breast cancer before.

I am so so scared.

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Comments

  • cookie54
    cookie54 Member Posts: 702
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    Hi tnnsd, Sorry to hear you are going through such a stressful time. We all understand the stress of waiting to have the biopsy and then waiting for results. The best advice I can give is try your best to not let your emotions get the best of you. Until you have biopsy results you can drive yourself crazy worrying! But the proof is in that tissue biopsy no matter what the radiologist may suspect. I have had many biopsies and I always told myself I can't change what is there. All I can do is have the best plan moving forward if it's positive. Remember there is still a chance that it's benign!

    I know how scary it can be but there are lots of effective treatments for breast cancer today. I know there is not much I can say to take your fears away but we are all here to support you. I will keep you in my prayers so that God gives you the strength to make it through this difficult time. Sending you big hugs(())


  • Poppy_90
    Poppy_90 Member Posts: 84
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    tnnsd, I am so sorry you are going through this. Especially during the holidays it has to be extra hard. The waiting is tough. I just wanted to let you know that I’m sending you a lot of good thoughts. You’ve found a really great place with a lot of information and support. Keep us updated on how you are doing.

  • sarahbarah88
    sarahbarah88 Member Posts: 9
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    I just wanted to pop on as someone whose very first mammogram and ultrasound resulted in a BIRADS 4c rating, was told it was more likely than not a low-stage cancer, and it turned out to be a radial scar, papilloma, and ADH. Obviously not saying you shouldn’t be prepared, but to say I’ve been where you are, and we’re all here for you to get through it - no matter the outcome!

  • LivinLife
    LivinLife Member Posts: 301
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    Welcome tnnsd! I too want to chime in with support... This is a great site full of information and support as I'm sure you've figured out by now. yes the waiting is so hard - any kind of limbo tends to worsen anxiety. You're less than a week out now - do what you can to engage in relaxing and enjoyable activities as much as possible. Your worry will be a known presence much of that time too... it's just about trying to buffer it and at times maybe it's not noticeable for a time...

  • moderators
    moderators Posts: 8,089
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    tnnsd, we're sorry you are here and worried, but wanted to say welcome!

    The main Breastcancer.org site has useful information that may reassure you, in the article What Mammograms Show: Calcifications, Cysts, Fibroadenomas. Hope this helps!

    We know it is hard not to worry but please, try to stay positive. There's still a chance your biopsy will be benign!

    Please, come back and let us know how it goes on the 29th. This wonderful community is always here to support you.

    The Mods

  • tntnsd
    tntnsd Member Posts: 124
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    Thank you for all your kind words. I am tryin g hard to not get my emotions getting worse now. Only my husband and me know about the biopsy at this time. I am trying to be normal in front of my teen/college girls during this time of the year.

    I will definitely come back with whatever result. Praying every night ...


  • tntnsd
    tntnsd Member Posts: 124
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    I am freaking out now after having the biopsy this morning.

    The biopsy went alright; however talking to radiologist, I am more convinced that the odds is not in my favor. She was the one that looked at my dx mammogram/ultrasound and gave it birads 4c; now she seems more sure that it will be malignant with the core needle biopsy she performed for me.

    I went home, and did not expect to receive result at least 1 or 2 days, or more giving this time. But just now I received some notification of test result in portal. It described the procedure this morning, with pre-procedure and post-procedure’s birads 5 . Does it mean it is confirm malignant ? There is not slim chance of b9 ? Is it how they let we know the preliminary result of biopsy?

    I am so scared

  • beesie.is.out-of-office
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    I'm sorry that you are going thought this. The diagnostic process is never easy, with all the waiting and all the uncertainty.

    From what you've described, it doesn't appear that the results are in, just a write-up of the procedure itself. A confirmed cancer is BI-RADs 6. Sounds like maybe the Radiologist changed the pre-biopsy assessment from 4C to 5 based on the imaging performed as part of the biopsy.

    It does sound as though you need to prepare yourself for a diagnosis of breast cancer, although this was the cases with a BI-RADs 4C too. Still you never know - there are even some BI-RADs 5 that come back benign. But start to prepare yourself mentally for a breast cancer diagnosis - and if it's not, that will be amazing news.

    image

    You'll be okay. There are lots of people here to help you through this.

    Sending cyber (((Hugs))).


  • sunshine99
    sunshine99 Member Posts: 2,638
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    tnnsd, I'm so sorry you are scared. Can you give your doctor a call and talk to her?


  • tntnsd
    tntnsd Member Posts: 124
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    I sent my Dr a text already via portal for some clarification, but not sure if she able to get back to me given she is out on holidays.

    How can one possibly prepare mentally to face this ?

    I am always be the caregiver of my own family and also to some degree my extended family. I cared and watched my father in law battled bone cancer 15 years ago and understood how hard it was for the family. This would be a devastated news to my aging parents and also mother in law who stays with us and has her own anxiety issue.

    I pray for the strength to face this with the minimal blow or impact to my loved ones


  • beesie.is.out-of-office
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    tnnsd, this board is filled with people who are currently going through treatment or have had breast cancer in the past. We've all had to face a breast cancer diagnosis. We are all here, going through treatment, moving on with our lives, and posting.

    Your experience with your father-in-law is shaping your reaction. Your breast cancer is not his bone cancer. Every case of cancer is different. Breast cancer is scary, but most people diagnosed with breast cancer have an early stage diagnosis, which is very treatable. Treatment isn't fun, but it's manageable. So don't assume the worst. Many people get through treatment with very few people even knowing that they have breast cancer, and without any significant changes to their lives. That's not to say that you and those you live with won't face disruptions, but it's not likely to be as bad as you fear. And until you have a diagnosis and know the specifics, you don't know what your treatment will be. Surgery? Yes. Radiation? Maybe or but maybe not if you need or choose to have a mastectomy. Chemo? Maybe but maybe not depending on the type of breast cancer you have.

    So take a deep breath. If you get a breast cancer diagnosis, you will put one foot in front of the other and take one step at a time, just as we all have. Sometimes it will be more difficult than at other times, but you will get through it. And your family will too.


  • alicebastable
    alicebastable Member Posts: 1,945
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    Tnnsd

    II found it helpful and nicely distracting to do a lot of fun things during the whole process. If my memory is correct, I went to an awesome concert the night after my biopsy. And I got the official confirmation of cancer while on a picnic. It was still a fun picnic! And I think I was at another state park when the surgeon called to give me the surgery date. Covid and winter can make it harder, but there are still nice days for outings, and silly movies to insert laughter into your life.

  • LivinLife
    LivinLife Member Posts: 301
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    I agree with all Beesie and Alice stated! I've watched several of my family members die of various cancers. Each of those were very different. Thankfully I was diagnosed with solely DCIS even though invasion was expected. They have come a long way with breast cancer if invasion is something you are diagnosed with. Search for the stories Beesie mentioned where people either no longer have any evidence of breast cancer or those that have quality of life in different ways despite still battling cancer.... I saw my experience as a way of vindicating for my family in some respects - I realize that would not be for other people... I hope you do not have to wait too long for your results. The waiting is soooo hard!!!

  • ILoveChocolate21
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    tnnsd I am praying for you and understand how you are feeling. My radiologist told me I very likely have cancer after viewing my ultrasound and diagnostic mammogram.He ordered a core biopsy to know more. Please keep us posted.


    ((HUGS))

  • tntnsd
    tntnsd Member Posts: 124
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    My doctor called me today when my husband and I were parking our car for our morning walk. She confirmed the news that I wished never heard. My pathology report returned with DCIS - she kept assuring me that although it is not good news, it is not invasive and with all progress in treatments these days and with her 16+ years experience seeing patients with BC, it is treatable. However, when I got home and access my portal, I see the report shows “ DCIS with nuclear grade 2 involving papilloma. ... The nuclear is 2/3. The pattens are cribriform and papillary and there is no necrosis”. I will my doctor a note asking for more info, but can someone please help to explain it to me with your understanding.

    I was glad that my husband was with me when I got the call. He is my rock right now. He kept me calm enough during the call. I don’t want to break down , it would make him worry more. We still need to break the news to our girls and family after we see breast surgeon, oncologist.

    Any advise for us on how best prepare to face this ? I am afraid if I keep googling for info, I will be worst mentally.I want to scream “dammit 2020!!! I hate hate this year”

  • moth
    moth Member Posts: 3,293
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    sorry you got the sucky news. Do stop googling. All the info you need (& more) is right here on BCO, it's current, it's real and realistic.
    Here's BCO's page on DCIS https://www.breastcancer.org/symptoms/types/dcis

    Don't really read much more than that unless you want to browse through the DCIS forums.

    The pathology notes are just discussing the types of cells seen. This wouldn't affect your treatment - it's all still DCIS.

    Hang in there; once you have a treatment plan it all seems way more manageable.

  • beesie.is.out-of-office
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    tnnsd,

    Yes, while no diagnosis is good, DCIS is as good as it gets. It is Stage 0 breast cancer, and by some definitions, a pre-cancer. It's not just treatable, but those diagnosed with Stage 0 DCIS have a long-term survival rate of 97%-99% - and that includes those who experience a subsequent recurrence, which you hopefully won't. The only reason you should be afraid of googling DCIS is because most of the articles these days talk about how DCIS is over-treated, and that can be a bad message, since DCIS should be surgically removed and adequately treated so as to avoid a recurrence. It's not the DCIS itself that is dangerous, because DCIS is not invasive and is confined to the breast, but it is the risk of invasive cancer that could develop from DCIS that is the concern and frankly, is the only reason why DCIS needs to be treated. So if your diagnosis is taken care of while it's DCIS, you will be just fine.

    Considering that you were 95% certain to receive a breast cancer diagnosis, if your final diagnosis remains DCIS, then that will be good news. The only fly in the ointment is that invasive cancer does develop from DCIS, and sometimes they are found together. As a result, in approx. 20% of cases where DCIS is initially found, some invasive cancer is found during the subsequent surgery. Most often when that happens, what's found is only a very small tumor, often just a microinvasion, meaning it's the smallest possible invasive cancer, with a prognosis barely any different from pure DCIS.

    Take a read here:

    Topic: A layperson's guide to DCIS https://community.breastcancer.org/forum/68/topics...


    .

    15 years ago I had two areas of grade 3 DCIS with comedonecrosis (that's as aggressive as DCIS can be) spanning over 7cm in my breast. And I had a tiny microinvasion of IDC, so technically that bumped me to Stage I rather than being Stage 0. I'm just fine, and I consider myself lucky to have had such an early stage diagnosis. I know that you aren't there yet, but hopefully you will get there soon and feel better about all this.


  • tntnsd
    tntnsd Member Posts: 124
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    Thanks moth, finding and learning from this BCO actually helps me a lot last several weeks. You all LADIES have such a strength and compassion that I wish I will learn someday for myself.


  • tntnsd
    tntnsd Member Posts: 124
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    Thanks Beesie, I followed many of your responses these days on this thread as well as other threads, they always give me a sense of calm, caring and full of compassion. Wish I could tell you how much it means to me.

    I am waiting for my breast team coordinator to get in touch with me with the appointments and tests. I am grateful that my dr seems to push to have this move along quick given this time of the year. A bit of me anxious because I am about going into new year with a project at work (I am an engineer). My husband kept telling me just take care myself first, not care about other things or what other people have to deal with when I am not there for them. I know he is right, but it is hard.

    We will wait for the treatment options, then will make the appropriate planning for that. From what I have learned past several weeks, I am leaning toward mastectomy probably without reconstruction. I don’t have big boobs to begin with (on 34c), skinny side.

    One question though, we don’t have any history of BC in my family that we know of (probably did, but not for sure if it originated from BC); I have 3 daughters, when I see my BC team, do I have to ask for gene test to ensure if we have the BC gene ? If so, is the test just for me or for all my girls ?

    Thanks

  • beesie.is.out-of-office
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    tnnsd, usually genetic testing is recommended when someone is diagnosed at a young age, or when there is a strong family history of breast cancer or related cancers. You are young, but not unusually young. And there is no family history. So your situation doesn't scream "get genetic testing" but it still might be worth a discussion with your MO, maybe just a question as to whether you should talk to a genetic counsellor to get an assessment.

    What's important to understand is that there are actually many genes that can increase breast cancer risk. Some people are just tested for BRCA1 and BRCA2, but these days people are often given a full panel test, which could include as many as 30 different genes. Some of these genes present only a small increase in risk for breast cancer but a higher risk for other types of cancer. Additionally, having a negative test result isn't necessarily an "all clear", meaning there is no genetic component to the cancer; it just means that you are not positive for any of the currently known variants. New variants are regularly discovered. And it is possible that a VUS could be found - that's a variant of uncertain significance, which means a mutation was found in one of the genes tested, but not enough is known about the variant to know if it is harmless or whether it possibly increases cancer risk. All these complications... that's why genetic testing shouldn't be done without talking to a genetic counsellor, who will explain all this before you make the final decision on whether or not to get tested.

    As for your daughters, no they should not be tested. It's always best to test the individual with cancer; if that person tests positive, then family members can be tested for the very specific genetic mutation that individual has. If the individual tests negative, then there is no reason to test family members. If you are negative, then there is nothing your daughters could have inherited from you (although they might have inherited something from their father).

    Hope that all makes sense.

  • tntnsd
    tntnsd Member Posts: 124
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    Thank you so much Beesie .


  • LivinLife
    LivinLife Member Posts: 301
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    tnnsd though you would have preferred to not go through any of this or for a benign result to have occurred, DCIS is a good diagnosis vs. the other cancer diagnoses. I was diagnosed with Grade 3 DCIS expansive comedo necrosis with micro papillary and cribiform types, along with a host of other benign and precancerous conditions. It is a Beesie said a pre-invasive condition, not technically cancer though only b/c it cannot survive outside of the ducts as is. It does evolve in most cases so getting it out is really important so it does not advance. Keep in mind the %'s Beesie offered for recurrence rate - really low, and lower if you decide to undergo Tamoxifen or a related med after surgery - that's for discussion with your oncologist. I chose not to go on such a med b/c my estrogen positive was so low (2%). I did not see where you listed your estrogen or progesterone status yet - likely you do not know that yet from just the phone call.

    tnnsd you can do this! I'm glad you have a great support in your husband and are also finding much support here. This part is very difficult though you will have a concrete plan soon and that helps a lot even if anxiety remains.

  • tntnsd
    tntnsd Member Posts: 124
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    Thank you LivinLife. It means a lot to me, able to share and offload my worry these days on this board.
    I don’t see my hormones status yet from my biopsy report in portal. I will definitely ask for that in my appointment next week with BS and RO. I hope not have to do a lot of chemo. At this point I am trying to gather as much info about lumpectomy vs mastectomy, so I can be at ease with myself when it is time to make decision. the hard part for me now also to maintain a normal face in front of my girls while keeping the anxiety at bay....

  • beesie.is.out-of-office
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    tnnsd, if your diagnosis remains DCIS, you will not need chemo.

    Chemo is never given for pure DCIS. If some invasive cancer is found, chemo might be recommended but it depends on the hormone status of the cancer, the size of the invasive component and various other factors. Many people with invasive cancer do not require chemo.

    If you have not already done so, read the link I suggested previously. Topic: A layperson's guide to DCIS https://community.breastcancer.org/forum/68/topics...

    It will explain about why chemo isn't given for DCIS and explain some of the considerations for mastectomy vs. lumpectomy.

    And this thread will be helpful too: Topic: lumpectomy vs mastectomy - why did you choose your route? https://community.breastcancer.org/forum/68/topics...

  • tntnsd
    tntnsd Member Posts: 124
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    Hi Beesie

    I spent quite some time to read the links you shared about DCIS. I can’t express my gratitude enough for the informative insight that you and all other amazing women on this board have (and still) offered. I am still in awe at how you all have the strength to deal with your own personal health or life issues and still able to reach out and help others like us.

    Of course, I am praying that I will be remained with DCIS given at this point. It is just hard for me not to get ahead of myself, not preparing for possible outcomes.


    I am leaning toward mastectomy because it is on my left breast (2:00 o’clock), 4 masses with total diameter about 3.6cm . My boobs just about 34b size. Not sure if lumpectomy is still a good option. We will have to wait until I meet my BS and RO next week (01/07). Also I am curious, for some reason the breast cancer coordinator scheduled appt for me me to see MO on 01/26. It is like 3 weeks out from 01/07. Is it normal ? Should I ask to see MO closer to the first appointment?

  • sunshine99
    sunshine99 Member Posts: 2,638
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    tnnsd, you and I are about the same breast size. I had a single mastectomy with no reconstruction. I have no regrets about the no reconstruction, but in retrospect, I wish I had had both breasts removed - more for "even-ness" sake. I'd sometimes like to just put on a tee-shirt and not worry about having to wear a bra to even myself out. I finally found a tee-shirt type bra that slips on, and has enough of a cup on the mast side to where I don't need an insert in it. If you do decide that you want some type of insert, there is a wonderful organization called "Knittedknockers.org". They make protheses of any size (up to a G cup, I think) and will send them to you free of charge.

    I'm glad you're coming here for information and support. Do keep us informed about your progress.

    (((hugs)))

    Carol

  • tntnsd
    tntnsd Member Posts: 124
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    Thank you Sunshine99, I appreciate very much you taking your time and share your experience. I don’t know any closed friends or family members who went through all of these. I am glad that I found this board, to keep me sane.

    I am almost 100% sure that I will not go with reconstruction. I truly believe my husband would want what is best for my health and my peace of mind. Now it is just matters which options would give the best chance of no recurrence in the future.

    Again thanks for sharing the info. About prostheses, I will keep that in mind and check it out.

    Thanks

  • LivinLife
    LivinLife Member Posts: 301
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    As far as a MO appointment - not unusual with DCIS not to meet with a MO until after surgery though some (including me) do get scheduled beforehand. Since I chose BMX and not to go on a hormone blocker I technically would no longer be meeting with a MO. She is continuing to follow me only b/c my breast surgeon had to go on medical leave days after she did my surgery (hope she is all right!) and b/c we (me and MO) are continuing to monitor blood work for blood work concerns unrelated to breast cancer. Docs are different so you will see what they recommend to you over time. If you agree to take a hormone blocker you will likely continue meeting with a MO after surgery since they are often the ones prescribing and monitoring that - I'm sure there are exceptions....

  • tntnsd
    tntnsd Member Posts: 124
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    Thank you so much for taking time to explain to me about the appointment.

  • tntnsd
    tntnsd Member Posts: 124
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    Hello Sunshine99 and all wonderful ladies

    May I ask you few questions regarding where to go for the treatment of your BC ?

    I live in San Diego, California. There are several hospitals with breast cancer treatments. The one I have now is Scripps, affiliated with MD Anderson cancer institution. Another option for me is University of San Diego California, it is a teaching hospital with a huge cancer center itself. I got PPO insurance, and I believe they are both in-network coverage.

    My questions ;

    When it comes to finding best place to have your treatment for BC, where would you go ?
    I have not met my BC team that my PCP refers me to yet (appt next Thursday). Should we alway seek out second opinion for peace of mind regardless ?

    For some reason, I have a hard time to compare those two centers in term of pros and cons. I was hoping if someone in San Diego already went through it might give me some inputs or if not in California,you might share your experience when choosing somewhere that can give you the best chance fighting this ?


    I appreciate very much.