This wild Ultrasound Experience as I wait for Biopsy Thursday
A few years back (like probably at least 5) I was called back for a follow up mammo and U/S. Was told basically not to worry, but if i wanted a biopsy I could have one. (Radiologist was awesome, and showed me on his computer the area, how it hadn't moved or changed in three years, hadn't vascularized. He was wonderful. ) the US part of this visit was MAYBE ten minutes, tops.
so this year when I get my annual mammo (I'm 52), and get called back for a follow up, I think nothing of it.
Last Friday, As the tech is wanding my breast, she is so quiet. I kept telling myself, "well maybe that's just who she is." it feels like it takes a LONG time.
When the doctor comes in, she starts wanding. for even longer this time. By the time she was wanding over my armpit, I knew I was probably fucked.
I said, "look, my mom's a nurse, and I'm comfortable with data, statistics, and science. tell me straight up."
"you likely have cancer."
What. The Fuck.
Me: "Well....what does likely mean? A greater than 50% chance? "
Her: Yes.
Me: "like 70%? 90%?" ( I didn't know til like now what BIRADS was).
Her: "well, not willing to say that."
My primary calls to tell me the size of the two masses.
No one tells me my BIRADS. I ping both the primary and my OB/GYN today after the long weekend: BIRADS 4.
'BI-RADS Category 4: Suspicious findings'. They documented 2 separate masses in the right breast -- 1.0 x 0.8 x 2.0 cm with moderate vascularity & associated calcifications @ 7 o'clock and 0.8 x 0.5 x 0.6 cm located ~2 cm distal to the first mass."
So the radiologist says Likely, but then gives me Category 4.
I'm working hard not to spin, so I found this forum and thought others would have an opinion on this Radiologist's choice. I asked her to tell me, so that's on me, but rest assured I'm going to the biopsy with a flash drive and a boat load of informed questions. 😈
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Sorry you are scared. I have medical professionals in my family, too, and I said the same thing. I told the radiologist to be straight with me. I had two tumors next to each other. The radiologist came into the room. This is RARE. He said I likely had early cancer. He was right. A good radiologist can see a textbook case of cancer. They just are not supposed to say anything. If your us report says " spiculated mass", "hypoechoic", and "lacks-basement membrane", these are positive predictors for cancer. I personally prepared for the worse, and when I was told I had biopsy proven bc, all I wanted was to get it the flip out of me. I am doing fine 6 years later.
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My understanding is that birads 5 is for 95%+ chance of malignancy. There is a lot of room between 50% and 95%, and that's the room in the radiologist's conversation with you. It matches exactly what she told you in person, that she was comfortable saying greater than 50% chance but not comfortable saying greater than 90% chance.
It sounds like you asked the radiologist to have a frank conversation with you, and she did. Focusing on the interaction with her seems like a very human response to find someone to blame for something that is less scary than the true fear, but I don't think it would be helpful for you even if there were something to criticize about her response. Which it sounds like there isn't.
This not knowing is a very hard time under any circumstances. Take good care of yourself.
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Thanks for taking the time to reply. I am not worried about the radiologist's response. no criticism intended. but wild that she'd be so specific (basically this is a BIRADS 4c, but 4 was put on the findings).
Of course I'm new to all this. so what do I know?
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ohholyhell, I suspect that they may not have letter qualifiers in their form report. I was enlightened about tech glitches in pathology after my surgery when I discovered my tumor had time traveled. He (Norman Bates is mine, because tumors are kind of like serial killers) arrived in pathology 24 hours before my surgery. I was really confused. My BSO said it was an issue with their templates and that she was part of a hospital group trying to fix that issue along with standardizing what information the reports contained.
You asked, what now? First, if you are getting a biopsy, make sure you have a sports bra that fastens in the front or back. The pullover kinds are les comfortable with the pokes you will have post biopsy.
Next, from my perspective as recently diagnosed and now in treatment person, start reading up on good BC surgical oncologists (BSO) and Medical Oncologists in your area. I actually found an open review that led me to the only fellowship trained BSO in my medium sized city. I saw her and another general surgeon once I was diagnosed. If you find one or the other that you think will suit your needs, their referrals are likely to be good. In my instance I decided I wanted an all female team, and was able to get it, but if I'd just relied on my Dr. I wouldn't have gotten that. In the possible event you don't need a surgeon or MO, file the information away. It may help someone else you know, or you could end up in a different situation later. I found out that the pace of BC is weird. It's hurry up. Then wait and wait and wait. Then it's hurry up and wait some more. Once you have a treatment plan the waiting is easier.
Oh, and come here and we'll be here for all the things you think and feel. It's a lot. Maybe you will be benign. My story was that on initial diagnosis the radiologist was spot on with what he saw. Imaging can be surprisingly accurate these days. But. When I had a breast MRI they thought I had another concentric tumor. The radiologist insisted it had to be cancer. I had it biopsied, and it was benign. Her path note was skeptical, so on lumpectomy day, she marked and wired that benign mass and it was removed with the tumor. It was still benign. So, be aware, you are waiting for a reason. If radiologic images were perfect, we could skip biopsies. So, hang in with the waiting and do fin things that distract you do from the waiting. Take a mini vacation. Watch a movie. Eat jellybeans.Whatever helps.
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Everybody could tell from my mammogram and ultrasound that I had cancer. I was BIRADS 5, it was that obvious. So 4 means it's suspicious but not so obvious they can make the call by looking at it. But honestly? At this point the number doesn't matter. At all. It's not worth worrying about. All that matters now is what your biopsy says.
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