Should I have asked for more testing besides ultrasound?
Hey all,
A couple years ago I noticed an area of "thickening" in one of my breasts. On both of my breasts there appears to be a network of tissue/glands (I guess, it's definitely not fat) in the upper outer part, sorta kinda mirrored on both sides. However on the right side it is noticeably thicker, larger and firmer. It's not rock hard and I can move it around as I can with other tissue.
First I saw a nurse practitioner who gave me an X-ray and took my c-reactive protein, which was normal. I'm not sure why she did that really because you don't diagnose breast cancer with an X-ray and I guess c-reactive protein can be taken to see if there is a lot of inflammation, which is present with more aggressive types of cancers most of the time (I *think*), but it wouldn't diagnose cancer. So kinda confused about that. She also said it felt normal to her and that with something the size of what I have I would be having other symptoms (but from what I've heard elsewhere it doesn't sound like that's true).
Anyway, last year I was thinking about it again and decided to see a gynecologist (the LNP I saw was primary care). He said he can tell what I'm talking about but it really feels like normal breast tissue to him, and that most of the time breast cancer is an extremely hard lump that doesn't move at all. I said "Well, it is kinda hard." He replied "Sort of, but I'm talking like -" *raps his knuckles on the wall*. He said I did exactly what I should have done by having it checked out though because you should do that when you notice an unusual change of any kind in your breasts.
I had an ultrasound and it was normal. I'm 28 with no family history of cancers except for thyroid cancer in my grandmother when she was very elderly but that was due to radiation exposure. Though I know 85 percent of women who have breast cancer have no family history of it.
The area in question doesn't seem to change throughout my cycle. Sometimes it will hurt before any other parts of my breast before my period, but usually not. Pain is tricky for me though because I get random pains due to anxiety which resolve once I force myself to relax. Also I have a desk job so sometimes I get tight chest muscles, especially in my right pectoral muscle because I'm right-handed.
And because of this anxiety thing it's hard for me to be like "I just need to follow my gut if something seems off" because I catastrophize everything and feel like everything seems off all the time (I don't tell doctors that though lol). But nothing has changed in my breasts since I first noticed it and I do self exams regularly.
So my main question is... should I do anything else? Just monitor it for changes? I guess I'm also kinda unsure about it because I'm not exactly sure what changed or why. Does the texture of your breasts really just change like that sometimes as you age and it's normal?
Comments
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You can request a mammogram if you want! And also look into treatment for anxiety so you aren't catastrophizing everything.
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Thank you for the response! So I thought mammograms generally aren't useful on women below 40 or so and that's why they don't do them? I could be wrong but that's why I didn't think to ask for one.
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I may be wrong, but mammograms for those under age 40 are useful. My impression was that they are not done routinely on those under 40 is that it is far less likely that women that young would develop bc. Of course, that is not 100% true as some women under 40 do indeed develop bc but it far less likely.
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Ah okay, my mom (nurse) told me they don't usually do the on younger women because younger women have denser breast tissue and mammograms have a harder time seeing things through dense breast tissue than ultrasounds. But hey it was a nurse practitioner who gave me an x ray and a blood test to try and check for breast cancer so my mom could be wrong lol. But I was thinking like an MRI or a biopsy or something for additional testing. I'll ask the doc though I guess, in January I could get an annual at my gynecologist I believe.
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Regular mammograms are not recommended for younger women as a general rule, not because they don't work, but because it's unnecessary. But they are absolutely used for high risk women and for specific situations where there's something unusual or suspicious going on! They definitely work. It's just not necessary as a routine thing for everyone. If the mammogram isn't giving the results someone needs, they can do other scans.0
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I see, thank you!
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Hopefully you have nothing to worry about but I wanted to share my experience because you describe the change as 'thickening' - and that's how it felt to me when I noticed something different. In my case it turned out to be lobular breast cancer (diagnosed at age 42 but likely been growing a while) which was missed in a mammogram and ultrasound. The thickening seemed to grow and sometimes it got painful if I exercised a lot. As I had no history of cancer in the family, most people told me it was probably nothing to worry about including doctors so I wasn't too worried. One thing I wish someone had told me was that if you have dense breasts (which I did), they often can't tell conclusively in an ultrasound and the only way to know for definite is via an MRI. I'm sad to say I avoided the extra cost of that scan so another 10 months went by after the ultrasound before I went back to the doctor. The MRI detected a large mass - lobular cancer that spreads like a web so feels like thickening of the breast. Fortunately it was slow growing, hadn't spread beyond a few lymph nodes and was successfully treated with chemo, mastectomy, radiation, etc. Anyway I wanted to make sure you were aware that ultrasound can miss some types of cancers.
Like I said, hopefully there are no issues with you but please keep checking in case the thickening gets worse.
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Hi, thank you so much! I seriously appreciate the perspective of someone who had something similar to me. I was told yesterday by someone else with breast cancer that they're often reticent to do MRIs because MRIs are super sensitive and they pick up a bunch of stuff that isn't actually cancer. She said the only way to know for SURE would be a biopsy, but since that's invasive at this stage she suggested I keep monitoring it and maybe change my doctor's appointments for getting it looked at from once to twice a year. I might ask my doctor about an MRI anyway though... it couldn't hurt to ask if he thinks it's a good idea.
The aforementioned person had a similar thickening in one breast and got an ultrasound for it which ended up not being cancer, but the ultrasound showed that there was actually cancer in the other breast which they thought was healthy!!!! Sheesh. Not ruminating over this stuff is hard sometimes with all the uncertainties haha.
Mine hasn't changed since I noticed it a couple years ago. But I'll definitely keep the self exams up and monitor for changes.
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Hmm. I think I may have noticed another bump, somewhat mirrored on the other side but larger and firmer on the "problem" breast. Although my period is coming in a few days and I just started drinking caffeine again after a few months of not drinking it. But it couldn't hurt to go back to the doctor. I'm nervous mostly because I really want kids though and I'm already 28. Ugh. The areas seem to get firmer around my period too.
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Another thing I forgot to mention is that the thing that prompted an MRI finally was a breast health doctor - she was a specialist and as soon as she did a physical exam I could see her face change and she brought out a measuring tape so I knew something was off. She told me to get an MRI immediately. The doctor I went to before was my regular primary care physician and he looked like he didn't have a clue what he was looking for. I remember him saying it's fine and that it feels the same on the other side. I knew it was different and I'm glad I sought out another opinion. Breast health specialists usually know exactly what to look for when they do a physical exam so maybe see if you can find one?
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Thank you for another response! So I had two gynecologists look at it. One I saw specifically for my breast. The other I saw a few months later just for an annual. The first guy I told him what I was feeling and he checked it out, the second I didn't tell her about it but she felt my breasts as a regular part of the exam and didn't say anything about anything seeming off. Then when I got the ultrasound at the breast cancer imaging place the radiologist felt it and said it seemed like normal breast tissue to him and said "See you back here when you're 40." I guess I assumed they would know what to look for lol. 😩 So frustrating. I could look for a breast specialist for sure though. I think I thought that gynecologists and a radiologist at a breast cancer place would more or less be breast specialists, but that was just an assumption.
Another thing that's tricky is that I freak out over things that end up being nothing a lot so I don't really trust myself... even giving myself issues like chest pains and difficulty breathing that end up being just because I'm upset. But I also don't want a boy-who-cried-wolf situation.
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Hello all, I just wanted to post an update for posterity lol.
My mom could see I was freaking out and ended up basically just telling me to go see the gynecologist again, if only so I could ask him questions about it. Basically I'm freaked out because I've experienced these changes but no one has told me anything besides "It's normal, see you when you're 40." He told me that breast tissue is not a static tissue and is influenced so much by hormones. Your breasts change naturally over the years. Often they will change throughout your cycles but often the changes won't seem to be influenced by your menstrual cycles. Often they will be symmetrical (like mirrored in both breasts) but often they will not be symmetrical. He said that my breast tissue feels exactly like healthy breast tissue that he examines every day. He told me that if what I had was lobular cancer since I noticed it almost three years ago he says by now I would feel very ill if it was that. However he still said he would order me an ultrasound if I wanted one, and if not he asked me to make an appointment for two months from now to see how things are. For now I chose to take the appointment for two months from now, but I'm going to talk to my therapist about it. Maybe I will get the ultrasound? I pointed out to him a new area that I felt but he said he couldn't feel anything there really. Which is weird to me because there's definitely something there. Sorta a small lump, maybe the size of a fingernail, edges not super distinct, movable, but attached to tissue someplace, like a cyst perhaps. He just said he felt a rib and at the appointment I was like "Oh okay" but I think because of the angle he didn't feel it. I could be wrong though, it's possible that he felt it and didn't think anything of it. But I see my therapist Wednesday so I'm going to wait on scheduling anything else for now. I have OCD and am trying not to engage in checking behavior, but want to get things checked out if there could be an actual problem. It's a fine line sometimes haha.
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