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concernedaboutresults
concernedaboutresults Member Posts: 85
edited December 2022 in Not Diagnosed But Worried

I am new, and this is my first post. I am 53 years old and post-menopausal since my mid-40s, confirmed by hormone testing. I had my mammogram screening a few weeks ago and was called back for additional diagnostic imaging due to a finding of a "developing focal asymmetry" compared to my 2020 mammogram. They found a small (6mm) spot that the radiologist gave a BIRAD 4C risk rating after the diagnostic mammogram and US. I do not currently have any palpable masses. I have no history of masses or breast cancer, and none in my family. However, every person who has passed away in my family to this point passed from cancer, including my parents from lung cancer, my dad at age 55, and my mom at 72. Indeed, in 2020 my mom's second opinion oncologist recommended that my siblings and I have some genetic screening to asses our cancer risks due to the prevalence of cancer (leukemia, lung, throat, bladder).

So my biopsy is scheduled for Wednesday morning, and I am in the place I call limbo hell. I don't know what to expect with the biopsy other than I will receive a local anesthetic, and a needle will be inserted. My radiologist told me that BIRAD 4C means my risk is 50% based on the attributes of the spot in US images. He also said that if cancer is found in the biopsy, we would have caught this early. I'm still unsure about that because my mom's lung cancer was one of the most aggressive her oncologist had ever seen. It metastasized to places not commonly found and failed to respond to treatment. Her initial prognosis was quite poor due to being found quite late at stage IV. I consciously realize that I am bringing much baggage from my experiences with other family members' cancers into this situation. As such, I am trying to educate myself and remain calm until we know something more.

I wonder if I should call the oncologist my mom saw in 2020 to find out what specific genetic testing he recommended. Does anyone have any thoughts on this? I told this to my PCP, and he did a low-dose CT scan of my lung and found a small nodule. I had a second done a year later, and no changes, thankfully. Anyway, I'm doing my homework to educate myself and be prepared to ask the right questions. I'm also trying not to make myself sick with worry.

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  • ctmbsikia
    ctmbsikia Member Posts: 753
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    Hi, Welcome. So sorry you had to join. Let us know how you make out with your biopsy. A 4C is a bit concerning, just try to keep busy until you know. Breast cancer, unlike lung cancer is really not an emergency. Most forms, (not all) are slow growing. Sending best wishes to you.

    There is much heart disease, stroke, and diabetes in my family history. My sister was diagnosed with breast cancer at age 50. Me, at 56. No clue where it came from, I am BRCA negative. We are both hormone positive, HER2 negative. She has invasive lobular with bone mets. Mine was mixed type invasive ductal with lobular features. Also found DCIS, and I have LCIS in my right breast.

    Really sorry about your parents. My husband died from small cell lung cancer which is very aggressive. It is not normally found until it has spread beyond the lung. He did respond to chemo for almost 5 months until the disease progressed and went to his brain. He passed 10 days after 10 radiation treatments to his head. It was awful.

    I just felt compelled to respond since I get how you feel. You are right in trying to remain calm. Hard as it is. Should things not turn out, there are many here that will help you through.

  • ctmbsikia
    ctmbsikia Member Posts: 753
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    Hi, Welcome. So sorry you had to join. Let us know how you make out with your biopsy. A 4C is a bit concerning, just try to keep busy until you know. Breast cancer, unlike lung cancer is really not an emergency. Most forms, (not all) are slow growing. Sending best wishes to you.

    There is much heart disease, stroke, and diabetes in my family history. My sister was diagnosed with breast cancer at age 50. Me, at 56. No clue where it came from, I am BRCA negative. We are both hormone positive, HER2 negative. She has invasive lobular with bone mets. Mine was mixed type invasive ductal with lobular features. Also found DCIS, and I have LCIS in my right breast.

    Really sorry about your parents. My husband died from small cell lung cancer which is very aggressive. It is not normally found until it has spread beyond the lung. He did respond to chemo for almost 5 months until the disease progressed and went to his brain. He passed 10 days after 10 radiation treatments to his head. It was awful.

    I just felt compelled to respond since I get how you feel. You are right in trying to remain calm. Hard as it is. Should things not turn out, there are many here that will help you through.

  • alicebastable
    alicebastable Member Posts: 1,940
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    My dad had kidney cancer and skin cancer - I've had both. My mom had breast cancer (as did a paternal aunt) - so did I. My maternal grandmother had uterine cancer - so did I. Dad also had an aneurysm - and guess what, so do I! I had genetic testing done, and no connections at all were found. It's a surprisingly small percentage of women who get breast cancer as an inherited trait. Good luck on your biopsy, and whatever happens, I suggest scheduling fun things before and after each office visit, test, and procedure. I did, and I barely remember all the medical crap, but I do remember the fun day trips and other things I did with my family.

  • alicebastable
    alicebastable Member Posts: 1,940
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    My dad had kidney cancer and skin cancer - I've had both. My mom had breast cancer (as did a paternal aunt) - so did I. My maternal grandmother had uterine cancer - so did I. Dad also had an aneurysm - and guess what, so do I! I had genetic testing done, and no connections at all were found. It's a surprisingly small percentage of women who get breast cancer as an inherited trait. Good luck on your biopsy, and whatever happens, I suggest scheduling fun things before and after each office visit, test, and procedure. I did, and I barely remember all the medical crap, but I do remember the fun day trips and other things I did with my family.

  • concernedaboutresults
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    Thanks for your response, ctmbsikia! My mom had non-small cell lung cancer (NSCLC) with mets everywhere when she was diagnosed and staged. I remember so vividly her pulmonologist coming out after her first biopsy. He told us that he did not need to wait for pathology results to let us know she had advanced lung cancer. And this was true by the time we had her staging surgery, sampled lymph nodes, and then PET showed it was everywhere, liver, adrenals, bones, skin, and heart. She was PD-L1 positive (tumor marker - programmed death ligand 1), making her eligible for Ketruda, an immunotherapy drug. But yes, small cell lung cancer is quite aggressive, and my mom's presentation of NSCLC was more aggressive than what was usually seen. It is good to know that breast cancer grows slower. I had done a tiny bit of research before my diagnostic mammogram. I read a couple of medical journals suggesting my breast cancer risk before the diagnostic for "developing focal asymmetry" was 12.8%. I also ran across an article that explained the BIRAD mammography classification/categorization system. I am a terrific researcher and learned how to look at research critically during grad school. However, I had not looked at the sub-sections of cat 4, mostly because I expected everything to be okay. I was shocked when the radiologist told me there was a > 50% risk of this being cancer. So, as I sit here, I am trying to stay calm and busy. I feel healthy, eat better, and work out probably more than ever since I hit 40 years old. I feel like it's so dumb that it would happen now.

  • concernedaboutresults
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    Thanks for your response, ctmbsikia! My mom had non-small cell lung cancer (NSCLC) with mets everywhere when she was diagnosed and staged. I remember so vividly her pulmonologist coming out after her first biopsy. He told us that he did not need to wait for pathology results to let us know she had advanced lung cancer. And this was true by the time we had her staging surgery, sampled lymph nodes, and then PET showed it was everywhere, liver, adrenals, bones, skin, and heart. She was PD-L1 positive (tumor marker - programmed death ligand 1), making her eligible for Ketruda, an immunotherapy drug. But yes, small cell lung cancer is quite aggressive, and my mom's presentation of NSCLC was more aggressive than what was usually seen. It is good to know that breast cancer grows slower. I had done a tiny bit of research before my diagnostic mammogram. I read a couple of medical journals suggesting my breast cancer risk before the diagnostic for "developing focal asymmetry" was 12.8%. I also ran across an article that explained the BIRAD mammography classification/categorization system. I am a terrific researcher and learned how to look at research critically during grad school. However, I had not looked at the sub-sections of cat 4, mostly because I expected everything to be okay. I was shocked when the radiologist told me there was a > 50% risk of this being cancer. So, as I sit here, I am trying to stay calm and busy. I feel healthy, eat better, and work out probably more than ever since I hit 40 years old. I feel like it's so dumb that it would happen now.

  • concernedaboutresults
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    That's quite a lot you have going on, Alicebastable. I love the idea of doing something fun before and after appointments. We are going out for dinner the night before with some family/friends, and that should help distract me a bit.

  • concernedaboutresults
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    That's quite a lot you have going on, Alicebastable. I love the idea of doing something fun before and after appointments. We are going out for dinner the night before with some family/friends, and that should help distract me a bit.

  • specialk
    specialk Member Posts: 9,226
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    I am sorry you find yourself in the waiting and run-up to a biopsy. That is never a comfortable feeling, and it is normal to have concerns and trepidation. You mentioned in your post initially about not knowing what to expect at the biopsy and I wanted to address that. My experience was with a hollow core needle biopsy using ultrasound guidance. I had a palpable lump - one of many, since I always had multiple cysts in each breast all the time. This lump did not show on mammo, but did show on the ultrasound that followed - which was routine for me annually, and had irregular borders rather than the smooth ovals of the usual cysts. My radiologist was not absolutely sure about what he was looking at and asked for the biopsy out of an abundance of caution. The biopsy was done at a breast only facility by a radiologist, accompanied by an ultrasound tech. I was gowned from the waist up, positioned on a table with a slight incline, preliminary ultrasound was done to locate the suspicious area. I was numbed with anesthetic, a mild pinching sensation, but not really painful at all. The hollow core needle was introduced through a very tiny stab incision and I only felt pressure, no pain. If you have any pain, please let the doc know! I will also say that the hollow core needle makes a snapping sound as it removes a core from the area, and the sound can startle some people if they have not been warned. During this process the tech was also keeping the ultrasound transducer in position so that the radiologist could accurately see where she was sampling. The whole process took a fairly short time - maybe 30-45 mins. total, and I was on my way home with an ice pack in my bra. I did work the following day with no problems, and just made sure to keep the little ice pack in my bra off and on throughout the day, and I took some Tylenol. I had a little bruising and some tenderness, but it was not bad at all. For those who have mammogram or MRI assisted stereotactic biopsies the process is a bit different - the positioning can be somewhat more uncomfortable, but the hollow core aspect is similar. Hope this is helpful and wishing you the best.

  • specialk
    specialk Member Posts: 9,226
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    I am sorry you find yourself in the waiting and run-up to a biopsy. That is never a comfortable feeling, and it is normal to have concerns and trepidation. You mentioned in your post initially about not knowing what to expect at the biopsy and I wanted to address that. My experience was with a hollow core needle biopsy using ultrasound guidance. I had a palpable lump - one of many, since I always had multiple cysts in each breast all the time. This lump did not show on mammo, but did show on the ultrasound that followed - which was routine for me annually, and had irregular borders rather than the smooth ovals of the usual cysts. My radiologist was not absolutely sure about what he was looking at and asked for the biopsy out of an abundance of caution. The biopsy was done at a breast only facility by a radiologist, accompanied by an ultrasound tech. I was gowned from the waist up, positioned on a table with a slight incline, preliminary ultrasound was done to locate the suspicious area. I was numbed with anesthetic, a mild pinching sensation, but not really painful at all. The hollow core needle was introduced through a very tiny stab incision and I only felt pressure, no pain. If you have any pain, please let the doc know! I will also say that the hollow core needle makes a snapping sound as it removes a core from the area, and the sound can startle some people if they have not been warned. During this process the tech was also keeping the ultrasound transducer in position so that the radiologist could accurately see where she was sampling. The whole process took a fairly short time - maybe 30-45 mins. total, and I was on my way home with an ice pack in my bra. I did work the following day with no problems, and just made sure to keep the little ice pack in my bra off and on throughout the day, and I took some Tylenol. I had a little bruising and some tenderness, but it was not bad at all. For those who have mammogram or MRI assisted stereotactic biopsies the process is a bit different - the positioning can be somewhat more uncomfortable, but the hollow core aspect is similar. Hope this is helpful and wishing you the best.

  • ctmbsikia
    ctmbsikia Member Posts: 753
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    I also think the ultra sound guided needle biopsy was the easiest. I've had all three ways done. Positioning is harder in the mammo machine and the dreaded MRI machine.

    Just to add, they will take you to the mammo machine afterwards to take a picture of the marker/clip that they place where the sample was taken. That maybe a little painful but it is very quick. Ice pack and tylenol will be your friend for at least 24-48 hours. I bruised but it did not hurt, just looked awful. Good luck!

  • ctmbsikia
    ctmbsikia Member Posts: 753
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    I also think the ultra sound guided needle biopsy was the easiest. I've had all three ways done. Positioning is harder in the mammo machine and the dreaded MRI machine.

    Just to add, they will take you to the mammo machine afterwards to take a picture of the marker/clip that they place where the sample was taken. That maybe a little painful but it is very quick. Ice pack and tylenol will be your friend for at least 24-48 hours. I bruised but it did not hurt, just looked awful. Good luck!

  • concernedaboutresults
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    Oh thanks to both of you for letting me know your experiences with the biopsy. I was getting more nervous as it approached not knowing what to expected in terms of pain and such.

  • concernedaboutresults
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    Oh thanks to both of you for letting me know your experiences with the biopsy. I was getting more nervous as it approached not knowing what to expected in terms of pain and such.

  • quietgirl
    quietgirl Member Posts: 165
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    okay so I’m annoyed on your behalf that they didn’t tell you more about your biopsy or at least give you something to read. If they told you you were having an ultrasound guided one, others have filled you but I’ll just add if on the other hand if you are doing a mammogram assisted one you will be lying face down on the table with your breast hanging through a hole and it will feel like a typically annoying squeeze that you get from a mammogram. Of course the upside is that they don’t need to move you after the fact to take a picture of the clip they will leave in as a marker because you will already be in between the paddles for them to take the picture. It might be uncomfortable but it’s not as if you are in that position for hours just longer than you want. I just wanted to mention it because if you are expecting to be lying on your back and suddenly you are asking to lay on your stomach it might make you wonder what’s going on.

  • quietgirl
    quietgirl Member Posts: 165
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    okay so I’m annoyed on your behalf that they didn’t tell you more about your biopsy or at least give you something to read. If they told you you were having an ultrasound guided one, others have filled you but I’ll just add if on the other hand if you are doing a mammogram assisted one you will be lying face down on the table with your breast hanging through a hole and it will feel like a typically annoying squeeze that you get from a mammogram. Of course the upside is that they don’t need to move you after the fact to take a picture of the clip they will leave in as a marker because you will already be in between the paddles for them to take the picture. It might be uncomfortable but it’s not as if you are in that position for hours just longer than you want. I just wanted to mention it because if you are expecting to be lying on your back and suddenly you are asking to lay on your stomach it might make you wonder what’s going on.

  • concernedaboutresults
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    Quietgirl, I recall that the radiologist also did tell me that he would use some imaging to guide and would tag the biopsy location in case they needed to remove the whole spot later. I can't recall if he said US, MRI, or the mammogram machine. I think I was still a bit in shock when I heard that I had a 50% chance of cancer. I think I was having a hard time paying attention, and you are right in that I could have used some pamphlet or reference to a website for information about the type of procedure I will be having. As I was writing this, I got up to look around for the appointment card and couldn't find it. They may have put a phone number to call if I had questions. I didn't even know what sort of questions to ask or even to know that there were different types of biopsies until I started talking to people and looking on the internet. I also was alone when I got this news and for the biopsy, I will be taking my husband. He is rather stressed about this as well. But I hope he will ask questions if he has them as well.

  • concernedaboutresults
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    They just called to confirm my biopsy appointment for tomorrow and I asked some better questions. I am having a US-guided core needle biopsy, and they said I would be there for about 1 1/2 hours all total. I can take some Tylenol preemptively for pain if I want to and will be numbed up prior to the beginning. I am thinking I am more informed now and feel a tiny bit more settled.

  • alicebastable
    alicebastable Member Posts: 1,940
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    I had a US guided one. My appointment at the breast center in 2018 was for an ultrasound and possible biopsy, so when the ultrasound confirmed what the mammogram had shown, I got the biopsy right away. It didn't really hurt, just the bee sting pinpricks of the numbing needle, and pressure more than pain for the actual biopsy. I don't think I switched to sports bras until after surgery, but you might consider one so you'll have gentle pressure on your breast after the biopsy, which helps to prevent swelling. I did not have a.mammogram after the biopsy, so that may vary by location.

  • dani_p
    dani_p Member Posts: 36
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    I had all 3 types of biopsies (with mammogram, MRI, and ultrasound) prior to my mastectomy, and the ultrasound guided one was by far the easiest. They did recommend wearing a sports bra, and told me to sleep in it the night of the biopsies. I was brought for a mammogram afterwards each time, so that they could verify placement of the clip they inserted to mark the location of the biopsy. This didn't bother me, since I was already numb from the biopsy. I did have some pain following the ultrasound biopsy, but that's only because they biopsied 3 different sites. Ice and tylenol helped. The waiting is the hardest part of all of this. Hopefully once you have the biopsy, you'll get results quickly.

  • concernedaboutresults
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    Hi everyone. I had my biopsy yesterday, and it went well. I was numbed up before the needle was inserted, samples were taken, and then after a low-pressure mammogram was taken to confirm tag placement. The worst was the burning of the needles when getting numbed up, and the radiologist dr applied relatively intense pressure on my breast for a few minutes after he was done before placing steristrips. They told me I would know that results by next Wednesday. So now it's just waiting...

  • concernedaboutresults
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    Does anyone know what is a normal amount of time to get biopsy results back?

  • exbrnxgrl
    exbrnxgrl Member Posts: 4,770
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    I am not sure if there is a norm when it comes to time for biopsy results. Facilities have protocols and procedures which may differ but not by much . If I had to ballpark it, and don't hold me to it, I'd say 3-5* days. I know this is an anxious time but try to hang on until you have the report.

    *Not counting weekends.

  • tntnsd
    tntnsd Member Posts: 124
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    I had my biopsy on Dec 29 , 2020 and got the result on Dec 31, 2020; and that was kinda still in pandemic time.

    I wish you a benign result, but if not, please take into consideration and know that it is very likely diagnosed eatly, and its treatment has come a long way.

    hugs

  • concernedaboutresults
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    Still no word on the findings from the biopsy. I'm not sure if that is good or bad. Maybe it doesn't mean anything.

  • salamandra
    salamandra Member Posts: 736
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    I had a family history of breast cancer, including my mother dying from it in her 50s. I was completely and utterly terrified when I was diagnosed. The baggage is real

    But so far my course has gone very differently from hers.

    I hope your results will be benign. But even if not, know that your path is not determined by your parents'. Heart'

    It seems like it's been about five days now since your biopsy. I think it's not too soon to try to call and find out when you can expect results. I had a situation where they were sending my results to my doctor's office but they both had virtual fax machines that weren't actually capable of communicating with each other. Super aggravating.

  • concernedaboutresults
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    I called to check on it. My doctor didn't have the results yet, so I called the mammogram place. They checked on it and told me that they were waiting for the pathologist to sign off on the results and the radiologist would call me back after 1:30 when I came in. So maybe I will know today, hopefully. Does it mean anything that the radiologist will call me back rather than a technician?

    The reason I ask is because when I was in for the diagnostic mammogram the tech told me that sometimes the radiologist tells what to say to the patient and other times he wants to come and talk with the patient directly. In my case he came in and talked to me directly to let me know about the 4c thing and that I needed a biopsy. I know I'm trying to read into it because I am anxious. I am starting to develop fever blister #2 since this all started.

  • concernedaboutresults
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    The pathologist has not signed off of the report yet. But the radiologist gave me the preliminary results of invasive ductal carcinoma. He has already made a phone call to a breast surgeon, and they have scheduled an appointment for next Monday. He did this for me because I expressed that I wanted to take care of any surgeries this year, if at all possible, to avoid dipping into brand-new deductibles next year. I am tearful and sort of in shock. I am in such a state of shock I am not sure what sort of questions I should be asking at this point. If you all have any recommendations, please let me know.

    I did ask him to explain what "invasive" means, and that was helpful. He says it means that the mass went outside of the margins of the duct. I feel like I have a huge education to embark upon now. He said the next steps would be surgery, either a lumpectomy or full mastectomy. Then he explained some other stuff about a nuclear medicine test to guide the direction for taking samples from lymph nodes. I am having a hard time focusing on the details because I can't believe the words that came out of my mouth a minutes ago when I told my husband, "I have cancer."

  • alicebastable
    alicebastable Member Posts: 1,940
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    Aw, hugs to you. Believe it or not, for a lot of people, it actually gets easier once things get rolling and the next steps are scheduled, because you'll feel more in control. It's going to be tough getting it all scheduled before the end of the year, though - good luck.

  • salamandra
    salamandra Member Posts: 736
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    I'm sorry it came back malignant.

    I'm glad you have an appointment soon!

    I know it's hard to feel lucky right after a diagnosis, but there's still plenty of chances for things to come back (relatively) sunny! Your life will be turned upside down and inside out for a while, and that sucks. But many (most) women with early stage cancer go on to live norma life spans and die of unrelated things.

    The shock and the fear and the uncertainty is very hard. Waiting for one test result after another after another just sucks. But hang in there, it does get better! Heart