Over 60, Birads 3 and a Story you Can’t Believe
I’m looking for input and advice. No prior history for myself. Mom diagnosed at age 90 with + - - grade 3 aggressive cancer. Died of unrelated causes before diagnostic work up completed.
For me - Screening mammo at the end of October…Birads 0, new bilateral focal asymmetries both upper outer quadrant.
Diagnostic spot compression views and left side ultrasound 2 mid-November. Birads 3, come back in six month for right side only.
Here’s where it gets interesting…decided I did not want to wait given my age (over 60), very late menopause and family history. (Mom - breast cancer, maternal grandmother died of pancreatic cancer and one maternal uncle died from colon cancer. ). After some initial issues (PCP on maternity leave) finally talk to OB/GYN’s nurse who says ‘right side’ follow up. Pointed out ultrasound was done on the left. The nurse tells me she’s going to talk to radiology and acknowledged that the report is unclear.
I placed a written request for the actual reports with the hospital. It’s obvious from the reports that they have mixed up the left and right side. The ultrasound for the left breast talked about the conditions that they found in the right breast. Put in a written complaint with a radiology group who also acknowledges the mixed up sides, but declines to correct the report (it’s only laterality). At that point, I decided to change imaging groups.
The new radiologist accepted images from the previous mammogram and ultrasound but declined to give an opinion on them. They suggested I get an appointment with a breast surgeon. Initial appointment was with a PA, who also thought Birads 3 and said no way they would biopsy She then called me and said they were going to bilateral diagnostic ultrasounds because the initial report is such a mess. The post visit notes were amended to say that both areas were amendable to biopsy.
My ultrasounds are next week. Obviously, my anxiety and stress are through the roof. My thought is that if I can get biopsies on both sides that I should do it. Everything I’ve read online seems pretty clear that I really should never have been Birads 3 due to age and family history. It probably wouldn’t be so upset if it hadn’t been both sides. And I shudder to think what would’ve happened if I hadn’t pushed back. I’m super frustrated about feeling like I’m being taken seriously. What is the point of pushing the message “get a mammogram” if they aren’t going to be prepared to address the results?
Comments
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Hi @frustratedandscared, I'm sorry you ran into problems with your radiology department. Even when there are mistakes in your medical record it is very difficult to get them corrected because they are legal documents. The most they will generally allow is adding an entry stating your concern. I've had this happen way too often and it makes care by the next provider problematic.
Radiologists do make mistakes. I had a callback and was given a Birads 2, the same score which was given on my next two mammograms. After a tooth extraction I developed an infection that would not heal. The oral surgeon biopsied my jawbone. When the result came back as osteomyelitis (bone infection) I was relieved until the oral surgeon told me that condition in the jaw only occurs if you have HIV or cancer. Because of the callback I went for another screening mammogram which showed calcifications and was called for a stereotactic biopsy the next day. That radiologist told me I had a lump deep in my breast and needed a core needle biopsy instead. She apologized for the other members of her practice which contracts with the small rural hospital saying that the occasional mistake is made but three in a row in highly unlikely. The radiologist who performed the needle biopsy wondered aloud who had read the previous two mammos and then in surprise said, "Oh, it was me." Needless to say I travel 100 miles each way to a big city for care.
I'm glad you advocated for yourself and found another provider. The protocol for Birads 3 is rescanning in six months. A biopsy is done only for Birads 4 or 5 since its value depends on checking the tissue in an irregular spot seen on imaging, not age or family history. I was surprised to learn that the vast majority of women diagnosed with breast cancer (80 to 90%) have no family history or genetic mutation.
I hope your ultrasound finds nothing to worry about. All the best.
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