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Jul 29, 2012 03:18PM
Jul 29, 2012 03:23PM
To your questions:
What if the biopsy is non-conclusive? More, even more invasive, procedures will be ordered ... (there are a few reports of this in this forum). Yes, that's possible.
Should I really add more traumatic events to my life just for the sake of knowing? We all had lives going on when this happened. Cancer can't be scheduled. Hopefully your calcs aren't cancer but if they are, then you already have BC. Waiting isn't going to do anything but possibly make the diagnosis worse.
How much is imposed on us just to cover the doctor's butts? Biopsies aren't ordered unless the films appear to present a high enough risk that the biopsy is warranted. There are lots of cases where something suspicious is found but rather than order a biopsy, the radiologist recommends a 3 month or 6 month follow-up. That's a normal part of the process. Most radiologists would prefer to take the follow-up approach rather than schedule an unnecessary biopsy. The fact that a short-term follow-up isn't the recommendation in your case suggests that the risk is high enough to schedule the biopsy now.
Did any of you consider alternative ways of healing before going into surgery? A stereotactic biopsy is a not surgery, not by my definition anyway (having had several of these biopsies and several surgeries). After a couple of my stereotactic biopsies, I drove myself home. I've been told to take it easy (no strenous lifting or activity) for 24 hours but that's the been the extent of it.
Doesn't biopsy only make sense if surgery is automatically the next logical step? A stereotactic biopsy is recommended in order to get a diagnosis and hopefully, if the biopsy is benign, avoid surgery.
Don't we all know that there is a strong correlation between stress and BC? That is a theory, one that I happen to believe. (Edited to add: I don't believe that stress causes BC - nobody knows what causes BC; there are hundreds if not thousands of risk factors. I think stress might cause dormant cancer cells already present in your body to come to life and begin to multiply and expand.) It's true that having a stereotactic biopsy is stressful. But would you find it less stressful to wait for 3 months or 6 months not knowing if you have cancer in your breast that might be growing, and knowing that the radiologist was concerned enough to recommend a biopsy?
Why would I volunteer to increase my risk factors for BC so dramatically? It is said that having a biopsy increases your BC risk but in actual fact your risk only increases if a pre-cancerous condition is found. And the truth is that your risk doesn't really increase; it's just your awareness of your risk that increases. Having that awareness allows you to take action, such as participating in a high risk screening program.
And, how about the chances of rendering an in situ carcinoma invasive through an excessive poking around in your breast during biopsy? The biology of DCIS doesn't allow that to happen. DCIS cells do not become invasive just by being moved from the ducts into open breast tissue. A change has to happen at the molecular level of the cell in order for a DCIS to become invasive and be able to survive and thrive in the open breast tissue. Since most women diagnosed with DCIS start off with a needle or surgical biopsy (a surgical biopsy also disturbs the cells and even cuts the milk ducts that contain the DCIS), if the biopsy itself were to cause DCIS to become invasive, it would mean that by the time they had surgery, most women initially diagnosed with DCIS would be found to have invasive cancer. That's not what happens. Most women (80%) diagnosed with DCIS via a needle biopsy are ultimately found to have only DCIS.
A few other points:
There is no lump on the mammogram associated with the microcalcifications. With DCIS, there usually isn't. I had what appeared on my mammogram to be only a couple of small area of somewhat suspicious calcificiations. It turned out that I had over 7cm of high grade DCIS and 1mm of invasive cancer. But there was never a lump.
The radiologist did imply that waiting a few months would probably do no harm. That's probably true. If you are one of the 80% whose biopsy is benign, then that's certainly true. And if your biopsy indicates cancer but only DCIS, then while surgery will be recommended to remove DCIS, usually waiting a couple of months to have the surgery isn't a problem. If the DCIS is low grade, waiting even longer likely wouldn't be a problem. But until you have the biopsy, you don't know whether waiting is a risk or not.
A biopsy is a simple procedure that will take a 1/2 day out of your life. It might be painful (although it shouldn't be if done correctly - mostly it's just uncomfortable because of the position that you have to stay in) but it doesn't last long and then it's over and done with. With the answers from the biopsy you know what, if anything, needs to be done next.
I've had lots of call backs. Sometimes nothing more needs to be done after the diagnostic mammo and ultrasound. Sometimes I've been scheduled for a short-term follow-up. And sometimes the radiologist recommends an immediate biopsy. With something as important as my health, I don't try to second guess the radiologist.
“No power so effectually robs the mind of all its powers of acting and reasoning as fear.” Edmund Burke