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Topic: How to insist on a biopsy..........??

Forum: Not Diagnosed but Worried —

Meet others worried about developing breast cancer for the first time. PLEASE DO NOT POST PICTURES OF YOUR SYMPTOMS. Comparing notes, symptoms, or characteristics is not helpful here, as only medical professionals can accurately evaluate and assess your individual situation.

Posted on: Jan 21, 2007 04:25AM

katinchatt wrote:

This past week I had a Mammogram, Also at the time of the Mammogram the tech asked me if I had had breast surgery (no) because of an indentation made by slight compression @ 2:00 o�clock. 2 days later I was called back for Diagnostic Mammogram & an ultrasound. Came back as, �unknown if cyst or nodule� Right Breast at 2:00. I was told to do weekly self-exams and to come back in 6 months for another ultrasound.
I don�t know a thing about Ultrasounds however the pictures the tech was taking consisted of a cluster, not one cyst or one nodule.
Well from all I�ve read and advise from a few others I am going this Tuesday to see my Primary Dr. because this in no way �feels� right and I don�t believe it to be the course I can live with anyway. Question is? How to I just get to the point and ask my Primary to PLEASE take this serious and get me into a surgeon. I just don�t understand how in 2007 they can ask this of me. Thanks for your replies! Log in to post a reply

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Jan 21, 2007 05:21AM maryannecb wrote:

Ask her if she would be comfortable waiting if it were her breast.

If lump is palpable, a biopsy could be done.

Sometimes MRI can be helpful.

Hopefully all will be fine.

Fists up!
Fists up! Dx 9/20/2005, IDC, 6cm+, Stage IIIA, Grade 2, 2/14 nodes, ER-/PR-, HER2+
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Jan 21, 2007 05:53AM VickiTN wrote:

Just tell your doctor that you are not comfortable waiting the six months and that you want a biopsy. If your doc refuses the biopsy then I'd get an appointment with a breast surgeon or doc who specializes in diseases of the breast. A second opinion about waiting the six months, in my opinion, is certainly in order if your doc refuses to cooperate with your wishes to have the biopsy.

A lot of us here have learned that we sometimes have to be a little pushy (sometimes even a lot "pushy") to get things moving in the direction we want and at the pace that we want. And, if that means throwing temper tantrums, then, so be it.

Praying that all will turn out to be benign for you. Keep us posted.
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Jan 21, 2007 05:59AM marshakb wrote:

Hey Kat...I replied to you before about that indention. Google "dimple in the breast" or "indention in the breast" and print that info and take it to your doctor. Indentions/dimples are serious business normally. And I agree with the above post, ask how they would feel if they had an indention in their breast? Hugs, Marsha

I'm not dead yet! Dx ILC, Stage IV, 1/13 nodes, ER+/PR+, HER2-
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Jan 21, 2007 06:59AM katinchatt wrote:

Thank You! My Primariy is a young aggressive Gal who I hope will speed all of this up and get me into a surgeon. I am not aware that the Tech told the Radiologist about the indentation, so putting 2+2 together may suggest a bigger picture for my Primary. Will keep posting because I am scared and need answers - my hubby almost refuses to discuss it and tells me I have nothing to base my worries on YET! He's just worried/scared too so I'll keep the majority of my worries here with you, if you don't mind?

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Jan 21, 2007 07:03AM marshakb wrote:

Kat...feel free to PM me if you need to. I was lucky, my husband was SO supportive and just didn't care if I have a breast or not, he needs me around to keep him laughing! I see you have only posted a few times so I will say again, this board is a life saver and a sanity saver. Anyone of us will be your support system if you need us! Hugs to y ou Kat, Marsha

I'm not dead yet! Dx ILC, Stage IV, 1/13 nodes, ER+/PR+, HER2-
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Jan 21, 2007 07:26AM roseg wrote:

I have an issue with telling your physicians what you want done. I mean, if you're telling them what you want done, why bother with them.

I met a fellow over the holidays who sells high end home theater systems. He was bemoaning the Internet. He's got a neuro-surgeon comes to him, wants a $100K system for his house. He works up a couple of options and sends them to him. The Doc comes back with some stuff printed off the Internet and says, 'but this is cheaper, and this looks better'. The Audio guy says, 'Doc, If I print some diagrams off the Internet, and buy a knife will you be ready for me to operate on your brain?' The point being that we consult professionals because they have knowledge and experience. Even a young Doc is mid-30s.

If you are not comfortable with the Radiologists recommendation you should go back to your primary, and tell her that, saying that you want to take an aggressive approach to the situation. If you can't rely on the judgement and experience of your staff then get another opinion.

But I think fixating on 'a biopsy is the only thing that is right' is not a good idea. Unless of course you've bought a knife and are ready to do it yourself!
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Jan 21, 2007 07:28AM katinchatt wrote:

Thanks Marsha & Vicki (my fellow Tennessean) the irony is he works in healthcare, "Cardiac Rehab" sometimes they are programmed (as are Dr's) not to react. However, he really is my ROCK. He'll be there when I truly need him, but for now we are both dealing with this in our own way.

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Jan 21, 2007 07:40AM katinchatt wrote:

Rose, I feel going to my Primary is a "second opinion". My Gyno is a PA and it was her assistant who called me with the results and couldn't even pronounce half the words on the report. I simply don't even have enough information on what my choices are. I own a pair of scissors but that doesn't mean I choose to cut my own hair.
"Informed Consent" can be effectively exercised only if the patient possesses enough information to enable an intelligent choice (AMA, 1999)."
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Jan 21, 2007 07:41AM marshakb wrote:

Rose....unfortunately we sometimes have to push our doctors to take our concerns more seriously. No one was suggesting she get a knife and biopsy herself, but my primary doc said IMMEDIATELY that the indention is almost always an indication of something that should not be there. I'm just not willing to put my life on the line and trust that every doc is God and knows everything. Being knowledgable about BC and signs and symptoms usually will make your docs respond to you better and at least do follow up to relieve the anxiety of not knowing. Yes, maybe she needs a new doc, but the analogy you used that questioning a doctors opinion is like picking up a knife and doing your own surgery is extreme. Like Vicki said, sometimes we have to be pushy, it is our bodies after all. Marsha

I'm not dead yet! Dx ILC, Stage IV, 1/13 nodes, ER+/PR+, HER2-
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Jan 21, 2007 07:49AM marshakb wrote:

Kat...I sent you a private message. Look under your user name at top and the mail should be blinking. Hugs, Marsha

I'm not dead yet! Dx ILC, Stage IV, 1/13 nodes, ER+/PR+, HER2-
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Jan 21, 2007 09:01AM LightTheWay wrote:

Advice from the "BREAST GODDESS"
Dr Susan Love (Dr. Susan Love's Breast Book, 2005 p.g. 92)

"What To Do If You Think You Have a Lump:

...It's important to stress one thing: if you're certain that something is wrong with your breast, get it biopsied, whatever the doctor's diagnosis. Often a woman is sure she has a lump, the doctor is sure she doesn't, and a year or two later a lump shows up on her mammogram. She believes the doctor was careless. Usually that's not the case. A cancer that shows on a mammogram probably wasn't a lump two years earlier, or it would be a huge lump at that point. It's likely that the patient -- who, after all, experiences her breast from both INSIDE & OUTSIDE, while the doctor can only experience the patient's breast from outside -- has sensed something wrong and intepreted that in terms of the concept most familiar to her, a lump. I'm convinced that this is the basis of many of malpractice suits that arise when a doctor "fails" to detect what later proves to be cancer. IF YOU REALLY FEEL SOMETHING IS WRONG IN YOUR BREAST, INSIST ON A BIOPSY. If you're wrong, you'll put your mind at rest - and if you're right, you may just save your own life. It's a minor procedure with low risks and potentially high gains."

Thank Dr Love for understanding that it is our body, and it is our responsibility to advocate for our body whenever and wherever.

I'm in limbo land just like you Katinchatt, I understand completely. Knowledge is power, and fear is not an option.
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Jan 21, 2007 09:32AM LightTheWay wrote:

Also I wanted to add (Dr. Susan Love's Breast Book, 2005 p.g. 104) this as you did mention they wanted TO CALL YOU BACK IN SIX MONTHS.


"...How can we tell which are bad and which are the harmless kind of calcifications? We look at the shape, the size, and how many there are. If they're tiny and tightly CLUSTERED, and there aren't a whole lot of them, they're more likely to be precancer. If they're all over the place they're more likely to be benign.

Precancer occurs in the duct, which is very small. For the calcifications to fit in a duct, they have to be tightly clustered and very small. The big chucks of calcium we see on the mammogram couldn't possibly fit in the ductal system, so we know they're benign. They're usually old fibroadenomas that you had as a teenager, which have faded and become soft and less dense and now are calcifying. Sometimes they're calcifications in blood vessel that's getting older and harder.

**There's middle group of calfications that are less easy to characterize. They may be new, but there are just one or two of them. In that situation, we'll usually REPEAT THE MAMMOGRAM IN SIX MONTHS. If it's a precancer, we might see more calcifications, or a change in the shape or size, whereas if there's no change, it's more likely to be benign. Patients get nervous about that; if it's cancer and we wait six months it's probably because we don't think it's cancer. And even in the worst-case scenario, it's precancer, not cancer, and precancer takes 10 years to develop into cancer. "So six months won't make any difference, and the wait prevents needless biopsies."

Also this link: http://www.y-me.org/information/concerned_about_breast_cancer/calcifications.php

I can't remember if you said that you also can FEEL a lump aswell? However, the above statement may still apply to you, but the indentation is something not to neglect, I'm glad you're going back to your doctor about this.

Also, you mentioned the indentation appeared on "COMPRESSION", did you mean it only appeared as the plates on the mammogram were coming down on your breast? Also, have you done a self-examination, where you raise your arm behind your head to see you if you can make the indent appear again that way?

I've found the Dr Susan Love book a great source of information, and highly recommend those of us that have just started this ride to get a copy for themselves or get one out of the library. I'm reading up as much as I can so I'm forearmed, forewarned before I meet the surgeon.

Wow what a ride this is turning out to be...
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Jan 21, 2007 02:49PM Shirlann wrote:

Well, after my dismal experience, and I KNEW better, I would try to get a biopsy and if refused (as I was), walk out the door, go home, call a breast clinic and get what you want.

I was too lazy, cheap, liked what I heard, who knows, but I sure was sorry I just accepted what that jerk told me.

Gentle hugs, Shirlann
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Jan 21, 2007 04:04PM katinchatt wrote:

Thanks Everyone! Shirlann, and LightTheWay for typing your little heart out for me. Yes, the indention is there without compression, it just made it longer & deeper. I can not feel it, I'm a 38DD with lumpy breasts anyway but this clearly shows up as something all together different. Just lucky they found "it" early what ever it is (was not there 2 years ago/compared the 2) I just find it hard to believe that when some bc doesn't show up on Mammo or Ultrasound their hands are tied for understandable reasons, however when it's black and white and "unknown" they would wait. Go figure!

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Jan 21, 2007 05:18PM VickiTN wrote:

I believe that you're doing the right thing....and sounds like you have good primary doc that you trust, so, hopefully, she'll get you in for that biopsy - if nothing else just to relieve your anxiety about it.

Just hang in here with us....we'll be here for you while you're waiting to find answers and resolution to what's going on with you. I'm sending prayers up for you that all will turn out to be okay for you....but, I do understand your fears - the "not knowing" is truly awful.

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Jan 21, 2007 10:21PM CaliforniaKate wrote:

I don't know if your insurance is like mine, but I have to have a referal from my Primary doctor to see a specialist. That said, I would never expect that doctor to refuse my request. If she did, she wouldn't be my doctor for long. Chances are when you see your doctor, you won't have any problem at all getting a referal. Fingers all crossed for you. Kate

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Jan 21, 2007 10:33PM Chelee wrote:

Rose, Katinchatt came here for support...hoping someone could help her out. This is a place she should feel safe to express herself and ask anything she wants too without judgement. You can feel free to get mad at me all you want...but I don't appreciate you jumping in here telling her you TAKE ISSUE with her telling her physicians what she wants done. I also think that is a bad analogy you made. One has nothing to do with another.

I've just went through heck and back this last year since DX...and THANK goodness I spoke up many times or I would of ALREADY been gone. (Dead) Doctors are only human...and thanks to the way healthcare is ran these days they have limited time and many times if WE AREN'T pro-active & SPEAK UP in our care it could cost us big time.

When I started my chemo I called my onc FOUR days in a row...scared to death because I could NOT breath and my face was fire engine RED and HOT. He blew me off. I *KEPT* telling him something is wrong! Four days of calls & being dismissed by someone I trusted with my life and I was put in a ambulance when I got there because my O2 was at 84. Ended up with a 10 day stay in hospital. Thats only one time I wasn't taken seriouly. (Again...doctors mean well...their only human...but they have far to many patients these days so WE need to speak up.)

I am going through something almost the SAME as Katin is right now. They EXPECT me to WAIT six months too for things found on my mammo and ultrasound films. (No way will I wait.)

God forbid if there was something wrong and she waited that long. The sooner you find something the better. She knows her body better then anyone...and if her gut feeling tells her something isn't right...she should get it checked out, even if its nothing...she NEEDS peace of mind. (Doctors do make mistakes...as we ALL do.)

The *tone* of your post seemed a bit harsh. If I am wrong and it was NOT meant that way...I apologize. But I have been on the *receiving* side where I was desperate for support, help, and had someone be rather nasty to me. I will tell you...It about pushed me over the edge of what I could take. I thought I was SAFE on THAT board. I never expected to get attacked by a bc sister. (And I was because MANY women came to my defense as I did NOT deserve to be treated that way.) We ALL NEED to support each other...this is no place to make judgements. (If you don't agree with someone just move on to another post.) Most of us here are all just to *fragile* and can't take it.

This women has posted ONLY eight times and she doesn't need some one taking a nasty tone with her. She is scared, worried and very concerned just as I would be if it was me.

And believe me...I am sitting in the same place she is now and I know exactly how she feels. One thing bad about emails or posts...you CAN'T always hear the true tone of where someone is coming from so it might be taking out of context or totally wrong. So again...IF I did mis-understand your post...I apologize. (But taking ISSUE with her & the knife comment I thought seemed a bit much?) There are NICER ways to get your point across. This board has been a God send to me & so many others. We all have something to add here. No one should ever feel leary of posting here for any reason. (This should be a soft place for ALL of us to fall if we need too.)

Dx 12-05, Stage IIIA, Her2/Neu, 3+++, Er & Pr pos, 5 of 16 pos nodes. Dx 12/20/2005, IDC, 3cm, Stage IV, Grade 3, 5/16 nodes, mets, ER+/PR+, HER2+
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Jan 22, 2007 04:01AM katinchatt wrote:

Good Morning Chelee. I chalk everything up to this being an "open board". Will do EVERYTHING I NEED TO DO, and althouh I don't agree with Rose she has her opinions and I did ask. Having said that, it's opinions LIKE YOURS that "feel right", I truly cherish and will turn to when I need real support. Thank You for coming into ring for me and speaking out. I am new and it did throw me for a while but others (on the side) have assurd me this isn't the norm here & I BELIEVE! Again thanks! In a little over 24 hours I will see my Primary so HOPEFULLY she will at the VERY LEAST explain the report, ease my mind, or get me in ASAP. Will keep posting as I LOVE hearing from EVERYONE! Well, almost
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Jan 22, 2007 06:28AM katinchatt wrote:

Participation in Treatment Decisions. You have the right to know your treatment options and to participate in decisions about your care. Parents, guardians, family members, or other individuals that you designate can represent you if you cannot make your own decisions.

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Jan 22, 2007 07:24AM jz20022001 wrote:

We all need to be our own best healthcare advocates. If something seems wrong, definitely insist on a biopsy. Doctors can make mistakes too.

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Jan 23, 2007 01:24PM katinchatt wrote:

Saw my Primary this afternoon. Didn't have to ask to go to a Surgen, she asked me which one I wanted to see. explained by mammogram & ultrasound results and "with adhesion" and a BI-RAD 3 certainly calls for a visit and she didn't understand the 6 month wait either. so I'm at least moving forward and not being left in limbo!

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Jan 23, 2007 03:27PM Shirlann wrote:

Honey, it sounds like you are in good hands, be sure and let us know what is going on.

Hugs, SHirlann
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Jan 23, 2007 05:26PM VickiTN wrote:

That's wonderful news, Kat!! I'm so glad that your doc is getting you moving in the right direction on this. Sounds like you're in good hands.

And, I'm so very proud of you for being proactive and not accepting the "wait and see" dance that the radiologist was recommending that you take - without at least getting a second opinion. When's your appt with the surgeon? Keep us posted!
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Jan 23, 2007 05:34PM LightTheWay wrote:

Yes, this is good news... I'm glad you have a supportive doctor too. Let me know how you get on... I'll let you know what happens on the 29th with my surgeon...

Monday is not coming soon enough I'll tell you that

Take care of yourself... you made the right move.
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Jan 24, 2007 03:31AM katinchatt wrote:

Thanks Ladies....don't know yet when my appt. is with the Surgeon, I have to be REFERRED. I know one thing I am totally exhausted. Haven't had one good nights sleep since "I got the call". Was so excited to see there is a conference on "Sleeping" tonight. Is anyone familar with these discussions? If I can keep my eyes open I will peek in see what's being discussed. I may call my Primary and ask for a little help with this matter until I do see the surgeon. Unfortuanately I am a worrier by nature, but when I really have something to worry about I go into overdrive and can become a real basket case! I think it's just the "mother" in me. My boys are 24 & 29, you'd think I'd be over it.

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Jan 24, 2007 04:17AM katinchatt wrote:

When I get out a little later today I want to pick up - The "Bible of Breast Cancer" Susan Love's book. I've read here on another board that it's a long, exhaustive & scary read. Another suggested that you just research to what stage you are currently/actually in and STOP. I feel since I "don't know" a thing at this point that I should read/reasearch everything I can.......to help prepare me in the "unlikely" event this is a problem. (I still see myself in that 80% B9) However I see the STOPPING as a valid point as well, why take your mind in directions it doesn't need to go in/yet? What has worked for you girls?

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Jan 24, 2007 09:19AM Shirlann wrote:

katinchat, I wore out my copy of Susan Love's Book and was astonished that others had problems with it. But I am very interested in medical things and a lot of people are not.

Good advice though, to only read as far as you need to. Of course, being nosey, I read on, but it didn't scare me. I know BC can kill. I am not an idiot, so while it is sad, she explained she did not want to put in the Met part or dying, but she felt bad that these women would be ignored if she didn't address their issues as well.

Its funny, I am 8 years post treatment and still come here. I love all the sisters and have made good friends with some of them. Most of us will be just fine and then you go post on the "Moving Beyond" section and end up trading recipes.

So try not to worry too much. I started anti-deps and what a blessing they were. I just sailed through the whole thing like I didn't know anything was happening. And I am a lifetime anxiety/depressive person. The anti-deps were a miracle mainly because this whole process is so long that you just run out of energy with no sleep and constantly afraid.

So think about asking for them, a lot of us gals have done this, and when you are well, and get your confidence back they are pretty easy to get off of. Just have to go slowly. They are not addictive, just bad side effects if you stop suddenly.

Anyway, sweetie, you will be just fine, there are thousands of us out here, no one says much. I do, I am a big mouth, I was at the dog park with my dog and a lady I had known for months said, "Oh yeah, I had breast cancer in 1985 and sometimes I can't remember which side it was on".

So there is definitely light at the end of this tunnel. It just is such a dang long tunnel!

Gentle hugs, Shirlann
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Jan 24, 2007 11:37AM Auntbiz wrote:

I agree with everyone else, if you do not feel right or have peace about it insist on what you want. I had a gyn doctor tell me after my D * C due to thickening of the lining of the uterus tell me my ultra sound was fine. I go see my oncologist and she tells me that my lining had thicken again to 19mm and had a complex cyst on my left ovary. I called him and he had me come in for another appointment and when I got there a different doctor walked in. I said to do another ultra sound in four months. It contiuned to thicken and they called me to come in to discuss another d & C and when I got there the nurse questioned me why I was seeing the second doctor and not the first. I said because they switched me and i did not asked to be switched but i made the appointment would was following me and ordering my ultra sounds. You have to get all of your reports. I would not have had any follow up I am with another doctor's office. Doctors are too busy and we need to be responsible for our own health care.
Dx 5/22/2003, IDC, 3cm, Stage IIB, Grade 3, 1/17 nodes, ER+/PR+, HER2-
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Jan 24, 2007 01:37PM katinchatt wrote:

Thanks Girls,
++Shirlann - I went to the Library and picked up a copy of Susan Love's book. I didn't want to "buy" a copy, something inside of me told me that would be giving into my fears of the "unknown". So here's hoping I can take it back with knowledge I never had, will never need, but has already changed me No Matter What!!
I found out today that my Breast Surgeon's appt. is next Thursday the 1st. So, my Primary did what she said she would and put me at the top of the Referral pile. My surgeon is a woman also, not that - that matters - just another ball in my court.
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Jan 24, 2007 02:26PM Shirlann wrote:

Oh Katinchat, I hope we don't see your pretty face more than one more time to tell us you are fine!!!!!

But see, we already love you and will miss you.

Hugs, Shirlann

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