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    Old 05-10-2009, 03:46 PM   #1
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    Biopsy for "atypical" fibroadenoma

    Well, I finally got scheduled for an ultrasound-guided needle biopsy-- will have at the end of the week. totally nervous and won't rest until I hear "benign." The radiologist told me he's pretty sure it's just a fibroadenoma (he saw 2 masses on the US, said one is definitely FA) but the only way to be certain is to do a biopsy. Radiology report said "corresponds to BIRADS 4" (somehow, as confident as he was that it's FA I thought I'd get a '3'). It's immediately adjacent to the other FA but says "somewhat atypical" because it "appears taller than wide."
    Guess it's normal to be nervous. Hate to have to wait over a weekend for results, but probably won't know anything until mid next week.

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    Old 05-13-2009, 10:23 AM   #2
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    Re: Biopsy for "atypical" fibroadenoma

    Hi rapsodia,
    I wish you peace and that the time goes by fast for your upcoming biopsy.
    I pray that it's benign.
    have you ever had to go through this before?
    what is the difference between the two biopsies? why do some have an MRI guided biopsy and other's have an ultra sound guided biopsy?
    how long did you have your fibroadoman before they saw that it may be changing?
    and how did they find it?
    did a mammogram pick it up too? or just the ultra sound?
    Did you ever have an MRI of the fibroadoma?

    I have SO many questions because I too have something that needs further investigation and I'm trying to jsut forget about it, till I get the 2nd U/S from a different radiologist who happens to be the director of this new breast imaging center that I was referred to by my gyno.
    my gyno initially sent me for an ultrasound of my dense right breast.
    they saw something, she referred me to a breast surgeon who sent me for an MRI, and now the radiologist usually tells the patient the same day of the MRI the results. but she wasn't there at that time.
    so I had to wait a few days for my results.
    breast surgeon then told me this radiologist wants to do her own ultra sound on it than go by the 1st set I had done at a different facility.
    the 2nd U/S is coming up this friday and I'll get an answer as to whether she thinks I should get it biopsied.
    my family wants me to get the biopsy anyway.
    My breast surgeon spoke to me as if we were going to do it soon but after the ultra sound. so I don't know who to listen to?
    the radiologist who's not treating my breast issue?
    or my breast surgeon who I was initially referred to?
    I'm very confused and just want to get this over with and know for sure if i have a malignancy or NOT!
    so I can understand totally what you're going through, nerve wise.
    I'm here for you.

    PLEASE come back and give us an update.
    i'll be looking for a reply from you. OK?
    I wish you the best.


    Old 05-13-2009, 06:27 PM   #3
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    Re: Biopsy for "atypical" fibroadenoma

    Hi Linda, thanks for your post. I am sorry you are having to go through all of this, too. I am not sure I'm the one to be giving advice, but I think at least for peace of mind I would have the biopsy. Any time they see a mass the only way they can only confirm it, according to my understanding, is through a biopsy.
    To answer your questions: this is a first for me. I am 47 and had not had a mammogram in 3 years. (I go through a free cancer screening for uninsured). A week after the mammo, the doc called and said they need to do a followup just on the right breast. He assured me that this isn't uncommon; then I talked to several women who said they've been called back several times. Two weeks later, I went for the 2nd mammo and the tech said not to get dressed until the radiologist saw it and made a decision. Then another tech came in and said she was doing an ultrasound. Immediately after the ultrasound, the radiologist came in and showed me two solid masses. One he said was definitely a fibroadenoma; the other is likely a fibroadenoma but he said appears 'atypical' and he can't confirm this without a biopsy. I picked up the radiology report the next week and read the conclusion: "suspicous, Correspond to BIRADS 4." This is vague to me, as I've heard that this could mean 23-34% probability of cancer; other places I've read the '4' category ranges from 2-95% (I didn't get a subcategory of A,B, or C). And I know that 80% of biopsies are benign. But now I worry because this mass is described as "atypical fibroadenoma appearing solid mass"- "atypical" because it is "taller than wide." I need to stop reading! I've seen reports that masses that are taller than wide tend to be malignant. (I know there are other aspects, too- mine is well circumscribed, not irregular.) It's just impossible to take this casually (the doctor and radiologist seem to be, although the radiologist admitted that if this was his mother's US finding, he would recommend a biopsy. That tells me he is moderately concerned). I would almost rather they say "it's 50/50; it could go either way" or "it does look worrisome" as I would rather go in thinking omg it could be cancer and be surprised to hear it's benign rather than going in confident it's a benign tumor than be unpleasantly surprised to find out it's malignant. And I hate waiting!
    I will be back to report my results- and to give you support and keep up with your reports, too.

    Old 05-19-2009, 09:49 AM   #4
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    Re: Biopsy for "atypical" fibroadenoma

    sorry it took me so long to get back to you.
    I initially wrote you a long reply and then had to delete it all because I had an emergency to tend to the other day and didn't think of saving it and then coming back to it another time.

    what type of biopsy was performed?
    a fine needle? or a core needle biopsy guided by Ultra sound?
    or mammo?
    from reading I do know there about four different types depending on the size and location of the tumor or if it's a cyst or solid.
    I agree with you about reading too much.
    it can put more fear into our already nervous minds.
    the waiting is the worst thing of all.

    I did go for the ultra sound on Friday and the radiologist confirmed that I do need to have a biopsy. a bilateral biopsy because she see's something in the left breast as well. but feels the one in the left may be just benign because of the shape of it, just like you mentioned about your shape. whether it be taller vs wider, etc.
    I wound up making an apptn for the biopsy wtih the radiologist because she performs them in this womans breast facility. not realizing, all I was supposed to do was get the ultra sound performed by her, get her opinion on whether it matched up with the MRI and then go see my breast surgeon.
    well did I cause problems between the two doctors.
    leave it up to me to cause chaos.... such drama.
    now my breast surgeon thinks the radiologist was trying to take her patient away.
    but it's all been fixed and the surgeons nurse called me to reschedule the apptn., WITH the breast surgeon who went onto explain in detail how she is going to numb the breasts, then make a small incision where she will perform the core biopsy and then put in two titanium markers that won't effect me or hurt me. I was told I wont' need any type of sedative so I can drive myself home and return to normal activities the same day.
    it's so different than it used to be compared to when my sisters had their diagnosis of breast carcinoma and the biopsy that she went through.

    times are changing swiftly and if we were ever going to get a dx of BC, now would be the time to have it rather than the past because they're able to catch it earlier and earlier now which means better and quicker treatment while in the beginning stages rather than later when it's harder to treat.

    my date is set up for June 4th at 9am.
    I"m not nervous about it. and like you said, it's a 50/50 chance.
    doctors are taught not to show their emotions.
    and I find that most of them always say "they feel it's nothing" and or "not to worry".
    that's what was said to my 1st sister dx'd with BC. her dr. told her he thought everything looked good when he did the biopsy so she left there thinking she didn't have cancer. was she ever shocked when she got the news.
    so it's better to go in with the attitude it may be cancer, this way you can at least handle the news if it winds up being malignant.

    Did you get your results back yet?

    Hope you get this reply and hope you are doing well.

    best wishes,


    Old 05-20-2009, 02:30 AM   #5
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    Re: Biopsy for "atypical" fibroadenoma

    Hello thanks for getting back to me. I had the biopsy on Friday afternoon -15th- an ultrasound guide core needle biopsy, local numbing, got to watch on the monitor as the radiologist inserted needle and removed tissue samples. I didn't know about the titanium clip until he finished getting samples and told me he was inserting the clip to 'mark' the mass to alert on future mammograms that yes, this had been biopsied; also, to find it again if they need to go back. I've been telling friends that I now have a bionic breast.

    Still awaiting results. After the biopsy was finished, the radiologist made some remark about getting the results to "confirm" that it's a fibroadenoma. And yes, all the reading I've done drove me crazy because mine has well-circumscribed margins (very rare in a malignant mass) but is taller than wide (very rare in a benign mass) so I assume one will cancel the other out, hoping it will be the former. And I know about 80% of biopsies being benign, but then how does that explain the women who are diagnosed? Some end up in the 20% group-- and you start to feel guilty that you're hoping it's someone else and not you.

    I will probably call the imaging center later today- dogs woke me to go out and here I am online- to see if a result is in. I'm hoping I don't have to wait for the public health doctor's phone call on Friday as the waiting is driving me crazy.

    But right now I am dealing with the pain and heartache of ending a relationship of nearly 3 years with my guy, who went with me to the biopsy (they told me I needed to have someone drive me home; I still don't understand why). Then the next afternoon when I asked about our plans for the evening, he informed me that he was attending a performing arts event directed by his former lover (with whom I've been repeatedly told for over 2 years now is a "friend"- who he offers to pick things up for whenever he's going out of town etc. and doesn't really 'see' but I know from mutual friends he is frequently in touch with and offering various kinds of assistance). He had not asked if I wanted to attend- probably because I stopped attending these shows a long time ago- but bought one ticket last week, then waited until 3 hrs before the event to inform me he was going, leaving me with no plans- and a very sore right breast- for Saturday night. Then I realized why he'd acted a bit surprised when I had told him the biopsy was scheduled for Friday- opening night of the show- and he said, "No, that's fine" and agreed to go, but obviously went out promptly and bought ONE ticket for Saturday night-- and never told me.

    This is the same man who took care of me for two weeks following a hysterectomy last year and who has been very helpful and supportive, even financially, when needed. I've just looked the other way about this "friend" (who never called, visited, or sent a card when I was in the hospital and never gets invited to any gatherings to which he invites other friends) and finally had enough. The day after a biopsy for cancer, for God's sake, and he chose to support her event rather than take me to dinner or relax with me at home. I guess, in his mind, he gave me one night; Saturday night was her night. But I have no right to complain, because these shows are only a few times a year-- and he makes plans with me all the other nights.

    Sorry this is so long, but now I feel like news of cancer would be nothing. At least cancer can be cut out. My heart is completely broken; I feel empty and rejected that he's, really, choosing his "friendship" with her over his relationship with me. I didn't buy his argument that I was trying to control who he could be friends with and that he didn't want to lose friends. All my friends are telling me I deserve better. But it hurts just the same. He's asked if my results have come back, and I told him that my results are none of his concern.

    Old 05-25-2009, 08:15 AM   #6
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    Re: Biopsy for "atypical" fibroadenoma

    AGAIN! I'm late in wanting to catch up with you to find out how you've been doing and I can see by your reply that you are in need of a hug and some friendship.
    Forget him!
    I know it's easier said than done, but right now you have enough on your plate to worry about. He's really not a friend if he's going to be so insensitive to your feelings. don't let him destroy what little peace you may have.
    IF your biopsy winds up being malignant, you're going to need all the positive energy you can muster. Some people are just not worth it!
    Family is...... Friends are......
    There's nothing you can do to make him pull away from this other person and make him come to you. HE has to want to do that. I don't waste time withe people anymore like I used to. I understand the pain you're feeling right now. A broken heart is hard to mend. try to ask yourself if this is what you want to deal with in your life??? Is it worth it for one person to make you unhappy?
    or would you rather be happy and enjoy your life?
    choose positive over negative.
    make a point of staying away from people who are going to make you feel sad or jealous.
    all these thoughts and feelings are negative and can make your health poor and your body acidic. It's true. it really can.
    our minds are connected with our health and body.
    did you ever notice how you can walk into a room and feel it polluted by someones bad mood, or bad attitude or feel their saddness?
    we can actually feel it.
    well the same feelings can course through your veins and through your connective tissues and cause havoc in the body. it causes illness.

    I wish we were close in distance because I'd be there right now girl knocking on your door to take you out for a long walk in nature, or taking you to a little restaurant where we can sit and talk and order one of your favorite meals.
    You don't need this man to make you happy, You need a "friend".

    Now.... to change the subject. You happened to mention that your breast hurts. the one that they took the biopsy out of.
    I was anxious to know what I'd be going through on the 4th, and now I know. due to you sharing what you went through. did you put ice on it for a certain length of time afterwards? I was told that I can drive myself home.
    which I was supposed to be driving my older sister to the airport the same morning I have my bilateral biopsies but now I can't. so my significant other is taking her instead. I wanted HIM to come with me, but I guess there's no need for him to.
    My 19 yr. old daughter may come with me just in case i"m too sore to drive home. She just recently got her learners permit but I don't know how comfortable I'd be with her driving home. I am not a good candidate to sit in a passengers seat to someone learning how to drive.
    I make her nervous and she makes me MORE nervous!!!!
    I didnt' tell my sister yet that I won't be driving her, but as long as she has a ride, i"m sure she won't care.
    I'm sure your mind is running rampant on you right now waiting to get the results. or did you already get it in?
    I know my mind is going nuts with thoughts and questions and what if it's cancer and if it is, what's going to happen next?
    it's all a process.
    my daughter asked me why can't the doctor test mine right away?
    I had to explain to her that there's other surgeries that were set up before I came into the picture and that I had to wait for a slot to open where they can put me in for a bilateral.

    So I might be going by myself. all the woman in the waiting area where the lockers and chairs are, which is a separate area than the waiting room you come into when you open the door to the office.
    I still have visions of us sharing small nervous smiles at one another, wondering what each one is going through. We're all wearing the stark white robes that one puts on for the examination or biopsy.
    it's so quite there you can hear a pin drop, even though the t.v. is on to distract ourselves from thinking too much, it's almost impossible to really understand what's being said on the t.v.
    forget about reading one of the many magazines that lay there in a messy pile, that I tried to organize one early morning the day of my utlra sound.

    I go into a cleaning frenzy when I"m nervous. I call it "nervous energy" which I used to have all the time. Now I have to PUSH myself to clean at times or wait till I have a good day where i"m not suffering some sort of joint pain and swelling. I deal with chronic pain almost on a daily basis.
    I see a rheumy dr. who's trying to find the culprit.
    then to be hit with the news of having a potential case of b.c. only adds to the annoying problems in my already painful life. Mentally and physically.

    so you see? I know what you're going through, pain wise, broken heart wise, etc.
    I just want you to know that if you ever need a shoulder to lean on, or need to talk about it, I'm here for you.

    PLEASE let me know if you got the results back.

    hang in there. God may bring you to it, but he will get you through it.


    Old 05-25-2009, 11:19 PM   #7
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    Re: Biopsy for "atypical" fibroadenoma

    Quick update sorry to leave you hanging. I got my result Friday morning- BENIGN. I'm hoping yours will be, too. Can't remember, what did they think yours was from the ultrasound? Mine did turn out to be a fibroadenoma, so I have two. I've had mammograms for years now but this is the first I've had FA, and I'm 47 now. I had read that if you're over 40 they usually want to remove fibroadenomas- that it's possible they can prevent a radiologist from seeing what could be underneath on future mammograms.
    The doctor that ordered my tests told me no, they can see "around them." Huh???
    Mine was not very big, I think just over 1 cm. The biopsy wasn't bad. I did ice myself 30 minutes on, 30 off, for 6 hours as instructed. I didn't have swelling- just a very small nick where the incision was, and probably a bit of bruising though not visual. But it's been over a week and my breast is stil slightly sore. I've been running and walking, though, so no biggie.
    Everyone says the same about this guy- but it still hurts, no matter how you slice it. And to complicate matters we live very close by each other and I'm not able to sell or rent my house and move, but I honestly wish I could.
    How do we send private messages or emails to each other from here?

    Old 05-26-2009, 09:53 AM   #8
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    Re: Biopsy for "atypical" fibroadenoma

    This is EXCELLENT news Rhapsodia!!!
    Thank GOD it's benign. but you have to be extra careful when you get fibroadomas because of your age now. Is this why your surgeon put in the titanium markers?
    a very small percentage of them have the potential risk of turning malignant, that's why they have to really watch it.
    What exactly did your report read from the radiologist that wound up having to make you have the biopsy?
    was it an MRI? or an Ultra sound? or the mammo?
    I'm sorry I forget which modality it was and i"m too lazy to go back and read your first post on it.

    you know.... I never asked the radiologist OR the surgeon what exactly they see. Isn't that insane? she didn't mention the right breast which is the one we intially wanted to exam more thouraghly, so when i was on the table having the test performed by the radiologist herself, she did say that she sees something in the left breast too and wants to biopsy to be on the safe side and feels it's just a normal fibroadoma because of the shape of it. she didn't say that about the thing they see in my right breast. I do have the measurements of it on the reading from the MRI.
    I still didn't have a chance yet to retrieve the written report of the 2nd ultra sound that I just had. I want that sheet. I can call the office to ask them to fax it to me, but I just can't get myself to do it today. This sheet may explain in more detail to me.
    I do know they wanted the 2nd ultra sound in their facility to see if it's matching up with the MRI they gave me, which is what signaled them to do a biopsy.

    this is what the MRI report said:

    FINDINGS: Scattered islands of fibroglandular tissue are present. In the lower aspect of the right breast at approx. 5 to 6:00 there are ovoid enhancing foci in a segmental pattern on images 30 to 34 with the most anterior component on image 32 measuring 9 x 4 x 9 mm with rapid initial enhancement and plateau delayed phase.
    In combined dimension this area measures approx. 2.5 x 1.8 x 2.8 cm

    In the remainder of the breasts bilaterally there are scattered enhancing round and ovoid foci in a stippled type pattern that are likely due to areas of benign proliferative condition and/or fibroadenomas.
    The largest of these on the left are located at 8 to 9:00 on images 32 to 38 in the central breast measuring approx. 6 mm each of progressive kinetics and linear nonenhancing septa.

    IMRESSION: Segmental enhancement at 5 to 6:00 in the mid to posterior third of the right breast. The largest component of this is oivid with plateau delayed phase. This could represent an area of fibroadenomatoid change.
    In the remainder of the breasts bilaterally there are enhancing foci present as above that are likely due to areas of benign proliferative condition and/ or fibroadenomas.
    A second look bilateral breast ultrasound is recommended for further evaluation. ( which I had) If there is no ultra sound correlative, MRI guided biopsy of the anterior of segtmental enhancement at 5 to 6:00 in the right breast is recommended and if this is benign, 6 month follow up breast MRI is recommended.

    My surgeon was happy we can do it by ultra sound rather than the MRI guided which makes it easier for her and me.

    I'm not worried about this too much because it sounds more benign than cancerous.
    they're just being super good in wanting to biopsy the left breast too. I feel I am in very competant hands, rather than the idiot breast specialtist I saw years ago for four yrs in a row. he never mentioned ONCE to me to get an ultrsound or an MRI because of both of my sisters having had breast cancer.
    I even found 3 enlarged lymph nodes and asked him if this was ok.
    he told me they were just part of the breast tissue.
    but I dont' have them on my left and the one in the middle is getting larger.
    I had the radiologist at the new place go over them too and she agreed that they are indeed lymph nodes.
    I became a little concerned when they popped out and even more concerned they stayed. this was BEFORE I was sent for an Ultra sound and an MRI and now a biopsy.
    why did they enlarge? why only on the right breast only? it can't be seen on a mammography because it's too far along the edge of the breast to be put on the plate. but the ultra sound did pick it up. not the MRI though which is a good thing I guess.
    the surgeon and I previously discussed when I went for a visit to get the results of the MRI weeks ago that she'd also biopsy these nodes for me being it bothered me. she didn't seem to be too concerned but said she'd do if for me.
    that made me feel good that she actually listened to me or cares enough to listen to me.
    I have so much to say for a person who's not overly concerned i need a bilat biopsy, huh?
    I am so happy for you.
    but what did your doctor say to do next? have a follow up MRI on it in six months?
    oh, did they leave the titanium markers in your breast or take them out? and if they leave them in, how long do they leave them in?
    Is this standard procedure for ALL breast biopsies?
    I haven't had a chance to even ask the surgeon this. I thought maybe you might know being it happened to you also?

    I sent you a message, so don't forget to go to the very top of this page at the right hand corner, where it says" PRIVATE MESSAGES:" and it's underlined in black. it will tell you how many you have there and if theyr'e read or not.

    To send a message to someone you first have to invite them to be a friend first I think. you add them as a contact and as a friend. there's both options.

    You personally have to go to your "settings" and put in a check mark that you want to receive private messages.
    because when I tried to send you a message, it stated that "Rhapsody" has it marked where you don't want to recieve them. so go to your settings and edit it.
    let me know if you ever recieved my message so I know to go back and write another one once you edit your settings. the "settings" info is in a box on the left hand side of your screen, along with other options.

    thank you SO much for letting me know what happened.
    Now you can take a deep breathe and relax, for the moment anyway.
    who knows when it will happen again when you have lumpy breasts.
    I never had them before either, not until now at age 48. but I'm also on estrogen patches which makes me have to be extra careful on my exams and follow ups. I can't live comfortably with out my estrogen replacement therapy. I was falling apart phsycially and mentally. I was so sick now that I look back. I am afraid to come off of them.
    the surgeon said she wants me to try to and if we find that I STILL am getting horrible symptoms due to menopausal symptoms caused by the total hysterectomy back in 2005, then she'll let me get back on them.

    we'll see. everything is about "waiting".....

    boy am I learning patience, more so now than I ever did in my entire life!


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