Imaging prior to biopsy

[AlaskaAngel]

I think my problem here is that the poll function allows just very short uncomplicated questions to be asked, with only very simple responses. Some have indicated that they found their own lumps themselves by being able to feel them.

What I want to know is how many people were biopsied without anyone (including themselves) determining that there actually was any lump at all TO biopsy.

I want to know if it makes any sense to all you people who have been diagnosed with breast cancer, if neither the doctor nor the patient has felt any lump or symptom AND the medical provider refuses to provide an ultrasound or MRI to show that there really is any lump at all, and yet advises the patient to have a biopsy just because the patient has calcifications on mammogram. In the case of the person I am concerned about, the calcifications are even not typical for cancer but instead are coarse calcifications (although there are a fair number in the clump). It makes no sense to me at all, but I'm trying to find out from all of you whether this is becoming standard practice for some strange and undetermined reason.

Inflammatory breast cancer would be the exception in that it would be seen as a sign on the skin, and then biopsied to verify it rather than imaging it or finding a lump. But what I am asking is if there is no sign or symptom other than calcifications, is it still standard practice to verify that there is a lump before doing a biopsy, or is it normal for a breast cancer imaging center to biopsy all women who have no sign or symptom and no demonstrated lump just because they have calcifications on their mammogram? This woman has tried to request further imaging from her HMO to verify whether there actually is any lump at all, and they are refusing and basically telling her she should have just the biopsy. Does that make sense to you? It doesn't to me.

Thank all of you for your patience with this question. I think something is not right about this. Not only that, but when she asked about possibly choosing an excisional biopsy, the doctor at the breast cancer center said "that would be pretty extreme, given her mammogram". Either she does need a biopsy or she doesn't; what kind should be entirely up to her. It makes me all the more suspicious when they are not willing to verify that there actually is ANY lump and just want to go straight to stereotactic biopsy.

Please help with further replies and by answering the poll as best you can. She is supposed to be biopsied on this coming Thursday. I just want to know if I am wrong about this or not, and if so, why?

Thank you,

AlaskaAngel

[StephN]

Hi AA -

Yes, it is not a simple question.

I do have a friend who is a nurse who had suspicious calcifications a few years back. She did not have a family history of BC, but pushed to have a lumpectomy and have the tissue removed.

They did find "atypical cells" which likely would have gone on to form cancer.

She was fairly flat chested and the place of the excision was on the side and not noticeable. She was most relieved not to have to keep going back and and be in the "watchful waiting" mode.

Seems to be a similar situation to the person you are asking for.

P.S. It took THREE biopsies for them to confirm my cancer. My actual tumor was quite small but there were "atypical cells" in the tissue surrounding the tumor since it was no longer in situ. This is why I think she needs to get more than what a needle biopsy can take.

[Montana]

Yearly mamo found calcifications (dcis) which were then immediately ultrasounded. No lump was felt. Stereotactic biopsy followed later in the week. The IDC was found during lumpy.