Waiting for Breast Biopsy Results

This column was written by Patch opinion columnist Christine Wolf and is the second part of a three-part column on finding a lump in her breast. To read part one, follow this link. To read part three, follow this link.

Let’s just get this over with, I thought, waiting for an ultrasound on what doctors told me was a "questionable mass" on my right breast. Just tell me it’s nothing. 

“Okay,” the radiologist at The Center For Breast Health said after a few of the longest, quietest minutes. “Let me give you a quick lesson in reading an ultrasound image, just in case you come to work here some day.”

I think he expected me to laugh, but I didn’t. He angled the monitor so I could see it from my prone position on the table. 

“What we have here,” he said, indicating one spot darker than all the others, “is the area in question.”

He pointed to the monitor.

“This is your chest wall, and right next to it is this area of density. The good news is it’s very small. It concerns me, though, that we’ve never seen it before.” 

I stared at the dark spot. Compared to the rest of the white wisps of tissue on the image, the dark spot seemed like a place of emptiness rather than something filled with the potential for danger.  

“It’s not a fluid-filled cyst”, he said, “so we need to find out what it is.” 

That makes sense, I thought. I want to know what it is, too. 

He explained that in the past, suspicious masses were almost always taken out. End of story. But, research has shown that the majority of these questionable areas turn out to be benign – consisting of either calcium deposits, fatty or fibrous tissue, etc. In my case, because the mass is so deep, he recommended an ultrasound guided needle biopsy.

“A biopsy will tell us exactly what we’re dealing with and how we’ll need to proceed.” 

And that’s when the tears rolled from the outside corners of my eyes into my ears. Helped by the female ultrasound technician, I sat up, apologizing for my tears. She handed a box of tissues to the radiologist.

“Don’t apologize,” he said. “It’s understandable. You’re a human being.” 

“I just kept telling myself it wasn’t anything,” I said, taking several tissues. “I wasn’t expecting a biopsy.” 

The technician looked at me with sad, understanding eyes. 

“So,” the radiologist said, “We’ll have you meet with a coordinator to schedule the biopsy. I’d like to do it today, but we’re already filled with patients.” 

And then I really couldn’t stop the tears. Suddenly I just wanted to know. I’d already waited six days and now I’d have to wait more?  I pulled the cotton mammo-jacket a little tighter and straightened up. 

“What if I just want to have it taken completely out now?” I asked. “And not even do the biopsy?” 

He looked at the technician, then back to me.

“The fact is, you’ll need the biopsy to know what the mass consists of. It may be nothing, which means you’ve saved yourself from unnecessary surgery. If, however, the biopsy reveals a malignancy, you’ll need surgery anyway, and one surgery is always better than two.”

He leaned back against the counter, giving me a chance to take it in. “Do you have any questions?” he asked. 

“Can a benign mass ever turn into cancer later?”

 I asked, knowing I’ve heard that happen. 

“It can, but the biopsy can help identify the probability of the tissue becoming a malignancy.” 


Likely to do that. Probability. Malignancy. 

In that moment, I’d wished I’d brought my husband or my friend Jana who, after reading my ChicagoNow post about the initial mammogram, had offered to come with me. In all my focus on trying to think positive, I hadn’t even prepared myself for the possibility of a biopsy. It didn’t matter how low the percentages or rare the probabilities – we were talking about them in relation to cancer in my body. And this terrified me. 

DIGITAL DIAGNOSTIC RIGHT MAMMOGRAM AND TARGETED RIGHT BREAST ULTRASOUND:
CLINICAL HISTORY:
Patient returns for further evaluation of questioned nodule seen in the posterior central right breast on screening mammogram performed on 05/23/2013. 
Digital spot compression views confirm the presence of a partially secured nodular focus in the deep central slightly medial slightly lowerportion of the right breast. 
Sonography of the deep central slightly medial slightly lower portion of the right breast performed. In the approximately 5 o'clock subareolarregion there is a subtle rounded hypoechoic mass deep in the breastmeasuring 6 mm x 6 mm. This is nonpalpable to my targeted examination.
OFFICE VISIT: In summary, this patient presents with a nonpalpable small solid mass in the right breast. Clinical history reviewed. Differential considerations, including the possibility of malignancy, were discussed with the patient. Management options were discussed. I have recommended ultrasound guided needle biopsy. A total of 20 minutes was spent with the patient of which 12 minutes or greater were spent counseling the patient and coordinating further patient care. 
Findings and recommendations relayed by telephone to the office of [patient’s doctor]. 
IMPRESSION: Small solid mass in the right breast for which ultrasound guided needle biopsy is recommended. Findings and recommendations discussed with the patient and she is currently in the process of making arrangements for that procedure with our biopsy coordinator nurse.    

I’ve scheduled my biopsy for the first opening available: Monday, June 3 at 9:15 a.m., back at The Center For Breast Health. Even though I won’t receive the results until Wednesday, June 5th, my husband has insisted he join me. I won’t discourage the company this time.

Last week, I was unable to reach my ob/gyn or my primary care doctor to talk through options about needle biopsies vs. lumpectomies. It bothered me greatly that I had to reach out to friends who knew doctors to get some of the answers I needed. I spent this past weekend whispering with my husband, dabbing my eyes, avoiding crowds, and thinking about my mortality.

My mother always says I’m melodramatic, and I hope she’s right once again. Most of all, I hope the results prove this all to be nothing but a nerve wracking layer to an already hectic period in my life and that this column inspires someone to get that mammogram he or she has been putting off (yes, men get breast cancer, too). While this wasn’t a topic I was planning to write about, it’s the only topic I can think about right now.