Hello,
My wife has recently discovered a lump in her breast (about 1 cm.). She
has been to her doctor who originally diagnosed it as a cyst, but she had
an ultrasound, which didn’t show anything. She can’t have a mammogram
because she is 5 months pregnant. She had a baseline mammogram 4 years
ago which didn’t show anything, but she has been having regular check-ups
which hadn’t shown anything until recently. She is 32 years old, and this
is our 3rd child and she breast fed the first two which is suppose to
help, but unfortunately there is a very high rate of breast cancer in her
family. She had an older sister die from breast cancer at 33 years of age
about 8 years ago, and another sister who has also battled with it and
had a lump-ectomy (sp?) about 4 years ago, and she hasn’t shown any signs
of reoccurrence since. Her doctor has been taking this very casually, and
wants to wait until after the baby is born before she proceeds with any
other tests. This obviously has my wife very upset, and I was hoping to
get any advice, recommendations, etc.
My questions are:
How accurate are ultrasounds?
If it was a cyst, which is liquid, shouldn’t it have shown up on the
ultrasound?
Therefore, if it isn’t a cyst could it be something else that wouldn’t
show up on the ultrasound, but is related to her pregnancy?
If it is cancer, would a biopsy accelerate the cancer?
Are there any other safe tests she could have performed to help identify
this?
Can anyone recommend any good books for me to read?
Any other holistic cures or any other ideas, suggestions,
recommendations, etc. will be greatly appreciated.
Best Regards,
Brian
>My wife has recently discovered a lump in her breast (about 1 cm.)……
>…. but unfortunately there is a very high rate of breast cancer in her
>family. ….. Her doctor has been taking this very casually, and
>wants to wait until after the baby is born before she proceeds with any
>other tests. …..
You have a right to be worried. Unfortunately, most other tests
(mammograms, nuclear medicine tests) require radiation and could be
potentially dangerous (although at 5 months the risk is lower).
I would suggest another opinion. A surgeon, or better yet a surgical
oncologist, might be able to help you. I should point out that
statistically the odds are high that this is not breast cancer, but
that wouldn’t stop me at this point. Yes, a cyst generally would show
up on ultrasound.
By the way, a negative mammogram at age 32 also has to taken with
caution, since breasts are so dense at that age that the mammogram
will often not pick up a cancer. Good luck (and congrats on the
baby!)
Why not have the lump biopsied. That is not dangerous, no radiation.
Maybe a little local anesthetic, maybe not even that if it is a needle
biopsy.
In article <42n30c$…@hpavla.lf.hp.com>, "B. Donnelly"
<Donne…@LF.HP.COM> wrote:
> Hello,
> My wife has recently discovered a lump in her breast (about 1 cm.)….
As is often the case, there are several possibilities.
1. It may be a cyst. (sometimes the first impression IS the right one!)
Such lesions may be seen with or without associated calcifications or
areas of fibrous tissue formation. If the baseline mammogram showed signs
of these changes, this would be the most likely. Such lesions may change
size with hormonal stimulation, as occurs in pregnancy.
2. It may be pregnancy-related.
Such a lesion would be known as a lactating adenoma, and does not imply
an increased risk of cancer.
3. It may be a bundle of fibrous tissue and breast tissue (fibroadenoma).
These also do not imply a greater risk of cancer.
4. It may be a papilloma, a shaggy lesion, usually found in the central
part of the breast, and associated with a nipple discharge.
5. It may be a malignant process. This would be uncommon in a younger
woman, but with a strong family history, I can understand the concern.
I am not a radiologist, but the appearance of the lesion on ultrasound
would be affected by the surrounding tissue, and the depth of the lesion.
Concerns about cancer being spread by the act of the biopsy don’t really
hold much water in my limited experience.
This topic seems to come up every so often… is there a FAQ for it yet???
> Are there any other safe tests she could have performed to help identify
> this?
If the lesion can be felt, two other techniques, a fine needle biopsy, and
a fine needle aspirate can be used to take a small sample of the lesion.
In experienced hands either (or both) can provide enough tissue for a more
definite diagnosis. Often only local anaesthetic is required, and it can
be done as an outpatient.
Most general practitioners (OB/GYN, Internal Medicine) do not do these
procedures, and would defer to the person in the area doing them. Often
these persons do most of their work in conjunction with mammograms, and
would be found in a radiology department or in a dedicated Women’s Health
Center.
Keith Krabill, M.D. (A pathologist, trained in laboratory medicine)
Brian, the best advice is to get the lump biopsied via what’s
called "fine needle aspiration". It’s a simple, relatively
painless technique, which can give you important answers quickly.
A lump that is not cystic may be a benign fibroadenoma, but given
her family history, and the new appearance of the lump, an
aspiration could easily tell you whether you can continue to
wait and watch what it does, or whether it needs more agressive
treatment. The prognosis of breast cancer occuring during
pregancy is worse than other breast cancers, and I’d go for the
test! If the lesion was just a cyst, and the ultrasound wrong
(which is unusual), it could be drained at the time of the
aspiration. A negative mammogram isn’t helpful–it is not
accurate enough. If you feel it, biopsy it. Biopsy does not
cause the cancer to spread, in this situation. Please let us
know what happens, we share your concern…H2
–
H2
In <42n30c$…@hpavla.lf.hp.com> "B. Donnelly" <Donne…@LF.HP.COM>
writes:
- Hide quoted text — Show quoted text -
>Hello,
>My wife has recently discovered a lump in her breast (about 1 cm.).
She
>has been to her doctor who originally diagnosed it as a cyst, but she
had
>an ultrasound, which didn’t show anything. She can’t have a mammogram
>because she is 5 months pregnant. She had a baseline mammogram 4 years
>ago which didn’t show anything, but she has been having regular
check-ups
>which hadn’t shown anything until recently. She is 32 years old, and
this
>is our 3rd child and she breast fed the first two which is suppose to
>help, but unfortunately there is a very high rate of breast cancer in
her
>family. She had an older sister die from breast cancer at 33 years of
age
>about 8 years ago, and another sister who has also battled with it and
>had a lump-ectomy (sp?) about 4 years ago, and she hasn’t shown any
signs
>of reoccurrence since. Her doctor has been taking this very casually,
and
>wants to wait until after the baby is born before she proceeds with
any
>other tests. This obviously has my wife very upset, and I was hoping
to
>get any advice, recommendations, etc.
>My questions are:
>How accurate are ultrasounds?
>If it was a cyst, which is liquid, shouldn’t it have shown up on the
>ultrasound?
>Therefore, if it isn’t a cyst could it be something else that wouldn’t
>show up on the ultrasound, but is related to her pregnancy?
>If it is cancer, would a biopsy accelerate the cancer?
>Are there any other safe tests she could have performed to help
identify
>this?
>Can anyone recommend any good books for me to read?
>Any other holistic cures or any other ideas, suggestions,
>recommendations, etc. will be greatly appreciated.
>Best Regards,
>Brian
Brian, I am a 29yr old female with a similar STRONG family history
of breast cancer. My mother experienced a lump in her breast, while
she was pregnant with my younger brother. The doctor’s told her it was
due to milk glands. There were no ultrasounds available at this time,
and so she had no further diagnostic tests. Subsequently, she was
later diagnosed with breast cancer after my brother was born, and
treatment efforts were too late and would not have been an option while
she was pregnant. This, however, was in 1971 and there are probably
more treatment options available now.
From my understanding an ultrasound is more reliable in detecting
breast cancer at an early stage than a mamogram.
A biopsy should not accelerate any cancer growth, should it be
cancer, and they should be able to perform it with a local anaesthetic,
which would not harm the child.
My recommendation would be to definately seek out a second opinion
(from another physician).
I hope that things work out for the best,
Diane