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Friday, March 7, 2014
Breast Pain and BI RAD3 ?
I am 43 and have had pain in my left breast for about 6 weeks. It seems to come and go with my cycle. I had my annual clinical exam and the doctor said everything seemed normal. I had a mammogram followed by other views and then an ultrasound. The doctor said the tissue is heterogeneously dense with a focus of asymmetric breast parenchyma within the upper outer left breast which has not significantly changed from last year. Spot compression showed slight architectural distortion. No other suspicious findings. The ultrasound revealed a 2 mm anechoic lesion with post acoustic enhancement consistent with a simple cyst. Underlying breast parenchyma is normal. They have ordered a follow up mammogram in 6 months. I have no history in my immediate family but my aunt had breast cancer which presented with pain and did not show up on a mammogram or ultrasound. She insisted on a Pet Scan. Should I press for further follow up or does my case truly warrant waiting 6 months?
From your history and the events that have taken place, the most appropriate thing to do will be to wait for 6 months. All the results point to a benign problem and it is appropriate to wait. No role at all for a PET scan. If you feel very concerned about waiting, the only other suggestion is to get a second opinion with a surgical oncologist who specializes in breast cancer surgeries. This will mean another expert reviewing your mammograms and ultrasound and doing your exam. If this expert also feels it is appropriate to wait, then you have your answer.
Bhuvaneswari Ramaswamy, MD
Assistant Professor of Medical Oncology
College of Medicine
The Ohio State University