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Q: 

tiny cyst I have squeezed

A: I would go make sure that is was just a cyst first. I don''t think you can apply anything to make it look better especially since it is on that part of the body you have to be extremely careful what you apply. I would let it heal naturally and try to avoid sex even with a condom on to not irrate the area...


Q: 

Dear Lillie,I am 48, premenopausal. Only family history of breast cancer is my paternal aunt, who died at age 65. I have never had any surgeries or biopsies. Seven years ago, mammogram and ultrasound showed that I had a small fibroadenoma and a few tiny cysts at the 9 o''clock position in my mid-outer right breast. After following the right breast on a 6-month basis with mamm and u/s with ?no significant change? for about 2 years, I returned to a yearly bilateral mamm schedule.In 2002, I switched to a breast health center that is part of a local hospital because it has better equipment. They read the films right there, and then you are examined by a surgical oncologist, who discusses the results. They did a mamm and had me go for an u/s because they insisted on having a complete set of films performed on their equipment. These revealed the same area on the right breast, but he had me go for a 6-month follow-up on the right breast again, just for comparison purposes. These studies reiterated what I had already been told. In 2003, 2004, and 2005, I returned to this facility for yearly mamms. The reports indicated that ?the overall appearance of the breasts is stable? and that there was ?no radiographic evidence of malignancy.? Except for the initial studies done in 2002, the fibroadenoma and cysts were hardly mentioned, other than to say that everything appeared the same. One report even indicated that the cysts had regressed somewhat. All of them (including 2005) state ?BI-RADS II (benign findings).? (I always ask for written copies of my reports, so it?s been easy for me to monitor these findings over the years).I returned to this facility on Monday for my annual mamm. The radiologist marked this same area on the mamm film, and his written notes were ?no significant change ? 12 month follow up.? When the surgical oncologist looked at the film, however, he decided to do an u/s right in that office. When I asked him why, he said that he wasn?t sure why the radiologist flagged it. He did the u/s and made a few comments to a med student who was with him such as, ?this is the area we?ve been following. See, there?s no evidence of shadowing.? He called the radiologist (while I was sitting right in front of him), who told him that no further action need be taken. Yet the surgical oncologist said that since I hadn?t had an u/s done in 3 years, he?d ?rather be safe than sorry? and that he wanted me to go for a ?diagnostic u/s? today. That?s all that I needed to hear for the panic to set in! He says that there are certain characteristics of malignancy they look for when they interpret these films, and mine showed NO evidence of these, yet he?s still sending me. I am a nervous wreck over this. I feel like he''s giving me conflicting info. Is he just trying to keep me calm until the other shoe drops, or do I take him at his word?My questions: what does ?no evidence of shadowing? mean? What characteristics do suggest malignancy? Can fibroadenomas and cysts just disappear? Last year, this same surgical oncologist said that he couldn?t see them on the film, yet now he seems concerned. Do benign conditions such as fibroadenomas and cysts increase one''s risk?Any light you could shed would be most appreciated.

A: cysts can disappear.... fibroadenomas can shrink... don''t be alarmed. i didn''t read anything that would have alarmed or worried me at all....
Q: 

I am 46 years old with a strong family history of breast cancer; my sister was diagnosed at age 50 and also two aunts from both sides of the family have had breast cancer. I have always had dense breasts and was told that I have fibrocystic disease so I am being monitored every six months. I recently had an ultrasound and was recommended to have US guided biopsy. The report reads as follows: within the right breast, a hypoechoic structure measuring 6mm in the 12 o''clock position is identified. A tiny cyst in the 1 o''clock position measures 5mm. Additional simple cyst in the 7 o''clock position measures 6 mm. In the 11 o''clock position, close to the chest wall, a well defined hypoechoic solid nodule is identified. This is close to chest wall and measure 1.3 cm. This is identified on the study of 7/25/06, however, it is not evident on images submitted from outside institution dated 5/3/06. Biopsy of this nodule is recommended. Within the left breast, a somewhat irregular hypoechoic solid nodule in the 7 to 8 o''clock position is identified with maximal diameter of 12 mm. This nodule is mildly lobulated, slightly irregular in its inferior aspect. Increased vascularity is seen related to this nodule. Ultrasound guided biopsy is recommended. Subcentimeter cysts in the 11 o''clock position are identified with fatty replaced axillary lymph nodes. Based on this report would you say that a US guided biopsy is the best course of action? Or is a biopsy even necessary. My doctor wrote me a for left breast biopsy only but nothing for the right breast. I only received a copy of the report after he had already given me the so I am questioning why the findings of the right breast don''t seem to concern him. Your thoughts and suggestions are greatly appreciated.

A: the radiologist feels he can access this easiest with an ultrasound core biopsy. the deion is a bit worrisome-- irregular edges and vascular supply noted so pursue it....
Q: 

hello, I had my mammogram done and got the letter to come in for a redo .I did it today and they found cysts on right breast(no problem, not bothering me)however on the left breast at the 3 oclock position, they found a 1.5 cm mass. The radiologist said it did not look like cancer, it looked liked a fibroadenona. After a fast discussion, ( I was in shock) i decided to have my biopsy done by them . They are doing a Sono- guided Vacuum asisted Biopsy. She said my breast changes looked hormonal. I said that was true, I had changed my form of estrogen since november 04 and was getting better absorption, thus more estrogen. I''m 54 , had a complete hystertomy in 82 and have been on oral estrogen until november when i switched to estrogel, and up until now, have had no problems on my mamograms, except one tiny cyst, 6 years ago. I am stopping the estrogen, because i feel it has to be the cause of this. Could u describe the procedure they will be doing? I''m going to buy some ice packs beause I know I will swell. I''m not a baby, I can deal with discomfort, but not outright pain. I guess I''m just scared .I''m afriad it will be cancer. RG

A: they will give you numbing medicine in the breast to start and a large guage needle connected to a vacuum instrument will be inserted into the breast guided with ultrasound. the instrument will cut a strip of tissue and suck it back into a chamber. they will be able to see on the screen that they sampled the intended spot. they will put ice on it afterward. no incision. just a bandaide. we hope you get good (benign) results....
Q: 

I''ll be 42 years old in 2 days. A couple of weeks ago I had a mammogram, and was called in for a second mammogram on my right breast and then had an ultrasound. The report says: There is a complex mass in the region of the palpable abnormality at the 2:30 position. It measures 1.2 X 0.6 cm. It has multiple tiny cysts with some intervening soft tissue. These lesions are often benign, but because there is somewhat more soft tissue associated with it, the current recommendation is to do an ultrasound guided biopsy to confirm that it is indeed a benign lesion. Suspicion level: 4-Suspicious.I have an appointment with a surgical oncologist who specializes in breast surgery in 6 weeks. The office triages, so I would assume this means nothing looks terribly alarming. But, it is going to be very hard to wait this long to even have my biopsy.My questions are: I''ve heard that having a BIRADS score of 4 means a 10-20% likelihood of cancer being found. While everyone is telling me not to worry, it is very hard not to if those really are the odds. Are some level 4s more suspicious than others?Also, I''m assuming that in the case that it is cancer, the six-week wait won''t be an issue. Correct?Having this happen now has been particularly difficult for me because my cousin, who was 4 years younger than me, just died a few months ago from breast cancer. Other than that no one else in the family has had breast cancer.

A: some bi-rad 4s are more suspicious than others and only the radiologist reading the images can tell you if yours looks more worrisome vs less so. this type of biopsy is usually done BY a radiologist and not by a surgeon. so rather than waiting 6 weeks, go back to the radiologist and see if he can do a core biopsy for you to get answers sooner vs later....
 
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