Should I get a 2nd Opinion

Hi,

In March 2009 a lump was detected in my left breast during a routine medical (I was aware that it was there). I was given a mammogram and told that the results showed nothing untoward, which I accepted. Two years later I changed my job, had a routine medical and again the lump was flagged by the doctor. I told her that I'd had a mammogram and that the results were negative, but she said that although she thought it was nothing to worry about she was referring me to a specialist. I went for the appointment and had a mammogram and an ultrasound, both were negative. He took a fine needle aspiration at the same time, an incidental finding was found and a core biopsy followed and MRI. It was diagnosed as Atypical Hyperplasia and the lump was removed by a lumpectomy and I am now being monitored annually. I went back 6 months after the op and the left breast did not feel right, a ultrasound showed nothing and I was sent away. I have had a lump in that breast now for a while and it's quite painful all the time. I do have dense lumpy breasts but they are only painful prior to a period and ceases after. This is a constant sharpish pain. I had my annual check up today, something was flagged on the mammogram so I was given an ultrasound which again showed nothing untoward. The consultant upon examining me was undecided whether to do a fine needle aspiration and do a biopsy on it, he decided not to do it. However, given that the last scans all showed nothing untoward and I had pre-cancer cells I am a little concerned that this lump feels different. It hurst for a start, whereas the other one didn't. I have read so many things where people have had scans that have shown nothing untoward yet have resulted in BC. Why mothers mum had breast cancer and had to have a mastectomy so I am naturally very concerned. I know I am a good position, but do I just go back in a year as the consultant has recommended or do I seek a second opinion?

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Seek a second opinion and get a core biopsy done which will test the tissue. Sometimes, as in dense breast tissue, the surrounding tissue is where the activity is-at any rate, a lump is a lump and until it is confirmed non cancerous, you should seek that answer and not rely on a tech consultant that sounds like a fop! You have a history of Hyperplasia so that right there should tell you to pursue a better answer. Be your own advocate! I relied on my private Physician of 15 yrs which he told me my lump was just a fibroid and not to worry-he told me this for 3 years! It is my fault though-Although I trusted him, I should have followed my instinct and got a second opinion as the lump kept growing and got more painful around period time (this meant my cancer was hormone driven-ER Positive, PR Positive) and by the time I was staged, I was a Stage 3C Advanced with 19 lymph nodes involved, 11 of them cancerous. Get a second opinion!

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Hi, thanks for your reply. I have just dug out one of the letters from last year. I was actually diagnosed with Atypical Lobular Hyperplasia (B3) whatever that means? There is so much information on all this it's hard to fully understand what you are reading and the consultant has been fairly dismissive. I'm not sure why they bother to give women mammograms and ultrasounds when they don't seem to be accurate. Why not just do the biopsy and cut all that out? Trouble is, if you have scans or if a so called expert tells you that they are clear etc, nothing to worry about you would take that as read wouldn't you? I am so very sorry to hear of your diagnosis. I hope that it is treatable for you?

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I'm doing Radiation now, my 3rd week, another 3 1/2 weeks to go; I don't trust doctors anymore that's why I will even go for a 3rd opinion if it doesn't make sense the first and second time around-especially when they dismiss you and tell you not to worry, that just means they are ignorant and do not know what they are looking for as they are not qualified!!! The reason they are not qualified is because they missed a big piece of the puzzle-your family history!!!! They should not have allowed you to walk out of that office without a core biopsy! Use your common sense and it will take you a long way!!!! Here are some links that may help guide your thought process and to help with your decision making. Since they stated Lobular, you might want to read about Invasive Lobular Breast Cancer.

TREATMENT FOR EARLY AND LOCALLY ADVANCED BREAST CANCER
http://www.guideline.gov/content.aspx?id=14312&search=breast

Cancer staging
http://www.cancerstaging.org/staging/posters/breast8.5x11.pdf

Breast Cancer treatment protocols
http://www.cancer.gov/cancertopics/pdq/treatment/breast/healthprofessional/ page6#Reference6.207

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Thank you so much for your reply and the links you've attached, I will definitely take a look at them. The doctor I am under is Professor Kefah Mokbel MB BS MS FRCS is the lead breast surgeon at the London Breast Institute of the Princess Grace Hospital, an honorary consultant breast surgeon at St George's Hospital, Professor of Breast Cancer Surgery at The Brunel Institute of Cancer Genetics and Pharmacogenomics (London, UK) and the founder and current president of Breast Cancer Hope; a UK-based charity "dedicated to improving the quantity and quality of life in women diagnosed with breast cancer".[1] He is ranked among the top 25 breast cancer experts in the world[2] and among the top 5 breast cancer experts in the UK.[3] Part of me feels that I should trust him, surely he knows what he's talking about, but there are so many stories all over the internet where women have been told exactly the same as me and it's been totally wrong. What a minefield it is.

I hope that the radiation treatment isn't making you feel too poorly and that the course does help and get rid of the cancer. Sending positive thoughts your way. Thank you for taking the time to reply to me, especially with what you are going through currently.

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I (a Stage IIIC breast cancer survivor) would definitely suggest a second opinion. If I had the wherewithal (and the funds) when I was told my lump in my breast was just another cyst . . . then several months later, after my regularly-scheduled mammogram (which showed "suspicious" findings), and a biopsy, the cancer was diagnosed--well, my life would possibly be VERY different than what it is today! (Though I admit I'm very grateful to BE alive.)

So many times, on this site, I've read about women who have told they most likely did NOT have cancer . . . then later, found it WAS. I really believe most caregivers (medical, etc.), are doing the best they can. But I speak from experience. Your life may be at stake here! Sounds like an EXCELLENT idea, to find out more about what's going on!

At least, with a biopsy of a breast--well, you most likely don't have to have major surgery, since breasts are not something that are tucked way INSIDE your body! I really hope you do this, and find out what's going on, for certain. My cancer diagnosis was made from what is called a "stereotactic biopsy"--don't know if it's the same as a core biopsy--but I would strongly encourage you to take the next step--whatever that turns out to be.

I realize none of this easy or pleasant. But the sooner you find out for certain what's going on, the easier it will be to get on with your life. I expect that many others on this site will suggest something similar.

Please take care, and remember how many others care! And please keep us posted, on this site.

Thinking of you,
Det

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Hi Det,

Thank you so much for your reply and so very pleased to hear that you are a survivor. I was just a little shocked given the diagnosis 12 months ago and having the lump removed that he hasn't done the biopsy, after all better to be safe than sorry eh. I will indeed seek a 2nd opinion and keep you informed as to the outcome. It's great to have sites like this and to know that the support/advice is there from people going through similar things.

You take care.


Barbra-Ann

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A Hollow Core Needle Biopsy was done for me as the tumor was large and the tissue was cancerous as well, aka "Core" Biopsy which is just like drilling for a thick Ice core that you see on shows like National Geographic. It was very painful, it was like a gun that snapped 7 samples one by one, each time creating such a force that I wanted to punch the tech in the face and that was with a local! It was guided by Ultrasound and by the time it was over, I just balled and let it all out! I went home with pain pills and had to take off the next two days of work as the procedure had caused 2 hematomas. The procedure had to be done as the Mammogram showed clear evidence of a wide spread of disease. And this was the start of my Journey......

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Barbra-Ann, if you DO end up having a biopsy done, just remember it's not going to last long! Whatever the results, there will be others to support you. Even though I was so certain I did NOT have cancer, one of my best friends insisted on driving me to my appointment for the biopsy. It's always nice to have support. After I was diagnosed, each mention of support from friends and acquaintances--and some sent gifts and cards--it was like a radiation jewel. I will mention that my breast cancer was diagnosed September of 2008. Right now, as far as anybody knows, there is NO sign of cancer in my body. I see my oncologist every six months. Yes, I went through a LOT. And I'm certainly not the person I was, prior to my diagnosis, in a lot of ways. But I'm here! TPalomares is truly great about researching needs and options--and SHE's here, posting--just like so many others!

Wishing you many good things. I think you're making the right decision, about taking care of yourself, your needs--your life.

Many care about you,
Det

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Thanks Beth-yeah that last post was probably pretty scary to anyone new-sorry for the abrupt description but when digging for answers to the Cancer question, none of the tests are ever pleasant! So if anything, prepare your mind, study up on your tests, results, meanings of blood panels, tumor marker tests, etc... know your cancer that way you know how to fight it! It's almost like going back to school but it's a 6 week class and so no time to waste as finals are approaching fast!!!! Best Regards, Theresa

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Certainly didn't mean to say "radiation jewel" in my post--just meant something like a glowing positive thing in my heart--good thing my friends don't love me for my strong sense of clarity!

Experiencing cancer has an extremely high learning curve. Barbra-Ann, please remember how strong and smart you are. Glad you're trusting yourself--you're concerned, so you're doing something about it.

You're a very powerful being,
Det

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LOL-Beth, you know I always get you! That was cute I thought!!!! :)

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Thank you both for your wonderful advice and support. And fantastic that you are now cancer free (please God let it remain that way). I feel like a bit of a fraud after what you've both been through. I'm not worried about the biopsy etc having been there before I know what to expect so that's fine, I guess I just don't know whether to push for a biopsy, the doctor has said it's nothing to worry about so I kind of feel as though I'm being a pain and wasting his time when there are women that need it far more than I do. Due to the previous history I just feel that he'd be more cautious. He was undecided whether to do the biopsy or not, so if you ever consider it surely you'd do it?

That's fantastic that you had that kind of support, I couldn't even get my family to come with me when I went in for the lumpectomy, it was a horrible experience having it by local anaesthetic (I would rather have been put to sleep). I felt so alone laying there on the operating table, was in tears. The nurse was absolutely brilliant and I'm sure she's used to it but she was really lovely. I wish you both a lovely weekend and thank you again.

Barbra-Ann

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You are NOT any kind of fraud! You have serious health concerns--you also have just as much right to a biopsy as anyone else--it's not like there are so many biopsies allowed! Sorry if I sound snoofy. It's easy to sound stronger while I'm not going through myriad treatments, or tests to figure out certain diagnoses!

All my immediate family have died (prior to my cancer diagnosis)--also my best friend died about a year ago. But as I get older, I realize how, in certain ways, I'm related to everybody. I can't tell you how many times, and how much, I cried during different procedures and circumstances, while I was in treatment. That doesn't include the times I cried when by myself. We are designed to cry, when you think about it.

My oncologist says there's a very good chance of my cancer coming back. I figure, in this case, part of my job is to prove him wrong. I partly mentioned about my being cancer-free (technically I don't believe ANY human has no cancer cells!), because I wanted to remind you there are all kinds of hopes and futures out there! Friends, nurses, lots of caregivers, fellow patients . . . there are a lot of great people out there. There are others who might be great, but as far as being supportive during my cancer treatments, were no help whatsoever. I would not have made it without . . . well, without myriad other human beings, but I certainly had to deal with a lot of situations by myself. Sometimes I tell people that my cats helped me through chemo, and my dog helped me through radiation treatments.

Just remember you're NOT alone. Also, you're smart and strong enough to find out more about what's going on with your body.

I'm telling you a lot of this because I figure one of the best ways I know how to support somebody else is to tell what I went through. I know how different each of us are from one another. But we . . . well, anybody reading this post most likely knows what a powerful struggle it can be to strive for wellness, for hope, for peace. And in those ways, a lot of us are together, and caring about each other.

So please pursue what you need to do, to find out what the heck's going on with your body--and if there's cancer going on, what steps you need to take next. Trust you to do right by yourself!

Det

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Well said Detonator!!!

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IMHO, you have to trust your oncologist if he is a breast cancer specialist. If you are feeling pain in your breast now, 3 years after the core biopsy and MRI, things may have changed. Dense breast tissue makes it very hard to see cancer on a mammogram. Call your breast cancer specialist again and get in to see him for another go round. At the very least it will make you feel better about it being nothing, at the most you may have caught it in the early stages. Good luck!

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Hi,

Latest update, got my consultants letter yesterday to my doctor and he's written in it "an area of nodularity in the upper outer quadrant of the left breast" - "demonstated cystic benign breast change in the upper outer quadrant with no suspicious features". I do have dense breast and there are quite a few cysts, however, the last which I could clearly feel wasn't totally unsuspicious and again didn't show on either a mammogram or ultra sounds. He's put the pain down to mastalgia. My breast usually hurt prior to a menstrual cycle but not for the majority of the time. I have started taking Evening Primrose Oil today and am arranging an appointment to see my doctor following her receiving this letter and will see what she says about how to move forward.

Thanks again everyone for all your continued support and advice. I hope you've all had good, positive days.

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I am obviously NOT a professional about such things. But, prior to my cancer diagnosis, I was taking many supplements and eating food, that had plant estrogens in them. Unfortunately, my breast cancer turned out to be estrogen-positive. So taking the supplements I did was NOT helping my situation. You might want to research the Evening Primrose oil a bit. I don't want to sound like a scaredy-cat. I just wanted to mention this.

Just wish you well, the best of luck, with however you proceed. Glad you made an appointment to see your doctor.

Take care,
Det

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I it is any comfort to you, I was told by my medical doctor to always remember the reason why they call cancer a silent killer is because it does not hurt. Since your's does hurt you don't have anything to worry about but you do what you think is best for you.
Peace and Love
Betty

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Aw thanks Betty for your kind note, good to know. Although some people have said that they had pain. Hard to know isn't it. So many different stories, symptoms etc.

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I have had mammography done nearly every year with no remarkable results. Last year while showering I felt a hard lump near my neck in my chest area. I brought it up to my doc who said not to worry about it. Didn't go away and after a month insisted on having some type of test done to determine what I was dealing with, All test came back negative and was told to come back in a year. Ok,so since could feel at 1 1/2 inch lump on my chest area, I wanted to get it removed. My primary doctor felt it wasn't necessary and did not give me a referral. Not knowing much about that much about doctor's specialties, I just made an appointment with the closest thoracic surgeon (To tell u the truth I am still not sure what they do) I showed up for the appointment and after feeling the lump he referred me to a breast surgeon who just happened to be sharing his office. She said it looked very suspicious and for her peace of mind, she did a core biopsy in her office. I wasn't even expecting it and neither was I expecting to get an invasive cancer diagnosis in a few days. I was so surprised that I wouldn't do anything more medically until the specimen was also sent to John Hopkins. It now a year later and have seen doctors or been treated almost every day since then. I am on my last week of radiation so hopefully this ordeal is almost done. If I had listened to my original doctor and diagnostic center, I could be on death's bed at the moment. Oddly enough, my diagnosis and subsequent treatment has calmed me down and taught me to never trust your primary local doctor for proper treatment Neighborhood doctors are fine for colds and notes and maybe a little chit chat but stick to major hospitals for lifesaving diagnosises and treatments.

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