AboutClaes-Gustaf Nordquist, M.D. Expertise I`m a doctor of medicine and a specialist in radiation therapy and medical oncology. I have long experience in diagnostics and treatment of breast tumours.
Experience I'm a Doctor of Medicine. Licensed/certified physician and surgeon and specialist in Medical Oncology and Radiation therapy in Sweden, Denmark, Finland, Iceland, Norway and the European Union. Background in Radiation Therapy, Medical Oncology, Radiation Protection, Nuclear Medicine, Diagnostic Radiology, Gynecological Oncology, Clinical Pathology, Clinical Cytology,Hematology and Internal Medicine. M.D. from the faculty of medicine, Royal Karolinska Institute, Stockholm, Sweden. Have also been an exchange student at the Hebrew University, Hadassah Medical School, Jerusalem Israel. Former medical consultant, Swedish National Board of Radiation Protection. Former Police Surgeon and Medical Examiner, Stockholm Police Department. Former Chief Medical Officer, The Royal Guards, The Royal Horse Guards and the Royal Household Brigade, Royal Swedish Army Medical Corps. Now in private practice in Stockholm, Sweden.
Question I (Age 39) with no family hx of breast cancer, had a very large palpable mass in right outer edge (10 o'clock on large breasts)that I found on exam. Mammo showed only dense breast tissue. US showed "large conglomerate of multiobulated complex cysts", and radiologist further stated "I highly doubt whether any of this is malignant". I guess my surgeon agreed and said he also thought it was just a cyst, let's remove it or watch it. Open biopsy confirmed IDC, Grade 3, 2.5 cm, ER,PR and Her2 Negative with KI-67 of 90%. MRI reconfirmed more cancer. Had second lumpectomy with SNB additional 4.2 cm tumor removed IDC and every thing else the same with one positive lymph node. I would like to know why was I not given a Core needle biopsy? It probably would have saved me some surgeries, because subsequently I found out I am BRCA 2 positive and had bilateral mystectomy. Is it possible that I would have benefited from neo-adjuvant chemo? Are there specific clinical findings that the surgeon uses when he decides on which kind of biopsy? Thank You in Advance!
Answer I would have ordered a core needle biopsy. I have never relied only on mammography. I have always since the early 1970ies used some form of needle biopsy (fine/thin needle aspiration biopsy or wide bore core needle biopsy) together with mammography (and ultrasound scans - and later also MRI scans) to ensure a correct diagnosis. However in parts of the USA needle biopsies are still for some unclear reason not popular with at least some doctors. I do not really know why. It is sad!
