Expert: Claes-Gustaf Nordquist, M.D. - 9/26/2011

Question
QUESTION: Hi, in March 2009 I had a mammogram which showed a small thickening in my breast that wasn't present on my previous mammogram from 2 yrs earlier.  I was sent for an ultrasound and the radiologist said she didn't see anything suspicious and to return in 6 months for a follow up mammogram to make sure nothing changed.  In Sept. 2009 I had the follow up mammogram and nothing was changed.  My doctor is very cautious and sent me for a stereotactic core needle biopsy which showed a few atypical cells.  I am now scheduled for a wire guided excision in January 2010.  I was wondering if it is possible for cancer cells to be present in the thickening?  The radiologist who did the CNB did four passes with the needle, and I would like to know if it is common to find cancer cells in an area even though the CNB only showed atypical cells?  I am very scared.  Previous to my suspicious mammogram in 2009, I injured a muscle badly in the exact spot where the thickening/atypical cells are while lifting weights, could irritation/inflammation from a torn chest muscle cause the thickening/atypical cells?

ANSWER: Almost anything and everything is POSSIBLE. What is probable is something else. However if atypical cells have been found it is best to do the excision to be on the safe side. A cancer there is however probably not very probable. Good luck!



You can also reach me at: http://www.liveperson.com/professional/expert-profile.aspx?gsBMQvSJ0S4K1haAm6AtH
There is no limit to the number of questions there. Please note: NEW SITE!


---------- FOLLOW-UP ----------

QUESTION: Hi Dr. Nordquist, thanks so much for your answer.  I had another question concerning my problem.  I had the thickening excised from my breast in January 2010 (from my original question), and it was sent to pathology where they determined no other atypical cells were found, just normal tissue and some fine calcifications.  During this process over the last 2 years, I have been exposed to mammograms for screening, the Core Needle Biopsy, and the wire guided incision.  Now, they want me to have a follow up mammogram in a few days to make sure they got all of the thickening.  I feel this to be an excessive amount of radiation and am concerned that it could in fact cause cancer if I get anymore so quickly.  Tt has only been 8 months since the surgery.  Do you think it's a safe for me to go with the follow up mammogram so soon?  Any recommendation would be greatly appreciated.

Answer
Yes cancer risks will increase by x-ray exposure. But the increase for each normal exposure is small. This "cost" must be balanced with the benefit, "profit", of the examination - in spite of the fact that breast cancer frequency due to more elderly people and life style changes (increased body mass, less breast feeding, higher mother age at first child birth, fewer children, lower age at first menstruation, higher age at last menstruation and hormonal treatment of menopause symptoms) has increased - the mortality of breast cancer has decreased significantly. So since the mortality of breast cancer has decreased by a substantial amount since mammography and other diagnostic techniques came into use this "profit" clearly compensates for these somewhat increased risks - and even more so. In this case there is also a CLEAR & IMPORTANT surgical reason for doing this mammography (to make sure that everything has been removed and nothing has been missed and left behind and not been checked) and the increased risk of one extra mammography is VERY small, so I do recommend that you have it done! Good luck!


You can also reach me at: http://www.liveperson.com/professional/expert-profile.aspx?gsBMQvSJ0S4K1haAm6AtH
There is no limit to the number of questions there. Please note: NEW SITE!