Expert: Claes-Gustaf Nordquist, M.D. - 8/29/2006

Question
Dear Dr. Nordquist,

After having my first mammogram at age 40, i received a note from the HMO that read, "Your recent mammography examination showed an area that we believe is benign (not cancer).  However, a follow-up mammogram should be perfomed 6 months in the future to evaluate this area and convirm that changes have not taken place."

How does a radiologist conclude that an area is benign vs cancer.  I understand based on what is seen.  But the verbage "we believe is benign (not cancer)" is not very reassuring when their recommendation is to wait 6 months.

Is waiting 6 months to wait and see if there are changes, the best treatment in your opinion and if you have any recommendations as to what would be the next step that I could suggest to my HMO.

I have not history of breast cancer in my family.  But what has changed recently is that i have noticed increased soreness and more lumps than before in my right breast with burning pains, that come and go, The area feels in flammed from the inside.

Thank you for your time,
lisa

Answer
No instead of waiting 6 months I think your mammogram should be complemented with 1. a breast MRI scan (probably an ultrasound scan too, but the MRI is the most important), 2. a thin needle aspiration biopsy of the lesion seen (if necessary done stereotactically based on mammography pictures if the lesion can not be felt by palpation). That way you would get a diagnosis immediately. However these investigations cost money and that is probably why 6 months of waiting is suggested instead. So I suggest that if they are unwilling to help you with this go somewhere else for help. Good luck!