Expert: Claes-Gustaf Nordquist, M.D. - 4/25/2007

Question
My mother has stage 4 metastatic breast ca with a previous right mastectomy.  I currently started getting mammograms at age 32 and the MD noticed several cysts in my right breast.  He concluded that I needed to be followed by 3 month ultrasounds and so far no changes had been found in the cysts until the mammogram today.  The tech noticed another spot that was unlike the one they were watching.  The MD at the center said both the spots were benign and that I should start getting yearly mammograms rather than 3 month ultrasounds, however, I don't see that MD and don't think I am unrealistic on getting a second opinion.  The first spot is approximately 2.4cm in width to 2.34cm in length and is completely black in color.  The second spot they found today is about the size of a large pea and grey in color.  Upon performing self breast exams I cannot notice anything because my breasts are so glandular.  Should I be concerned about these spots or not.  A surgeon has done a biopsy of the first spot, but nothing was guiding him to the spot, he just used his hand and a needle so I am not even sure if he got the right spot or not.  What should I be thinking about doing next.  Please help, I'm worried.  

Answer
With this kind of family history & medical history you should at LEAST have an X-ray mammography combined with breast ultrasound scans & breast MRI scans once every year and EVERY unclear lesion should be checked by biopsy. Needle biopsies are ok if the result is clear. If not a surgical biopsy should be done. In your case until clear biopsies are available in both cases I would say that new biopsies should be done for both lesions. In order to be sure that they hit the correct place they can be done stereotactically (based on mammograms or MRI scans), or guided by ultrasound or MRI.
A second opinion is never wrong! Good luck!