Expert: Claes-Gustaf Nordquist, M.D. - 5/7/2006

Question
I am breastfeeding a 10 month old son and recently found a mass in the upper middle quadrant of my right breast.  There are actually 2 palpable masses.  I had an u/s done.  (It was very difficult for the tech to find anything...it took about 20 minutes before she started taking pictures)  The report read:  No simple cyst, mildly distended and dilated ducts B/L as pt. is lactating.  No mass or debris identified w/in ducts.  There is a hypoechoic complex-appearing lesion at the 12 o'clock position with slight posterior acoustic shadowing.  The wall appears slightly thickened.  I went to the breast surgeon to have a biopsy and when the ultrasound tech tried to locate the mass it was undectable.  The doc came in and felt that the masses we feel are probably due to engorged tissue due to lactation.  He didn't really believe the u/s report.  He said he would blindly biopsy the areas we feel or to stop breastfeeding and come back in 2 months for a follow-up.  He recommended the latter.  I opted to wait.  As I was leaving he said if it is breast cancer waiting 2 months doesn't really change the prognosis.  To say the least now I'm really worried.  I weaned my son down to nursing 1 time a day and plan to stop all together in a few days.  Should I get a 2nd opinion?  Are there any additional test besides a biopsy that would help diagnosis?  Thank you for your time.         Sincerely,        Stacey

Answer
Is ultrasound the only examination you have had? At least an x-ray mammogram should also be done as well as a MRI-mammogram. All this together should tell you what it is. Also a thin needle aspiration cytological biopsy should be done. That together with the images should fix the diagnosis. If your original dr. does not want to do it get a second one.