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Forum Name: Breast Cancer

Question: Conflicting FNA and core biopsy


 ConcernedMama - Thu Dec 01, 2005 5:05 pm

I am a 32 y/o lactating woman, no history of family breast cancer. Nine months ago, my baby started sleeping through the night and I woke up laying flat on my right breast and it was red and engorged. I was treated for mastitis and the redness went away, but one month later I was still swollen. I was monitored by a surgeon and finally on 10/12 they performed an FNA (not guided by u/s). It was sent to 2 different pathologists and came back "suggestive of papillary lesion". FNA also classified as "difficult to read due to the presence of air-drying artifact". Core biopsy performed on 11/22 at a well-known breast center took 6 samples of the lump and came back with no abnormalities found and a diagnosis of stromal fibrosis. Ultrasound was consistent with stromal fibrosis and clinical exam was unalarming (thickened tissue and dilated milk ducts).

Surgeon recommends excisional biopsy. Here is the problem: I want to have more children and breastfeed them. I am currently breastfeeding my first child. The lump is subareolar and excision will interfere with future breastfeeding.

Do you know of any alternative to complete surgical excision? Is it possible to overrule the FNA with the core biopsy results since the core biopsy examined so many more cells? I am hesitant to consent to full biopsy unless I have some more evidence that I really need it.
 Dr. Tamer Fouad - Sun May 14, 2006 1:35 pm

User avatar Hello,

I hope you agreed to do the biopsy. Sometimes the needle and the core biopsies 'miss the target' and take samples from the surrounding tissue rather than from the disease (eg, cancer). Whenever there is a doubt it is best to be sure.

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