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Dr. Linder's Blog

BREAST BIOPSIES, EVEN WITH NEGATIVE DIAGNOSTIC TESTING

Posted On: November 24, 2009 Author: The Office of Dr. Stuart Linder Posted In: Breast Revision, Breast topics

In my practice, I believe that all breast masses have to be considered very seriously, especially breast masses that are enlarging over a short period of time.  As a case example, recently we saw a patient who had an unremarkable ultrasound showing no evidence of malignancy, no microcalcifications and no indication per radiology for any type of diagnostic testing of the mass itself. 

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The patient was to undergo a removal and replacement of implants that were over a decade old, but she had a mass that was approximately 3×5 cm and it was well loculated in the right upper breast.  Even though the ultrasound was normal or negative, did not show any evidence of malignancy, I believed that this should be biopsied intraoperatively with removal and replacement of the implants.  In the operating room, bilateral removal and replacement of implants, open capsulectomy and excisional biopsy of the right breast mass was performed.  The mass was hard, somewhat calcified and very thick.  It was sent to our excellent pathologist at the UCLA Medical Center for diagnostic purposes.  The diagnosis came back ductal carcinoma, which was invasive.  Thank God we took the initiative to do a biopsy at this time even in the face of a false negative report on her ultrasound where she was asked to repeat the ultrasound in six months to one year.  Who knows what the state of this patient would be in six months to one year.  There is a chance that she may not be alive in six months to one year. 

As a result, I believe in my practice all tumors, especially tumors or breast lesions that are enlarging rapidly over a short period of time, should be considered seriously biopsied either with fine needle aspiration, TruKor, or excisional biopsy.