My wife, who is 41 years old, developed lumps in her breast a few months back. She consulted a doctor and was suggested to take vitamin E tablets and asked to undergo mammogram and FNAC. The test results are enclosed. The doctor told us nothing to worry since the lumps are benign and the lumps have now completely disappeared. But, the report says further tests may be done. My wife does not want to undergo any more tests. Can we conclude that it is safe based on the reports? She had a similar problem about eight to nine years back and at that time also another doctor gave her vitamin E tablets and the lumps disappeared. No tests were conducted that time. Please advise.
I have seen your reports (attachment removed to protect patient's identity). The FNAC says it is benign (fine needle aspiration cytology). However, it is recommended to get an annual mammogram as a follow-up. Moreover, as FNAC is not the best for diagnosis, a biopsy is recommended. I am a little concerned because the BI-RADS 4 (breast imaging reporting and data system) is on the right side with the lymph node present. If a physical examination is suggestive, then probably would also like to get an MRI (magnetic resonance imaging) breast. Does she have a family history of cancer?
I hope this has helped you. Thank you.
My wife's paternal grandmother had breast cancer and maternal grandmother had stomach cancer. I did not understand the BI-RADS 4. As of now, all the lumps are gone. We will definitely do the annual checkup. Can you suggest what should be the next course of action?
Regarding your wife, with such positive family history of cancer, I would not neglect the current finding. At this moment, I would suggest you get examined by a breast surgeon. A breast MRI can give a more clear radiological picture. I also feel that a formal biopsy should be done. She will need a more detailed genetic history evaluation for the possibility of family cancer syndrome.
Should we consult a general oncologist or a breast surgeon? Should we go for MRI and biopsy first and then consult the doctor with the reports? I have heard that there are general tests that can detect cancer in individuals. Is it true? If so, can you please inform me about such tests and their efficiency?
What was her age at the time of her first menstrual period? What was her age at the time of her first live birth of a child? Any sister has a cancer-related diagnosis. Visiting a breast surgeon is definitely an option for a clinical breast examination. MRI is indicated only if clinically there is confusion. Probably an ultrasonic mammogram can be done because that gave higher sensitivity than a plain mammogram. The test which can detect cancer without biopsy is still experimental and not validated for clinical use.
Her age at the time of her first menstrual period was 13, and her age at the birth of her first child was 30. She does not have a sister.
Based on the data provided her risk of breast cancer is almost similar to the general population and does not categorize her in the high-risk group. However, it will be my personal opinion to have an ultrasound mammogram and cervical pap smear as it is more sensitive, any mass documented in that study can be biopsied on the same or later date. Please ask the radiologist to sub-clarify.
I hope this has helped you. Thank you.
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