Hi I Am Looking To Talk With A Gyn Oncologist

Posted on Wed, 3 Apr 2019

Question: Hi I am looking to talk with a gyn oncologist of the breast or a medical oncologist I always have normal mammograms for the last 25 years I went for my routine mammogram on 2/18/19 and the tech told me everything was ok. I was called back on 2/20/19 for additional views of my left breast. I had some other views hurt like hell. The radiologist ordered a sonogram of my left breast, after the sonogram she came in and did it herself again was looking at a very very small complicated cyst she said has more fluid but has a little junk in it. Then she said there where a few puncate associated microcalcifications.She said she see nothing alarming or irregular , just to follow up in 6 month for diagnostic mammogram. Am I to worry about this. I have so stressed about this as I read and read puncate microcacifications are bengin can you tell me your thought. My gyn called me and told me nothing concering follow up in 6 months.What do you think.

Follow up: Dr. Bhagyesh V. Patel (5 minutes later)

also the radiologisy said the complicated cyst was 4mm flattened and parrell oval with round grouped puncate microcalcifications please help

Answered by Dr. Bhagyesh V. Patel (3 hours later)

Brief Answer:
punctate microcalcification is common with cystic cases of the breast.

Detailed Answer:
Hello and welcome to 'Ask A Doctor' service.
I have read your query and here is my advise.

* As per my surgical (Oncology) experience, the microcalcification of punctate size is a benign finding, which, many times observed in cases of cysts.

Also, the complicated cyst of 4mm size is not clinically relevant.

* Unless the breast architecture and other internal structural integrity are absolutely fine, these lesions are of no danger/worry, but regularly follow up at the particular interval is suggested to avoid any untoward outcome.

Wish you the best health ahead.
Let me know if I Can assist you further.

Regards
Dr. Bhagyesh

Above answer was peer-reviewed by : Dr. Arnab Banerjee

Follow up: Dr. Bhagyesh V. Patel (50 minutes later)

she added fibro cystic changes also never was mention in the report worrisome or suspicious but put probrably bengin I guess radiology reading of 3 is this because of the cyst or puncate microcalcifications/

Follow up: Dr. Bhagyesh V. Patel (2 minutes later)

THE RADIOLOGIST TOLD ME EVERYTHING IS OK I DONT KNOW IF THEY SHOULD BE BIOPSYED OR WAIT THE 6 MONTHS. ALL MY PREVIOUS MAMMOGRAMS HAVE BEEN NORMAL .

Answered by Dr. Bhagyesh V. Patel (6 hours later)

Brief Answer:
follow up .

Detailed Answer:
Hello
Welcome for the follow up.

* Fibro cystic changes are also part of benign condition in ileu of current cyst size and
non specific micro calcification.

* Biopsy is not recommended on clinical grounds at this junction as per my surgical
experience of 20 years.

Regards.

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Bhagyesh V. Patel (8 hours later)

ok Dr you have been very kind this is the report I am sorry for repeating my self but have the radiology report in my hand as it goes Full field digital mammography with computer assisted section ultra sound and spot magnification. There are scattered fibroglandular density, there is a 4 mm circumscribed oval nodule with associated punctuate microcalcifications at let 11-12.00. Sonography targeting this area demonstrates a probable complicated cyst measure 0.4cm, circumscribed , oval parallel, flattened at 11.oo-oo 5 cm from the nipple, non palpable with absent vascularity . BIRADS 3 pROBRABLY bENIGN FINDINGS. WHY DO THEY WRITE PROBABLY BENIGN FINDINGS FOLLOW UP IN 6 MONTHS. I think this has me worried. the probably benign. also said addition; sub centimeter simple cyst left upper inner quadrant 2 mm. let me know your thought again, I really appreciate you taking the time to answer me.

Follow up: Dr. Bhagyesh V. Patel (2 minutes later)

BIRADS 3 ALSO IS THIS NORMAL WITH A COMPLICATED CYST THAT MICROCALCIFICATIONS ARE ASSOCIATED WITH THIS. CAN THIS BE A FIBROADNOMA?

Answered by Dr. Bhagyesh V. Patel (1 hour later)

Brief Answer:
follow up .BIARD 3 is normal with complicated cyst.

Detailed Answer:
Hello and welcome for the follow up.
Thanks for the relevant details again.

* Any radiology or other reports are only supportive documents, where you will find
most of the time probably word in reporting which has to be co related with clinical
findings for the narration and understanding clinical significance of the same.

* I repeat to opine in this issue that this is absolutely benign condition, nothing to worry
at all at present.
The follow up at 6 months period is suggested to evaluate for the possible changes in
the size of the lesion.

Would like to clarify further doubts anytime.
Wish you good day.

Above answer was peer-reviewed by : Dr. Kampana

Follow up: Dr. Bhagyesh V. Patel (27 minutes later)

thank you is the puncate microcalcification something to worry about or is this a normal part of the cyst where she said complicated cyst associated with puncate microcalfications I am just trying to understand this . Thank you for your understanding.

Answered by Dr. Bhagyesh V. Patel (35 minutes later)

Brief Answer:
follow up .

Detailed Answer:
Hi

* Usually the cyst is not associated with micro calcification, it is the presence of micro
calcification which added the word complicated cyst to the reporting.

* Many of such changes do remain as it is for long period, many times regress over
period of time with hormone changes of the body.

So the moral of the story is not to keep panic and let the nature do its job, just keep regular evaluation at the narrated intervals without keeping stress over mind as stress will surely make changes over the lesions via biochemical alterations at microscopic level through hormone mediation, which you would not wish.

Thank you.

Above answer was peer-reviewed by : Dr. Yogesh D

Follow up: Dr. Bhagyesh V. Patel (57 minutes later)

Thank you so much for helping me understand that this is a begnin process. I feel better now. I will try very hard to not let this stress me out lol You have been wonderful and very knowledgeable thank you again. If I have any other questions may I ask you? Thank again!

Follow up: Dr. Bhagyesh V. Patel (3 hours later)

one more question please does puncate micro calcification turn to cancer down the road and what makes them form do they ever go away.

Answered by Dr. Bhagyesh V. Patel (6 minutes later)

Brief Answer:
follow up .

Detailed Answer:
Hi
Welcome.

* It is the changes in the tumor genes at genetic level which provokes the changes of
cancer development as well as findings what are seen on the clinical, ultrasound as
well as biopsy findings.

* So the punctate micro calcification if it is there and remains for always do not mean
that it will turn out to be cancer only.

* As far as its clearance from the body is concerned, there are no medicines or
procedures what a consultant can adopt for any patient, as it is the inherent body
mechanism known as apoptosis of the abnormal structure through which it gets
cleared by the body.

And no thanks for anything, as it is part of our moral responsibility to satisfy your every minute doubts till best possible expertise of our knowledge.

Wish you best health always.
Regards.

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Bhagyesh V. Patel (1 hour later)

So I will take all this information and keep it in my mind so I will take this as you said a bengin process and not to worry about this my next follow up is in 8/19 It was just scary because I always had normal mammograms. Thank you Dr. I hope they know how good and patient and knowledgeable you are. Have a great night ! If I ever have any other question how would I contact you , would it still be on here?

Answered by Dr. Bhagyesh V. Patel (7 hours later)

Brief Answer:
follow up .

Detailed Answer:
Hi
Sure.

You can have access over this session till you close the discussion and validity period of your current query.

Later on you have an option of direct question to me in case if you desire.
Thanks.

Note: Revert back with your gynae reports to get a clear medical analysis by our expert Gynecologic Oncologist. Click here.

Above answer was peer-reviewed by : Dr. Vaishalee Punj