Can I Request a Biopsy for My Fibroadenoma? Key Considerations

Can I have a biopsy?

Hello, doctor.
I have been monitoring a fibroma for two to three years.
Recently, one of the fibromas has slightly increased in size to about 1.5 centimeters.
The doctor mentioned that its shape is not as round and smooth as the others; it is more irregular.
Additionally, I developed a pustule on my nipple two months ago, and now there is increased discharge, occasional sharp pain, and the nipple is retracted.
I am currently considering a biopsy and would like to ask: 1.
Can I request a biopsy on my own, or does a doctor need to determine if there is a suspicion of malignancy before proceeding? 2.
Is a core needle biopsy covered by health insurance?

Liu Xiaojie, 20~29 year old female. Ask Date: 2022/11/02

Dr. Li Zhonghuai reply Surgery

Hello! You can receive a coarse needle biopsy directly in the outpatient clinic, covered by health insurance.
Stay safe! Changhua Hospital cares about you!

Reply Date: 2022/11/02

More Info

When it comes to managing a fibroadenoma, particularly one that has shown changes in size or characteristics, it is essential to approach the situation with careful consideration and professional guidance. Here are the key points regarding your questions about requesting a biopsy for your fibroadenoma.

1. Can I Request a Biopsy for My Fibroadenoma?
Yes, you can request a biopsy for your fibroadenoma, especially given the changes you have described. While it is not uncommon for fibroadenomas to be monitored over time, any significant changes in size, shape, or associated symptoms (such as pain, discharge, or skin changes) warrant further investigation. In your case, the irregular shape and the recent development of a discharge and pain are important factors that should be discussed with your healthcare provider.
A biopsy is typically performed to rule out malignancy, especially when there are concerning features. The decision to proceed with a biopsy may depend on the clinical judgment of your physician, who will consider your history, physical examination findings, and imaging results. If your doctor believes that the characteristics of the fibroadenoma are atypical or if there is a significant change, they may recommend a biopsy even if malignancy is not strongly suspected.

2. Is a Core Needle Biopsy Covered by Insurance?
In many cases, a core needle biopsy is covered by health insurance, but this can vary based on your specific plan and the medical necessity of the procedure. It is advisable to check with your insurance provider to understand your coverage details. Generally, if your physician determines that a biopsy is necessary based on your symptoms and the characteristics of the fibroadenoma, it is likely to be considered medically necessary, which would typically lead to insurance coverage.

3. Additional Considerations
- Symptoms and Changes: The symptoms you are experiencing, such as increased discharge, pain, and the presence of a pustule, should be taken seriously. These changes could indicate an infection or other underlying issues that may require prompt attention.

- Follow-Up: If you decide to pursue a biopsy, ensure that you have a follow-up plan in place. Discuss with your doctor what the next steps will be depending on the biopsy results. This may include further imaging, monitoring, or treatment options if the biopsy indicates any abnormalities.

- Consultation with a Specialist: If you have not already done so, consider consulting a breast specialist or a surgeon who specializes in breast conditions. They can provide a more comprehensive evaluation and guide you through the decision-making process regarding the biopsy and any subsequent treatment.

In summary, while you can request a biopsy for your fibroadenoma, the final decision will involve a discussion with your healthcare provider, who will assess the necessity based on your specific situation. It is crucial to communicate openly about your symptoms and concerns, as this will help ensure that you receive the appropriate care and follow-up.

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