Breast Tumors: Navigating Diagnosis Discrepancies

Breast tumor

Hello, doctor; I had an X-ray taken at a clinic two years ago, and the diagnosis indicated a mass, but the physician said it was benign and that I only needed to have regular check-ups.
However, six months later, I had an ultrasound at Taichung Veterans General Hospital, and the results showed no masses.
I presented the previous examination results to the doctor, but he confidently stated that the report indicated no masses on either side, suggesting that what I felt might just be bone.
However, I can feel a firm mass in one of my breasts that measures approximately 1.5 to 2 cm in length.
Sometimes it feels larger, sometimes smaller, which makes me feel uneasy! Why is there such a significant discrepancy between the results from the two facilities? Should I seek a third opinion and have another examination? I would appreciate your detailed response! Thank you!

TIN, 20~29 year old female. Ask Date: 2001/04/21

Dr. Lin Zhemin reply Surgery

There are two different answers, and of course, we should find a third opinion to confirm which is better.
Additionally, breast examinations should be performed one week after menstruation for the most accurate results, as they will not be affected by the menstrual cycle.

Reply Date: 2001/04/21

More Info

Navigating the complexities of breast tumor diagnosis can be quite challenging, especially when faced with discrepancies in imaging results from different medical facilities. Your experience highlights a common concern among patients regarding the reliability of diagnostic tests and the interpretation of findings by different healthcare providers.

Firstly, it is essential to understand that breast imaging techniques, such as mammography (X-ray) and ultrasound, have their strengths and limitations. Mammograms are excellent for detecting calcifications and certain types of masses, while ultrasounds are particularly useful for characterizing solid versus cystic masses and assessing the structure of breast tissue. However, both modalities can yield varying results based on factors such as the skill of the technician, the quality of the equipment, and the specific characteristics of the breast tissue being examined.

In your case, the initial mammogram indicated the presence of a mass that was deemed benign, while the subsequent ultrasound suggested there were no hard lumps. This discrepancy could arise from several factors:
1. Interpretation Variability: Different radiologists may interpret images differently based on their experience and the context provided. The initial finding of a mass may have been based on specific characteristics that the second radiologist did not observe.

2. Changes Over Time: Breast tissue can change over time due to hormonal fluctuations, age, and other factors. A mass that was present two years ago may have changed in size or even resolved, which could explain the difference in findings.

3. Technical Differences: The quality of the imaging equipment and the technique used can also affect results. For instance, if the ultrasound was performed with a different machine or by a different technician, the results might vary.

4. Physical Examination: Your own physical examination findings are crucial. If you can palpate a lump that is not visible on imaging, it warrants further investigation. The lump's variability in size could suggest a benign condition such as a cyst or a fibroadenoma, but it could also indicate something more concerning.

Given these factors, it is reasonable to seek a third opinion, especially since you are experiencing palpable changes in your breast tissue. Here are some steps you might consider:
- Consult a Breast Specialist: A breast surgeon or an oncologist specializing in breast health can provide a comprehensive evaluation. They may recommend additional imaging, such as a breast MRI, which can offer more detailed information about the breast tissue.

- Biopsy: If the lump persists and is concerning, a biopsy may be warranted. This procedure can provide definitive information about the nature of the mass, whether benign or malignant.

- Regular Monitoring: If the lump is determined to be benign, regular follow-up with imaging and physical exams is essential to monitor any changes over time.

- Keep Records: Maintain a record of all imaging studies and reports. This documentation can be invaluable when consulting with new healthcare providers.

In conclusion, discrepancies in breast imaging results are not uncommon and can arise from various factors. Given your concerns and the palpable lump, seeking a third opinion is a prudent step. Early detection and accurate diagnosis are crucial in managing breast health, and you deserve clarity and reassurance regarding your condition. Remember to advocate for yourself and communicate openly with your healthcare providers about your concerns and symptoms.

Similar Q&A

Understanding Breast Lump Diagnosis: Benign vs. Malignant Confusion

Hello Dr. Li, Recently, my mother (56 years old) discovered a 1.2 cm lump in her right breast. After a biopsy, the doctor indicated that it is malignant and recommended a whole-body bone scan and CT scan to determine the surgical approach. However, the diagnosis on the applicati...

Dr. Li Zhonghuai reply Surgery
Hello! Currently, core needle biopsy is the primary method for sampling, while fine needle aspiration is not a diagnostic criterion. However, even with core needle biopsies, malignant tumors may sometimes sample less aggressive areas, so breast cancer biopsies may reveal ductal c...

Understanding Breast Cancer Surgery and Post-Operative Treatment Options

Hello Doctor, My mother has been undergoing regular mammograms every six months and was diagnosed with breast cancer last week. The tumor is located at the 9 o'clock position in the right breast, measuring 1.2 cm, and is a single tumor (the doctor mentioned that lymph node...

Dr. Lai Yicheng reply Oncology
Dear Madam, Thank you for your letter. Here are my responses: 1. If the malignant tumor is small, partial resection followed by adjuvant radiation therapy can be considered. However, if your mother has multiple benign fibromas in both breasts as you described, total mastectomy ...

Assessing the Risk of Malignant Tumors: A Case Study

Hello Doctor: My girlfriend (28 years old) previously had a breast tumor diagnosed as benign, but it has rapidly increased in size to 2.7 cm over the past three months. She is unwilling to undergo a biopsy, and although she visited a secondary clinic, she is reluctant to discuss ...

Dr. Fan Sheng reply Oncology
ICE: Both mammography and ultrasound can provide a high degree of accuracy in preliminary assessments, but a definitive diagnosis still relies on a biopsy. If a biopsy is not desired, fine needle aspiration cytology can be performed as an alternative. The most important thing is ...

Understanding Breast Cancer Tumor Size Discrepancies and Treatment Options

Hello Doctor: I was diagnosed with breast cancer a month ago during a breast ultrasound at a clinic, where the doctor found "irregular breast calcifications." The ultrasound estimated the tumor size to be 1.3 cm, while the mammogram at the medical center estimated it to...

Dr. Yuan Tianmin reply Breast and Thyroid
The first point regarding the size of the breast cancer tumor is that I am unclear whether a breast ultrasound was performed before surgery to confirm the size, given that you underwent hormonal therapy for one month prior to the operation. If another ultrasound was not conducted...