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Adjacent simple cyst accidentally hit during biopsy
Hello
I had a small (7mm) enhancing lesion detected on MRI that was recommend be biopsied. I have extremely dense breasts and multiple macrocysts.
During ultrasound guided core biopsy it fired through the target and into a large adjacent simple cyst (about 5cm wide). Clearly shown on post-fire shots. The large simple cyst then became quite a lot smaller with the radiologist noting this. She took further samples of the target mass.
The radiologist mentioned that she would make clear to the pathology lab that the non target simple cyst was included when sending to pathology (I assume to mitigate risk of false negative). But didn’t mention anything else.
Is this something I need to be concerned about if the intended mass comes back as non-benign?
I’m already feeling pretty fragile waiting on results of small target mass - and am now very worried about the possibility that biopsy introduced something problematic into a much bigger area.
Many thanks in advice for any advice.
Kate
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I think hitting the cyst and including it in the biopsy sample is not necessarily a bad thing. It gives the pathologist a chance to look at that fluid and what it contains.
The pathologist should be able to see that part of the cell wall enclosing the cyst was included in the sample ensuring that it is a benign cyst.
It sounds like enough samples were taken of the targeted lesion that they can determine if it is, or not, benign.
The good news, is that because the cyst deflated that confirmed that it was not a mass.
They now have samples of the targeted lesion, probably the cyst wall, and some of the fluid in the cyst. If it all comes back benign, I would guess they would schedule a mammogram and ultrasound in 6 months to track the targeted area. Or an ultrasound in 3 months if there were any concern about faster growth. With dense breasts it would be reasonable to ask for an MRI, if not now then in 6 months.
I had what was listed as a 1.6 mm lesion with a possible papilloma. Core needle biopsy determined it was dcis with a papilloma. Final pathology after surgery reported a 7 mm dcis. No papilloma mentioned - I was told the papilloma was probably removed in entirety by the core needle biopsy. So the biopsy can change and affect what cells remain. The oncologist had told me in the beginning to not be surprised if the pathology changed from biopsy to final after surgery. He said that the core needle takes a small section and they wait until they see the entire lesion for the final determination of what it is, and how to treat it.
If its any help, below is what my core needle biopsy reported. The biopsy has important information, such as cell type, E-cadherin, smooth muscle myosin, and p63. The last three are significant indicators that it was a non invasive DCIS. The pathology looks closely at the cells that were collected - so they should report everything they see in your samples which would probably include some benign cells, and hopefully ALL benign cells.
DIAGNOSIS: Right breast, 9 o'clock, biopsy: Intermediate Grade Ductal Carcinoma In-Situ, Cribriform Type, appearing to involve a papilloma and with associated fibrosis and chronic inflammation; supported with E-cadherin, smooth muscle myosin and p63. Estrogen receptor: Positive (strong, 100%) Progesterone receptor: Positive (weak to strong, 90-95%)
My final pathology reported it included cribriform type, papilloma type formation (not a papilloma), and solid cell type formation. The solid cell is a bigger concern, and helped me decide to follow through with the recommended treatment.