Ongoing concerns? Get a second opinion | Dr. Ulissey

Published 1:21 pm Wednesday, July 15, 2015

Q. A friend of mine was recently diagnosed with breast cancer, but her mammogram three months ago was normal. Now I am worried. Do I need any additional testing? Should I get a second opinion?

A. First, let me extend my sympathy to your friend. I hope she is doing well, or as well as can be expected under the circumstances.

My response to your questions is two-fold. First, no test in medicine is perfect, so please don’t let this incident deter you from your yearly checkup.

Although mammograms can often pick up a breast cancer the size of a dot, they can, on rare occasions, fail to identify cancers the size of a walnut. This is not because mammograms are substandard tests; they are often excellent tests. Mammograms are the only imaging studies that have been shown, by randomized-controlled trials, to significantly lower mortality for women who get them on a yearly basis. Despite the news you relate above, I strongly urge you and every eligible woman to continue getting yearly mammograms.

Without reviewing your friend’s mammogram, I can’t say for sure why her cancer might have not been identified. Often this can relate to dense breast tissue, a subject covered in recent postings and worth learning more about. An estimated 40 percent of women in the U.S. have dense breasts.

Secondly, without reviewing your mammograms and analyzing your risk factors, I cannot form an opinion on your mammogram results or whether you would benefit from additional testing. Do you have dense breast tissue? Do you have elevated risk factors? Have your recent mammograms been done with 3D Tomosynthesis? These are questions your mammogram facility should be able to answer for you.

Also ask them if they did a Tyrer-Cuzick, BRCAPRO, or other risk assessment as part of your yearly checkup. And if you have ongoing concerns, then yes, a second opinion can provide amazing peace of mind.

For more information on the topics discussed above, see “The importance of mammograms” and “Issues with dense breast tissues,” both written by Dr. Michael J. Ulissey for the Auburn Reporter.

Michael J. Ulissey, M.D., is a partner at the Breast Diagnostic Centers of Auburn and Federal Way. You can reach him at Mike@breastdiagnostic.com.