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• Stella01

  

  • 5 posts
  August 29, 2013 7:09:55 PM WATime

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  Hi Glenys,
  Thanks for your help with my ultrasound inquiry last week.
  I saw my surgeon today as I have been having some milky? Discharge from my left breast (same side as the cysts). This used to happen to the right side as i was diagnosed with duct ectasia. I then had a duct excision on that right side. She was comfortable to leave it and not do the same surgery on the left side. She was also ok to leave the cysts as is.
  My question is this today. She did not do a proper breast exam, she only tired to elicit some discharge (which she couldn't). Was this an oversight or is it because the ultrasound would do the same job. Does an ultrasound replace the need for a physical exam? I usually rely on her for this as I am a bit lumpy, it's hard to tell what's what. The ultrasound is only a week old. As usual, I left the appointment without having said everything I should have said!
  Thanks so much for your time,
  Stella
• Glenys

  

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  • 162 posts
  August 30, 2013 4:46:51 PM WATime

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  Hi Stella
  
  Good to hear more surgery is not needed for you, and the cysts are okay. I'm sure it's reassuring to hear that from your breast surgeon - great news!.
  
  No, an ultrasound doesn't completely replace a clinical breast examination (CBE). Neither does an ultrasound replace other forms of imaging (where appropriate), as each form of investigation provides a different perspective, and each is used in combination with the others to provide the best overall assessment of the breast where indicated.
  
  The important question is how often are these tests required? This depends on why the investigations are being carried out. If investigating a benign condition, then only specific tests may be required. If there is a degree of concern or 'risk' of breast cancer or other serious condition for an individual, then more tests and greater frequency may be needed.
  
  We may feel the more often we have investigations carried out the better off we'll be - however too many repeated investigations are usually not necessary and may cause an increase in anxiety. Your doctor may have felt extra 'tests' were not required for you at this time - even doing a full CBE, depending on how long ago this was done.
  
  The recommended time-frame for these tests depends on your circumstances. If you are classified 'high risk' of breast cancer, a CBE is usually recommended 6 - 12 monthly - though this may vary depending on your age and the protocol of your breast team. If you are not in a 'high-risk' group, this is usually much less often - perhaps 1-2 yearly after 40yrs of age. As I'm sure you've been informed, duct ectasia does not increase your risk of breast cancer, though of course there may be other factors involved for you.
  
  My best guess is that the surgeon did not feel you would benefit from another breast examination at this time. Do you have more follow-ups with the surgeon planned? Your GP would also be able to carry out any regular CBEs as needed.
  
  If you're feeling like this was overlooked and should have been done at your review Stella, I would recommend chatting with your GP or contacting the surgeon.
  
  All the best Stella. Very happy to help with any other queries you may have.
  Hugs, Glenys xx

  The Click Breast Care Nurse