Breast biopsy and what are the subsequent procedures

[Lim Yuan Hai]

Hi, Good afternoon.

Ultrasound Breast
My wife (she is 55 years old) right breast has 2 solid nodules (Solid mass), no Cystic mass, in her right breast.
 - at 9-10hr/3cmFN=0.35x0.24cm, no vascular flow
 - at 8-9hr/4cmFN=0.54x0.4cm, slightly fine shaggy surface, no vascular flow  

5 mm nodule has 10 % chance of cancer (nodule is rough)
3 mm nodule has just 1% chance of cancer (smooth nodule) according to ultrasound doctor.

They suggested to take biopsy on 5 mm nodule.

Mammography result show normal.

Kindly feel free to ask further info if needed.

Can anyone advise the best doctor and his/her hospital for biopsy and subsequent procedure if require? If quality and service of the Thai government hospital (specialize breast clinic) are almost equally good, then my wife prefer government one due to relatively less cost.

What are the all possible procedure and their estimated cost?

Thank you so much and have a nice day!

Edited March 17, 2020 by Lim Yuan Hai

[Sheryl]

Is your wife Thai? As if so she can have this done through the government system at no cost, but has to start at the hospital where she is registered under government scheme.

 

Where in Thailand are you? If in Bangkok, two good government hospital options:

 

Queen Sirikit Center for Breast cancer at Chulalongkorn hospital

Queen Sirikit Centre for Breast Cancer Foundation

02-214-6044

02-214-6047

[email protected]

 

Chulabhorn Hospital

https://www.cccthai.org/

 

The procedure will be taking a tissue sample from the nodule. It might be possible to do with just a needle (fine needle aspiration) or they might need to make a tiny incision in which case an outpatient surgery.   Cost in a government hospital - maybe 20,000- 25,000 baht including path exam but that is just a guess. 5 times that at a private hospital.

 

[Lim Yuan Hai]

2 hours ago, Sheryl said:

Is your wife Thai? As if so she can have this done through the government system at no cost, but has to start at the hospital where she is registered under government scheme.

 

Where in Thailand are you? If in Bangkok, two good government hospital options:

 

Queen Sirikit Center for Breast cancer at Chulalongkorn hospital

Queen Sirikit Centre for Breast Cancer Foundation

02-214-6044

02-214-6047

[email protected]

 

Chulabhorn Hospital

https://www.cccthai.org/

 

The procedure will be taking a tissue sample from the nodule. It might be possible to do with just a needle (fine needle aspiration) or they might need to make a tiny incision in which case an outpatient surgery.   Cost in a government hospital - maybe 20,000- 25,000 baht including path exam but that is just a guess. 5 times that at a private hospital.

 

My wife is not Thai. Yes, we live in Bangkok.

It is hard to choose between these 2 good hospitals as a lay person. Can you kindly suggest? We will go there a day after tomorrow (19 Mar 2020).

Is fine needle aspiration mean biopsy? What is difference between fine needle aspiration and tiny incision? What is path exam?

Many thanks, Sheryl.

[lopburi3]

Fine needle is as sounds - a thin needle that must get into the mass to retrieve cells for check.  Simple and painless as a vaccine shot if they can locate the mass but may not get the required cells (at least for mine on thyroid that was the case) and would not expect it to cost that much at a government hospital as doctor procedures are normally very inexpensive if not requiring imported materials but Sheryl knows much more than I.  The path (pathology) is the actual cell check to determine what it is.  Other method would be small incision to open skin and obtain sample.

Edited March 17, 2020 by lopburi3

[Sheryl]

Chulabhorn is likely to be less crowded.

 

Difference between the 2 approaches is as Lopburi3 describes. Path exam is the examination of the specimen under a microscope.

[Lim Yuan Hai]

17 hours ago, lopburi3 said:

…..if they can locate the mass but may not get the required cells (at least for mine on thyroid that was the case) …..

Hi, good afternoon!
How did you manage to find out that sample was the required cells or not?

Thank you.

[Lim Yuan Hai]

Hi,

What are the chances of not getting the targeted sample for a fine needle aspiration and a tiny incision? If they missed the required sample, then it might be very dangerous for a patient.
I am very worry for my wife as a lay person.

How would one manage to find out whether we get the required/targeted sample or not?

Can anyone who has knowledge/experience kindly advise?

Thank you and have a wonderful day!

[lopburi3]

There is no added danger involved - just for Thyroid they need to get 4 types of cells to make cancer judgement and doctors experience is a major factor - in my case they only got two or three so later had operation to remove and it tested negative for cancer (but was not working so no loss).  I have no knowledge of breast procedures (being male and only speaking of what I have experienced).  They make the determination in lab.

[Sheryl]

2 hours ago, Lim Yuan Hai said:

Hi,

What are the chances of not getting the targeted sample for a fine needle aspiration and a tiny incision? If they missed the required sample, then it might be very dangerous for a patient.
I am very worry for my wife as a lay person.

How would one manage to find out whether we get the required/targeted sample or not?

Can anyone who has knowledge/experience kindly advise?

Thank you and have a wonderful day!

 

The doctor will determine if the mass is accessible by needle or not. They may also use ultrasound to guide it. If they make an incision then of course they can directly see what they are doing.

 

I understand it is anxiety provoking but you really need to leave this to the doctors.

 

There is nothing dangerous if they attempt a needle aspiration and the specimen is inadequate. Just some inconvenience.