How Hard Do You Push on Medical Diagnostics?

Updated on February 15, 2018
J.B. asks from Boston, MA
14 answers

Hi - so I have a situation that I'm guessing is pretty common and wanted to see how other people go through the decision process. When it comes to my own health, I tend to ignore symptoms/not follow my gut/not advocate very hard for myself when it comes to something that I don't think is life-threatening. A lot of times, nagging things clear up on their own. Other times, I've learned that, for example, my 5-10 years of feeling that there was really something wrong with me that explained a hodgepodge of annoying symptoms was, in fact, a real disease (Celiac in my case) and had I just pushed for a blood test and spoke up for myself, I could have felt better years earlier.

So with that...I'm going through a process of getting reassurance that a breast lump is really just nothing. Chances are, it's fine - and I'm not a high risk for breast cancer anyway. Chances are, it's just fibrous tissue that can be felt but that a mammogram and u/s didn't see. But with so many friends dealing with cancer (primarily breast but one with colon), I pushed my doc for a more definitive answer and had a consult with a breast specialist today. She, too, thinks it just feels like normal, healthy, lumpy tissue but tentatively offered that she can ask for insurance to cover an MRI, which is scheduled for later this month. So I've had three doc appointments, two imaging tests and another one coming up, all to probably tell me that I'm fine. I had a lump years ago that was a clogged milk duct seen on u/s - that's the kind of certainly I want. I want someone to see it and know that it's just...whatever..and not a tumor.

Is that crazy? Am I paranoid and overly cautious? Is this the kind of thing that you would take your doc's "we have no reason to believe that this is cancer" feedback to heart and be able to let go of? Or do you also have to know for sure, no matter how many procedures, how many appointments, and how it costs to get that 100% answer?

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R.B.

answers from San Francisco on

Years ago I had a breast lump training somewhere (maybe at a doctor's?), where they gave us a fake breast with cancer-like lumps to feel so that we would know what cancer lumps feel like. There were a few different sizes, I recall. What I remember is that they were very hard, harder than I expected, and much different than what fibrous tissue feels like. When I was young I was cancer-phobic and needlessly had a fibrous lump removed, and it felt quite different from what those fake cancer lumps felt like. So...I don't know if that helps at all, but there's my experience.

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D.B.

answers from Boston on

I used to let things slide because I either assumed I was totally healthy, or I'd get to it "when there's time," or I assume the (usually male) doctors were smarter than I was.

I had a friend in a similar situation to Lori H's sister-in-law - breast lump and the doctor said "recheck in 6 months" and "If this were in my wife or sister, I'd tell them the same thing." Unfortunately, in 6 months, the cancer had spread to the breast bone and beyond.

My husband had a bizarre condition 2 years ago - it looked like heart failure and AFib, bu that didn't make total sense. He spent 4 days in Cardiac ICU, and after the 8th time they couldn't produce an up-to-date medication list, took him out of one hospital and put him in a cardiologist's office at a major Boston hospital. They were also struggling to figure out what was going on, but I had a big notebook I had started in the ICU and in the appointments leading up to that, including an off-the-wall suggestion by the ER attending. Because heart failure didn't make sense in someone who didn't have some of the classic symptoms, they looked at this other suggestions - an endocrine tumor. So, he went to endocrinology and, after lab work and scans and MRI and PET they found the tumor (not the one the ER doctor suggested but a very close "cousin" of it). So , after surgery, he was fine. My point is, if I hadn't pushed, he'd be taking massive heart meds that he didn't need, when in fact it was the endocrine tumor making excess stress hormones and pounding his heart with them.

You know you are the only source of stability and wisdom for your kids, so I would suggest that you follow the flight attendant directive to "put the oxygen mask on yourself first before attending to the needs of others." We women don't take care of ourselves as much as we should.

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M.D.

answers from Pittsburgh on

I would push for a definitive answer in a situation like yours, “probably “ wouldn’t be good enough for me because early diagnosis makes a big difference in the outcome. And I’m surprised your doc hasn’t suggested a biopsy as an option. That is usually the surest way to answer this question.

7 moms found this helpful
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L.H.

answers from Abilene on

J.B.,

No, you're NOT paranoid or overly cautious. Breast lumps of any kind do NOT need to be blown off.

My sister in law found a lump and the doctor told her it was nothing. He said they'd monitor it for 6 months. It was causing pain and his response was "it's not cancer because breast cancer isn't painful". I asked her to get a second opinion because of past experience with a dear friend of mine. The pain became so intense she decided to go in before the 6 months recheck. He decided to go head and do a biopsy and it was cancer. My sister in law is fine. She's in remission and had surgery as well as chemo and radiation. I am not saying this to scare you. What I want you to hear is that medicine is a practice. As such, doctors make mistakes. Patients present differently. You keep pressing until you get a confirmed (backed by scans or a biopsy) diagnosis. If everything comes back normal, great, you have peace. If it doesn't, you're a strong lady and you will get through whatever it is. The main thing, you won't have given it a waiting period to continue to grow and/or spread.

Stay on them! If your insurance won't pay for the MRI, ask for a biopsy. Advocate for yourself. If this was your sister, what would you say to her?

7 moms found this helpful

V.S.

answers from Reading on

My son is a type 1 diabetic. He got diagnosed two years ago because I knew the symptoms and called the doctor and told her my suspicions. Luckily, she listened and diagnosed him. But a lot of doctors don't and send children home with some "undiagnosed virus," when in fact they are type one diabetics. I hear of new deaths of children this has happened to every week. I put off taking him in for several months because relatives have treated me like a hypochondriac for being very sensitive to changes in my body. But in fact, I'm usually right about these things. My son was very sick by the time I took him in. I will never let anyone make me second guess myself again.
Trust your gut and get the answers you need.

7 moms found this helpful

S.T.

answers from Washington DC on

i am notoriously bad for letting things slide. i'm also hugely leery of bandwagon medical practices, and have frustrated more than a few doctors over the years by my steadfast refusal to take statins for my high cholesterol after a stint of lipitor with bad side effects.

i'm so, so glad that you are taking THIS seriously, though. chances are very high that this yes, just normal lumpy healthy breast tissue, but we've whipped breast cancer into a corner and mostly by early detection. wait and see makes sense for a lot of things, but not breast cancer.

i'm not sure 100% sure is ever an option, but in a case like this i think you're being smart and pro-active.
khairete
S.

6 moms found this helpful
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N.K.

answers from Miami on

PLEASE pay attention to the lump, and push for further testing -- better safe than sorry. My mom's GP said her breast's lump on the nipple was nothing but fibrous tissue or a benign mole perhaps. She didn't feel comfortable with that and went to her OB/GYN and kept insisting that it felt hard to the touch and something was not right. Eventually, her OB/GYN relented and scheduled an MRI for her. Suddenly, they finally listened to her, did a biopsy, and sure enough, she had stage 3 breast cancer. Had she just listened to those TWO doctors and ignored the breast lump, she would have died long ago!

6 moms found this helpful
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J.C.

answers from Anchorage on

I like to know for sure, but I have exceptional insurance that covers pretty much anything a doctor says is necessary with at most a very small co-pay, so I can afford to push. Most people I know would like to push for definite answers but simply can not afford the cost. Maybe one day we will have universal health care and doctors will no longer have to take into consideration the high cost of imaging when deciding how to recommend a patient proceed.

4 moms found this helpful
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P.K.

answers from New York on

Persue an answer. Had a friend doc said no it's nothing. We will recheck in six months. She wasn't comfortable with that. Guess what. Early breast cancer. Is well five years later because she didn't listen to doc.

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D..

answers from Miami on

Not crazy. The doctor wouldn't order the MRI if she were really certain.

Not to say that it could be cancer, but an ounce of prevention is worth a pound of cure. And look at it this way - the cost of an MRI to the insurance company is cheap compared to what they pay if you end up with advanced cancer because a diagnostic test wasn't done.

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T.D.

answers from New York on

in your case i would of pushed as well.
i tend to just let everything slide, and several years back when i had a intercranial hematoma i blew it off for weeks! didn't press much when the neuro diagnosed it, but now i think i should of. with reoccurring migraines (some that last days) i think i should of pressed for a more than what he told me.. "it looks like its a shrinking bleeder. so get some rest and make a followup appointment if the headaches don't go away"

every time i get a headache now i can't help but think what if he was wrong and my headaches are from something more? only problem with finding out for sure this time is the money, i cannot afford to see a dr and the insurance i could afford does not cover much of anything

3 moms found this helpful
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N.Z.

answers from Los Angeles on

I don't think you're paranoid or overly cautious. We need to take our health seriously. While a doctor can give you an opinion based on his/her expertise and experience, without diagnostic testing, nothing can be ruled out. It's always better to be safe than sorry, especially if it might be cancerous.

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S.W.

answers from Amarillo on

It is your body and you know it. Continue until you get an answer one way or the other.

I had a lump and pursued it. The results came back that it was cancer and we took care of it right away. I had a lumpectomy and did radiation for 8 weeks. Cancer free for 20 years.

It is best to be proactive than reactive with your medical health. Something small that can be resolved early is much better than waiting for a longer period of time and it being a huge surgery.

Keep us posted. Sending you a huge cyber hug.

the other S.

2 moms found this helpful
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J.C.

answers from Philadelphia on

My friend went through something similar. The mri was denied by insurance she paid out of pocket for it. Her lump was benign.

You have to do what feels right for you. Personally though, I would trust that the doc knew bad lumps from okay lumps. I have 3 lumps in one breast and one in the other but they could see on ultrasound they were fluid filled cyst.

1 mom found this helpful
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