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Any chances of BRCA despite negative results in mammogram and physical examination?

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General & Family Physician
Practicing since : 2009
Answered : 681 Questions
have had pruritis on left breast about 4 oclock for several months. Went for physical and had mammo and bilat breast u/s for thickening of breast tissue bilat... All neg... No redness (unless itching!) , tenderness or dimpling, scaly tissue... Family hx of br ca amongst other ca, . Should I pursue this ?
Posted Wed, 29 Jan 2014 in Breast Cancer
Answered by Dr. Yogesh D 26 minutes later
Brief Answer: No, Detailed Answer: Hello, Thanks for writing in. I have gone through your description and understand that you have a family history of BRCA... If a mammogram and physical exam have ruled out any ca changes, it is highly unlikely that you would have anything. However, it is important to get a physical exam done every 6 months once and to continue self breast examination at least once a month. At this time that is all that is required, you don't need to aggressively pursue this issue. Wishing you all the best. Regards.
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Follow-up: Any chances of BRCA despite negative results in mammogram and physical examination? 10 minutes later
Dr, XXXXXXX I guess I have concerns of inflammatory brca- which can apparently not be identified by mammography or u/s? Also I forgot to mention that the left breast has increased in size.
Answered by Dr. Yogesh D 20 hours later
Brief Answer: A biopsy or FNAC would be ideal. Detailed Answer: Dear XXXX, Thanks for writing in with additional details. Yes, you are right in saying that inflammatory ca of breast is rarely detected by routine mammograms and ultrasound scans. However, a physical exam will be more revealing. In your initial query you have stated that you don't see any tenderness, dimpling or scaly tissue, hence my suggestion that it is unlikely to be ca breast. It is very difficult to come to any firm conclusion without the benefit of physical examination, a recent increase in the size of the breast needs to be taken into account and you need to go for an FNAC or a tru cut biopsy to rule out the possibility of ca breast. Absence of skin changes such as dimpling and nipple retraction are a good sign, so relax, get an appointment with a breast surgeon and ask for FNAC or biopsy to be performed so that you can be sure about what is going on. If the biopsy turns out to be fine, then you may consider paying a visit to a dermatologist to look for other causes of localised itching, such as infections, inflammation of the veins. A localised itching is not very specific for inflammatory ca. I hope this answers your question, if you, however have any doubts, please feel free to write back to me. Wishing you good health. Best regards.
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