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Breast MRI showed mass. AMAS cancer blood test showed negative. How to diagnose breast cancer?

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Cosmetic & Plastic Surgeon
Practicing since : 2000
Answered : 249 Questions
I was recently diagnosed with breast cancer . My initial diagnosis was before biopsy (while ultrasound was being done) but then confirmed when pathology came back. Since then, I had a breast MRI which shows the mass as having benign characteristics. Now, I was given an AMAS cancer blood test and told I'm absolutely negative for cancer in my body. In fact, I'm told I'm the picture of health. I feel like I need a 3rd opinion to get an accurate diagnosis. Is there a way to get an unbiased opinion? All institutions want the initial diagnosis. I'd like an independent view.
Posted Fri, 12 Apr 2013 in Breast Cancer
Answered by Dr. Souvik Adhikari 2 hours later

Pathology is the single most important investigation for diagnosing breast cancer and can be considered as the "gold standard" against which all other tests can be compared especially radiological ones. In your case, you seem to have a positive pathological diagnosis of breast cancer, which should be taken very seriously.
I am not too confident about MRI depicting benign characteristics of a tumor as a malignant mass in its early stage can mimic a benign one. Also, the AMAS blood test which screens for anti-malignin antibody cannot be considered as an extremely accurate test with 100% sensitivity and specificity. Therefore, based on the pathological report I would label you as having breast cancer.
If you have doubts then the best thing would be a repeat core needle biopsy to note the pathological characteristics of the tumor. This is an extremely good test. An even better one would be an excision biopsy of the mass, which would remove the mass in its entirety and outline the pathology best.
Therefore, the pathological diagnosis stands true in your case and I would not give too much importance to a negative diagnosis by the MRI and AMAS tests.
Please let me know if you have further queries.
Wish you all the very best!

Dr. Adhikari
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