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wieyedoc, Board Certified MD
Category: Oncology
Satisfied Customers: 13036
Experience:  Over two decades of clinical practice. Completed a medical internship in New York City
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I was diagnosed after a routine mammogram with early primary

Customer Question

Hello. I was diagnosed after a routine mammogram with early primary breast cancer in 2014. I had a tumour of 13 mm behind my left nipple. I had a lumpectomy, followed by 3 weeks of radiotherapy. The margins were clear, there was no node involvement, and I did not have chemo. I take 20mg Tamoxifen daily. I have had clear mammograms annually since then. Most recent was 17 April and was told it was “completely satisfactory “. But I have since been recalled by the Breast clinic and invited in for an ultrasound. The breast care nurse didn’t know me nor my case and could not say why they want me to come back. My question is what does an ultrasound say that a mammogram doesn’t? I don’t feel at all lumpy anywhere in my (mutilated) left breast or indeed my right one. Can’t feel any lumps anywhere.
Submitted: 9 months ago.
Category: Oncology
Customer: replied 9 months ago.
Posted by JustAnswer at customer's request) Hello. I would like to request the following Expert Service(s) from you: Live Phone Call.
Customer: replied 9 months ago.
Let me know if you need more information, or send me the service offer(s) so we can proceed.
Expert:  wieyedoc replied 9 months ago.

Hi. My name is***** have over two decades of experience, and I'm online and available to help you today.

We can also chat by hone and skype.

Expert:  wieyedoc replied 9 months ago.

Have you asked the physician who told you that your recent mammogram was OK why the breast nurse would invite you back so soon for an ultrasound?

Customer: replied 9 months ago.
No, I haven’t had a chance to ask the consultant, she’s kind of hard to contact. But, I will email her office tomorrow. If she’s correct about the mammogram being fine, then please can you tell me what an ultrasound is going to add? Many thanks.
Customer: replied 9 months ago.
Fine, please don’t bother calling but I’d still be interested to know what an ultrasound may show that a mammogram can not.
Expert:  wieyedoc replied 9 months ago.

First and foremost I would not get worried about being called in for an ultrasound. They probably just want to look at an area in more detail.

An ultrasound is very good at telling a fluid filled area from an area that is more solid in nature.

It is not uncommon to want to examine some areas in the breast with both techniques.

It is not a sign that they are worried about a cancerous tumor etc.

Does this make sense to you?

You are likely experiencing a PVD or posterior vitreous detachment, a common event that happens in many people.

You have a thick gel material in the middle of your eyes called the vitreous. Over time as it liquefies, this gel material collapses on itself, forms little clumps that you can see as dots, lines or bugs. As these clumps form the vitreous pulls away from the wall of the eye. In the process it can stimulate the retina -- causing the flashes that you may see.

It is recommended that you see your ophthalmologist to look at the retina to make sure there are no problems such as a retinal hole or tear. In most cases, there are no problems, but this exam is precautionary and allows for preventative treatment of any lesions that are found.

If you notice a sudden increase in floaters, flashes of light (like a lightning storm), a shadow/veil in the periphery of your vision, or a decrease in your vision that doesn't improve in a few minutes this can be worrisome for a retinal detachment. You would need to contact your ophthalmologist promptly in that case.

What can you do about the floaters? Well, floaters don't go away, and they don't really get worse. Over time they tend to "sink" out of your central vision and you brain "filters" them out so you don't notice them so much anymore. They almost never cause significant visual problems except, of course, if they cause a secondary retinal detachment as discussed above. The only way to decrease or remove the floaters is with a major surgery called a vitrectomy. As a retinal specialist for almost 2 decades I only do this procedure to remove floaters in extreme cases.

In January 2013 a new drug, called Ocriplasmin, was approved by the FDA to dissolve vitreous strands in a particular eye condition called vitreomacular traction. Perhaps someday this drug could be used to also remove floaters…. Only time will tell.

Does this make sense to you?

I hope this information was helpful for you. But I do work for tips so I want to make sure you are happy with me before rating me. If you have another question on this or a related issue feel free to fire away. You may also receive an email survey after our chat, if you can please give me the top rating in all areas. It has been a pleasure to assist you today.

Thanks in advance,

Dr. Rick MD FACS

Customer: replied 9 months ago.
Something has gone amiss with the reply here, as I have been sent quite a lot of information about PVD which I’ve not heard of before, and don’t think I’ve got. A bad breast is quite enough thanks........
Expert:  wieyedoc replied 9 months ago.

Ya. I just noticed that :(

You can ignore everything about the PVD......not sure how that got attached to your question.

Expert:  wieyedoc replied 9 months ago.

But, in any event, there is no need to think that something horrible is going on just because they have called you back for an ultrasound.

Although it would have been nice for the nurse to tell you that up front....

Does this make sense?

It's safe for you to press the positive feedback button now if you so desire. And, never fear, even after you press that button I'll still be right here to continue helping you, but, as I do work for tips, I want to make sure you are happy before rating me.

Dr. Rick MD FACS

I wish you the very best.