Would a Dr say 'sorry' and give out macmillan nurse details of he wasn't REALLY sure?

[iamthedanger]

Sorry for the difficult topic.

One of my close friends was at the breast clinic yesterday. It all sounded slightly ominous tbh, her GP rang to chase the urgent referral etc. The lump was biopsied, results in a few days, but the consultant she saw said 'sorry mrs so and so...', he then sent her off with a counsellor who told her, amongst other things, to bring a notebook and write everything down when she comes back, explained there would be lots of people in the room.... Etc etc.

So, I thought without a definitive biopsy it would be unusual to go this route? At most you I would have assumed you might get a 'I suspect its cancer but we will know for sure on next week ..'. Are some lumps just so obviously cancer (to the experts) that they can be confident without a biopsy?

Well for what it’s worth they were able to tell me my breast lump was benign without a biopsy. After being recalled for second mammogram they did an ultrasound and told me they knew by the shape it was benign. I think they referred to it as a hammer cyst.

Possibly in your friends case they are fairly sure and the biopsy is to confirm it.

the consultant - was it an oncologist?

After copious amounts of testing, I was asked to attend a double appointment at the GP and told to take someone with me.

He told me that it was most likely I had cancer.

turned out I didn't. I thought what happened was really poor form and am still furious about it. However, if that's considered normal, then I do wonder if an oncologist who is pretty sure might also do this kind of thing.

Everything crossed for your friend.

My friend's mum was told by her GP that she had untreatable, terminal breast cancer and that she would be lucky to live for a month.
When she saw the oncologist the prognosis was nowhere near so bad, that was almost 2 years ago and she's still going strong now. I wouldn't take what the GP has said as gospel until your friend has seen a specialist.

The consultant would have been a breast surgeon, not an oncologist. The biopsy is what determines that it is a cancer. However, certain features when examining and imaging the breast can be very suggestive of cancer. If those were seen then the assumption would be that it likely was cancer. That may be what's happened with your friend.

The counselor was probably a specialist breast nurse. If your friend has any questions before she's seen again, she should give them a call - that's what they're there for.

Reading your OP again, I wonder if there's been some kind of policy change.

I looked at all this fairly extensively because I was very unhappy with how I was treated. (Long story short, didn't have a lump or anything, but ended up being fast tracked for cancer of the possible every-organ-you-can-name for no reason at all).

You say your friend was seen by a specialist. Are they now handling it this way because they don't want to say stuff on the phone? Or they think it saves time to say "be prepared for cancer and bring a person and notebook to the next appointment" etc etc.

FWIW the consultant I saw for the final test was not happy at how the GP handled things. One other thing I found out was that they don't like to give results over the phone, so I think one reason the GP acted as he did was so that when the call came saying "come in for your results" I was prepared in advance, rather than a receptionist saying "come in for your results and bring someone with you".

I still think the whole thing was appalling but certainly having looked into it, it might be a thing now, a way of approaching it. Terrible really.

I had a breast cancer scare at the end of last year. I had the biopsy but the head radiologist told me straight away she didn't think it was cancer because of the characteristics of the lump.
When I went home, I looked it up and yes the pathology test is the only way to know 100% but cancer does present itself in a different way.
At that time, I found this article very useful. www.ncbi.nlm.nih.gov/pmc/articles/PMC2766883/

The article is from 2009, so I would think Ultrasounds machines can give an ever more accurate image now.

My lump turned out to be a fibroadenoma. So the radiologist was right.

Thanks so much for all your responses. Apologies for being a bit woolly, I don't have all the info myself. She just said consultant, but of course he may not have been. She was referred to the clinic, saw this Dr, had biopsy etc, went back in to see him which is when she got all the 'sorries...', he then sent her off with the nurse/counsellor, who gave her all the info about the follow up appt. I believe my friend asked her 'so, do I have cancer?' and the response was 'the doctor thinks so....'. AFAIK there has been no contact made by phone and the whole thing has followed the referral pathway. My experience of this, of which sadly I have some, is that noone commits until they are super sure so it seemed scary that all of this happened so quickly. Thanks again.

I hate to say this for you and your friend, but sometimes you just know by looking at it.

Yes, you can always be wrong without a biopsy but you can be so certain that you would be preparing the patient for bad news, bring a support person, get the specialist nurse around already - things you might not do in a routine clinic.

I used to work in a rapid access breast cancer diagnostic clinic. If it's a rapid access, 'one-stop shop' clinic, they do a breast examination +/- ultrasound +/- mammogram +/- biopsy, all on the same day. They then porter the biopsy over to the lab, where they are waiting and view the biopsies as they arrive. Then they report on the biopsy, which the doctor views as the result comes in.

The woman is called back into the room and either told 'all results are negative', then given advice regarding their symptoms, or 'unfortunately the tests showed X. We will invite you back to a Multidisciplinary team clinic for further plans'.

What happens then, is that a Multidisciplinary Team Meeting is held to discuss each patient and their findings. After that, the woman attends clinic and is seen by surgery, oncology, radiology, etc., so they can be given their plan.

It can be very overwhelming, which is why notebooks and company are advised.

I hope your friend has great support around her and that she doesn't need too much treatment.