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New Member

Date Joined Dec 2008
Total Posts : 3
   Posted 12/31/2008 8:29 AM (GMT -6)   
Hi Everyone.

I'm new to the site.
I would like some advice if at all possible.
I have had this lump under my armpit for many years and finally went to a breast surgeon for a consultation. She checked it out and told me I had nothing to worry about. It can be taken out through surgery because it's just extra breast tissue. It was categorized as a Lump or Mass under the armpit.
I just had my procedure done. The day after my surgery, I went in for my post-op appointment. As she was taking off the bandages and dressing, she started to tell me that she didn't want to take too much [of the lump] out. I was in complete shock because she told me she was going to take out the entire lump. She said she wanted to wait for the pathology report before deciding on next steps. I told her that I was confused, because she clearly said she was going to take out the entire lump. Then I asked her "oh so what you did was a biopsy?" she claimed it was billed as a biopsy and always was a biopsy. However, not once did she mention the word biopsy to me up until I brought it up!!! She said it turns out it was not extra breast tissue so she decided to take only part of it out. She said this is what medicine is all about, making a judgment call on the spot. From the way it looks, I don't think she took out very much at all!! Even if it was truly supposed to be a biopsy, then two things come to mind (1) why wouldn't she use a needle that way I wouldn't be left with this long scar across my armpit and (2) why wouldn't she take out the entire lump since it's not supposed to be there in the first place?...From the beginning, I told her it is from an infection from shaving.
I have a feeling that she is trying to make as much money as possible off of me...Everytime I see her, I pay the co-pay, wait 45 minutes, then see her for about 8 minutes -- and let's not forget she gets money from the insurance. When I had my surgery, I had to dish out a whole lot of money for the hospital co-pay, and you better believe that she will receive lots of money from the insurance. Now, multiply that by twice as many office visits and 2 procedures!
I asked her "so I have to go through this again!"
She said you can decide if you want surgery to take out the lump after the pathology report.
I'm extremely disappointed and I feel cheated. I asked her why did she wait until my follow-up to tell me that she didn't do what was planned. She said legally, she couldn't, because she had to wait for the anesthesia to wear off. I could see her point, but why couldn't she then call my emergency contact to inform them that she didn't perform the procedure that was planned. The other thing is, based on her answer, she just basicaly admitted that she did in fact initially plan on taking out the entire lump.
I will be asking for copies of my paperpwork when I see her this week as that is when the pathology report will be available. I am fearful that she will insert the word 'biopsy' in the paperwork (since she claims it's mentioned in all the paperwork -- yet oddly enough, it's not mentioned in any of the paperwork I was given!). I'm an educated person and so, I know what she said and what she didn't say she was going to do. Like I said, not once did she mention biopsy.
Hypothetically, let's say she mentioned 'biopsy', then I would have asked a whole bunch of follow-up questions pertaining to that specific procedure.

Has anything like this every happened to anyone? Please advise.
Thank you :(

PS - I should mention that she definitely overbooks people because there isn't even a place to sit while waiting for your appointment! all seats are taken! There's no real privacy either, her receptionist and assistant both discuss sensitive matters with patients right there in the waiting area :(

Regular Member

Date Joined Sep 2008
Total Posts : 23
   Posted 1/1/2009 12:47 AM (GMT -6)   
I honestly think you're making a huge deal out of this unnecessarily.  It seems that your surgeon felt that the lump you felt was accessory breast tissue which is just normal breast tissue higher up.  I'm not sure what sort of work up you may have had, but if there was any significant suspicion of malignancy, she could have done a US and or mammogram.  But if she really just thought that it was accessory tissue, a lot of surgeons would just plan to take out the whole thing, especially the older more experienced surgeons. 
When your surgeon opened up that area, she probably had second thoughts that it may not be just accessory tissue.  In this case, it wouldn't make sense to try to take out the whole thing at that time without a biopsy, since if it does turn out to be something bad, you would need clear margins etc.  So she probably wanted to take a sample only.  A needle biopsy would not make sense if she had already made an incision. 
This scenario happens all the time. 
I honestly don't think it has anything to do with reimbursement.  There are other ways to make money for a surgeon.  I really think that she initially thought that it was accessory breast tissue; and when she opened up that area, she changed her mind and did a biopsy only. 
Just pray that your path result is benign. 
Good luck. 

New Member

Date Joined Dec 2008
Total Posts : 3
   Posted 1/1/2009 1:11 AM (GMT -6)   

thanks for the reply Superbigmac.

I could see your point, but, I am very disappointed because she is claiming that it was always a biopsy and it was billed as a biopsy. this may have been decided after she did my procedure, but like i said, not once did she tell me that she was going to perform a biopsy. she made it seem as if her original intent was to perform a biopsy. i find it disturbing that she couldn't be upfront with me.

Forum Moderator

Date Joined Mar 2003
Total Posts : 10382
   Posted 1/1/2009 12:39 PM (GMT -6)   
I think we're quibbling about semantics here. Any tissue that is removed from a person's body during surgery is sent to pathology for examination. The term "biopsy" often means partial removal, although there are also "excisional biopsies" which remove all of the tumor/lump/unusual tissue. Billing as a biopsy in these cases often makes the difference in whether insurance covers the procedure. Many policies only cover medically necessary procedures. Removal of non-tumorous, non-troublesome tissue would not be considered medically necessary. Biopsy (regular or excisional) would be, so the insurance would cover.
Most often tissue is given a preliminary examination by the lab during surgery. Either the results of this quick look or something about the appearance of your bump apparently cued your surgeon that a definite, microscopic diagnosis was needed before the total lesion was removed. In some cases of infection or neoplasm, incomplete or removal can cause the problem to spread. For instance, if you remove certain types of malignant tumors in the wrong way, it can cause them to "seed" and spread the malignancy.
I understand your upset because of this, but really I think your doctor was looking out for your best interests. In a worst-case scenario, what she did could have been life-saving.
Moderate to severe left-sided UC (21 cm) diagnosed 2001.
Avascular necrosis in both shoulders is my "forever" gift from Entocort.
Colazal,  Remicade, Nature's Way Primadophilus Reuteri. In remission since April, 2006.
"My life is an ongoing medical adventure"
Co-Moderator UC Forum
Please remember to consult your health care provider when making health-related decisions.

New Member

Date Joined Dec 2008
Total Posts : 3
   Posted 1/1/2009 12:57 PM (GMT -6)   

thanks for the reply Judilyn.

I will have to wait until tomorrow to see what the pathology report says. i would hate to go thru the procedure again :(


I will keep you posted.

thanks again!

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