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All TopicsForum: Waiting for Test Results → Topic: Got report. Birads 4. What does it mean?

Topic: Got report. Birads 4. What does it mean?

Forum: Waiting for Test Results — Biopsy, mammogram, CAT scan, PET scan, ultrasound, or other tests.

Posted on: Sep 14, 2011 06:20PM

Kimmer1975 wrote:

Hey there, 

So I got the report. I now know we DO use Birad in Canada. So another question answered. Here is what the radiologist said in the report. I'm just going to type it word for word. 

REPORT:

Left breast ultrasound was performed.  At 2' o'clock, 5 cm from nipple, there is an isoechic nodule which measures 1.1 x 0.6 x 0.7 cm. No definite internal vascularity. 

Left auxillary ultrasound is unremarkable.

Recommendations: Indeterminate left breast nodule. Further assessment with ultrasound guided biopsy.

Final Assessment: BIRADS 4 

As I suspected, I have no idea what any of that means aside from the word "Indeterminate". It was the exact same thing the first Radiologist said. 

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Posts 1 - 21 (21 total)

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Sep 14, 2011 06:32PM catbill wrote:

BIRADS 4 is pretty much "radiology speak" for we see something but we don't know what it is yet.  We need to check further.

Oncotype 8, no chemo, no rads, bilat mastectomy, on Arimidex

Dx 9/29/2010, IDC, 1cm, Stage I, Grade 1, 0/2 nodes, ER+/PR+, HER2-
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Sep 14, 2011 06:55PM marie5890 wrote:

What catbill said. Something is there, but the radiologist doesnt know what

"No definite internal vascularity. "

Is a very good thing. It means it doesnt have a definite blood flow supply (BC needs blood flow to grow)

Have the biopsy and find out what it is, but I wouldnt panic. There is nothing that really is sending red flags concerns.  

DO NOT READ ANYTHING INTO THE TECH'S EXPRESSION OR WHAT THE TECH SAYS. Jan '11 Biopsy Dx-ed a PASH tumor (rare, but benign tumor)....All I ask is for peace and serenity to the depths of my soul. Makes the rest of life more live-able.

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Sep 14, 2011 06:55PM mags20487 wrote:

80% of birad 4 come back benign at biopsy...odds are on your side...hope you get that B9 diagnosis!!

Mags

DX @43yrs old triple negative metaplastic. BMX 8/23/11. 4 taxol and 4 AC finished 12/29/11 35 rads completed 3/16/12 Bilat Diep 11/1/12 left side flap failed 11/6/12 Gap flap left 3/5/13 lymph node tx 5/22/13 Revision 8/13, Revision 12/13

Dx 8/17/2011, IDC, 2cm, Stage IIa, Grade 3, 3/18 nodes, ER-/PR-, HER2-Surgery 08/23/2011 Mastectomy (Both); Lymph Node Removal: Axillary Lymph Node Dissection (Left)Chemotherapy 09/22/2011 Adriamycin, Cytoxan, TaxolRadiation Therapy 01/27/2012 ExternalSurgery 11/01/2012 Reconstruction: DIEP flap (Both)Surgery 03/05/2013 Reconstruction: GAP flap (Left)Surgery 05/22/2013 Reconstruction (Left)Surgery 08/21/2013 Reconstruction (Both)Surgery 12/04/2013 Reconstruction (Both)
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Sep 14, 2011 07:21PM Kimmer1975 wrote:

Thanks guys. (gals)

Marie: I did have the biopsy, right after the ultra sound! Same day.  

FibroCystic Breast Condition (FCC)

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Sep 14, 2011 08:31PM Kimmer1975 wrote:

I'm so friggen grumpy! This really is a up and down experience. One minute I'm fine and the next I am snappy. I can't believe I have another 16 days to go. Seriously ladies, how did you manage your mood swings? I am a stay at home Mom in a new town and know hardly anyone. I am alone with my thoughts and I had a great hold on my emotions until my doc decided to leave town and leave me hanging. Now I am up and down like a roller coaster. My mom lives 2 days away and both my siblings have passed away. My kids are in school all day. During the summer months it was so easy to just pass the time going camping, doing the races, taking the kids outside, etc. Now that school is back on and I am alone with myself, it's getting harder to control my thinking patterns. This really really sucks. I'm sorry. I feel guilty even complaining because I know so many of you have and are, enduring so much more then I am right now. So please forgive me if it seems insensitive to cry the blues and share how scared and moody I am with you all. Right now, I wish I lived where we moved from because at least I had friends around. I wish my Mom was closer to me then a 2 day drive and more then anything, I wish my kids we're still home on summer vacation. I feel sad, is the only way to put it. 

FibroCystic Breast Condition (FCC)

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Sep 14, 2011 08:58PM LittleMelons wrote:

Kim - I would refer to the CPSO (College of Physicians and Surgeons of Ontario) guidelines in trying to get your biopsy results as well, either from your Onc's office or your family doctor.  You should not have to wait until the end of the month to get those results.  As I mentioned on your other thread, the CPSO policy on test results states that patients should be given significant findings in a timely fashion.  Keep pushing for the results and I think you will get them.

 Try not to worry too much, though.  chances are failry good that they are B9.

 Again, best of luck!!

Dx 8/18/2010, IDC, 1cm, Stage I, Grade 2, 0/2 nodes, ER+/PR+, HER2-
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Sep 14, 2011 09:42PM lwarstler wrote:

Kim,

What you are going through, the waiting game, is really hard ont he psychy. I think all the waiting was hardest for me so far. Once we had all the answers and plan, i was actually able to really calm down. Until then though, I feel you on the cranky part. I was up and down all over the place and it really is understandable. I'm sorry to hear about your loneliness, it sound like you have had a lot of loss in your life. Is there any chance your mom could come visit for a few days to give you someone you can talk to? I too am a stay at home mom in a new town where I don't know many people. Is there a cancer center near your house. Go there and talk to the social worker if they have one, she may be able to find a group that is meeting for people who are waiting on results.

Also, LittleMelons is right, you really shouldn't have to wait. I would call you family doctor and see if they can call and get your results for you. There is no reason for them not to. My doctor was going out of town and I had her leave permission with one of the nurses to call me with the results. I would push hard to get your answers before the end of the month. That's just really hard to wait for and there's no reason to suffer that if you don't absolutely have to.

Hugs,

Lee Ann 

Lee Ann: Lumpectomy/reduction w/removal of positive internal mammary node 9/8, TAC x6 starting 9/27, rads x32 after chemo. 4/15-diagnosis changed from TN to Her2+..Herceptin to start 5/4

Dx 8/22/2011, IDC, 2cm, Stage IIIa, Grade 3, 1/3 nodes, ER-/PR-, HER2+
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Sep 15, 2011 12:15AM Gottobme wrote:

Well kimmer, I got you beat unfortunately, I get to wait 5 weeks.  First, the surgeon is away and just as he gets back, his secretary is away.  I just keep reminding myself that the path report for the biopsy in May came back B9 even with a birads 5.  I also feel that because the freezing wasn't working great and that it may have prevented the surgeon going as deep, my path report might get done before the office shuts down.  I do really feel it's B9 as the first path report says partly because the radiologist who did the wire guide said things looked calmer then when I had the first biopsy.  The ducts weren't inflamed around the tumor like they were in May. 

Ok, I realize it doesn't excuse bad planning on the part of the surgeon and I can call my GP for results too.

On your question about birads 4, mine was birads 5 because the papilloma was surrounded by dense tissue and there was scar tissue.  There was too much going on but it turned out to be B9 even with a higher birads.  

Wishing you the best for a B9 outcome and keeping you in my thoughts.  

Smiles are like rocks, we reach out for them to save us from the raging river of emotions.

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Sep 15, 2011 02:17AM beacon800 wrote:

I like it. No vascularity is good. Nodule size is fairly small. They don't see any enlarged lymph nodes under your arm. All that bodes well.

Birad 4 means they want to check it, but really don't have a strong suspicion that it's cancer. Good luck and hope it's b9!

LCIS, PLCIS.

Dx 7/24/2009, LCIS, Stage 0, 0/0 nodes, ER+/PR+, HER2-
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Sep 15, 2011 02:27AM pejkug3 wrote:

Yes.  The lack of "internal vascularity" is GOOD! 

I got a BIRADS 4b.  (What the heck?1  Never heard of a 4b...)  BUT the internal blood flow was marked.  I remember the day that I had the u/s watching them just stare at the blood flow to the "thing" I was seeing on the screen.  I've had 5 kids so I know what blood flow on a u/s looks like.  Ugh.

80% are B9 - the odds are on your side, girl!!

Dx 1/13/2011, IDC, <1cm, Stage IIa, Grade 3, 1/8 nodes, ER+/PR+, HER2+Surgery 01/27/2011 Lumpectomy (Left); Lymph Node Removal: Sentinel Lymph Node Dissection, Axillary Lymph Node Dissection (Left)Chemotherapy 02/24/2011 carboplatin, TaxotereTargeted Therapy 02/24/2011 HerceptinRadiation Therapy 06/28/2011 ExternalHormonal Therapy 09/01/2011 Tamoxifen
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Sep 15, 2011 09:50AM Kimmer1975 wrote:

I didn't know "vascularity" was the blood flow.  That explains the No "definite" vascularity to me. She had mentioned the blood flow to me. Now I know what she was showing me too, on the screen. She had gone over the images with me to help me understand her choice for doing the biopsy. She showed me some very small red and blue dots within the lesion. She explained something about the direction of blood flow and each color. I forget what exactly it was now. The spots we're very tiny so she couldn't ascertain anything from them. It was also at that time that she explained that the previous Radiologist thought my lesion had charachteristics of a Complex Cyst, but he couldn't say for sure either. So she showed me what she was seeing to explain the reason she disagreed with that. She explained too, that the Ultra Sound they we're using Monday was specially designed JUST to use on breasts so it gave a much clearer image. So she believes it was solid and not septated like the orignial radiologist suggested. (Perhaps it changed though). I can understand the confusion I suppose. Nothing about this silly nodule has been straight cut and dry. A little of this, a little of that but nothing significant enough to make a diagnosis. I guess that's the way it goes sometimes.

Gottobeme: 5 weeks! How horrible! My heart goes out to you. That too is an incredibly long wait. I thought 3 weeks was bad. Hugs to you!

Thanks again for the explanation ladies! I will see what I can do about getting the oncologist office to send the results to my GP instead of waiting!

Kim 

FibroCystic Breast Condition (FCC)

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Sep 15, 2011 10:07AM marie5890 wrote:

Yes,

It does help to know "exactly what are they looking for, characteristic wise, and why are they looking for it".

Many times those of us who have no understanding dont really understanding that when tests are done, they are looking more for just than "what does it look like"---they are looking to see how it reacts. There are many characteristics that can be gleened by testing, not just it's shape etc.

It's always prudent to get a biopsy and I am glad you got one. That way you will know definitively. Smile 

DO NOT READ ANYTHING INTO THE TECH'S EXPRESSION OR WHAT THE TECH SAYS. Jan '11 Biopsy Dx-ed a PASH tumor (rare, but benign tumor)....All I ask is for peace and serenity to the depths of my soul. Makes the rest of life more live-able.

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Sep 15, 2011 12:21PM Wendyspet wrote:

Kimmer- did you get the results from the biopsy?  The path results from the lab?

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Sep 15, 2011 01:00PM Kimmer1975 wrote:

No, I didn't get that part. The oncologist won't have that until tomorrow (which he won't be around to review). I simply went and got a copy of the Radiologist report from Monday that prompted them to do the Biopsy in the first place. I am still trying to figure out what I can do about the long wait. I've had a few suggestions so far that I am/will try. 

FibroCystic Breast Condition (FCC)

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Sep 15, 2011 01:22PM, edited Sep 15, 2011 01:48PM by Kimmer1975

You know what I completely forgot to tell them???!! About the lump in my right underarm. They never even checked my right side because we we're looking only at the lump in the left side. I had forgotten about it until just a minute ago. I am still confused by that. Having a lump in the right arm pit (right at the very bottom in the center) but a lesion in my left breast. Doubtful they are any relation right? Maybe just a pulled ligament because it does feel like a ligament with a bubble in it. It moves around like a ligament would!  

FibroCystic Breast Condition (FCC)

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Sep 15, 2011 01:59PM lwarstler wrote:

Kim,

Do you drink a lot of coffee or caffeine? I get that under my right arm sometimes too and my doctor told me that it was a little swolen but felt like it might be from too much coffee. She told me to drink a lot of water for several weeks and see what happens. I did and it did go away. I have noticed that whenever I don't drink enough coffee it comes back.

Lee Ann: Lumpectomy/reduction w/removal of positive internal mammary node 9/8, TAC x6 starting 9/27, rads x32 after chemo. 4/15-diagnosis changed from TN to Her2+..Herceptin to start 5/4

Dx 8/22/2011, IDC, 2cm, Stage IIIa, Grade 3, 1/3 nodes, ER-/PR-, HER2+
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Sep 15, 2011 02:20PM Kimmer1975 wrote:

Ahh! That makes sense! I do drink a few cups of coffee daily! I should limit myself to 1 but sometimes it's as many as 3. It is kinda side to side bouncy, so I was thinking a ligament maybe. I am right handed so I use my right arm far more and thought maybe I had pulled the ligament which may have caused a bit of swelling. It's not like my arm gets much rest to heal itself! lol. 4 kids, 2 dogs, 1 partner = A whole lot of laundry, cleaning and cooking! lol. 

You might be right on the caffeine part too though! I've heard that before from someone. That they had something in their underarm and were told to cut back on caffeinated drinks! Thanks girlie! :) 

FibroCystic Breast Condition (FCC)

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Sep 15, 2011 04:38PM Gottobme wrote:

Wow, I just got a call from the surgeons office, they are going to call me with the results instead of me waiting.  The surgeon said I had already been through enough with everything that happened on Tuesday and he didn't think I needed a longer wait time to deal with on top.  It will still be 7 to 10 days, but better then 5 weeks.  YAY!!!

Kimmer, fingers crossed you get a better answer for your wait time as well.

Smiles are like rocks, we reach out for them to save us from the raging river of emotions.

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Sep 15, 2011 04:55PM Kimmer1975 wrote:

Thats such GREAT news for you! What a relief that must have been to get that phone call!!! I've very happy for you! For sure, 7-10 is better then 5 weeks!!!! Hope you get good news hun! Hugs!!! 

FibroCystic Breast Condition (FCC)

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Sep 15, 2011 09:12PM CoolBreeze wrote:

That sounds like an excellent report and there don't seem to be cancerous characteristics.  I am goign to guess you'll be on of the 80% and be benign.

When do you get the results? 

Ann's cancer blog: www.butdoctorihatepink.com .....multicentric/multifocal IDC/ILC+DCIS/LCIS/ADH Official dx? "Your breast was a mess." ~UniMastectomy/Chemo/Herceptin/Tamoxifen/Recon Almost Done! Oh wait. mets to liver 5/21/11 Now Stage IV

Dx 8/17/2009, IDC, 4cm, Stage IIa, Grade 3, 0/3 nodes, ER+/PR-, HER2+
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Sep 15, 2011 09:15PM Kimmer1975 wrote:

Apparantly I am not getting them until the 29th but I'm working on getting them sooner. They will be in his office tomorrow, he just won't be there until the end of the month! :( He's gone on vacation for two weeks. He had told me Monday, but that didn't pan out! 

Thanks for the encouragement CoolBreeze! Hugs.  

FibroCystic Breast Condition (FCC)