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Interpreting Your Report

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djmammo
djmammo Member Posts: 1,003
edited February 2023 in Not Diagnosed But Worried

***Edited by Mods to add: Unfortunately DJMammo has stepped away from the Community for personal reasons. Please do not expect an answer from him directly. However, you can still post here in an effort to get help from our other amazing members!***

Mammogram and ultrasound reports contain (should contain) a fairly specific vocabulary as recommended by the Birads Lexicon. They have very specific meanings so if used correctly other docs can picture in their mind what the abnormality looks like without seeing the actual images.

I have divided the more common terms into 2 groups Favorable and Less Favorable, favorable meaning it leans toward the benign side, and less favorable if leaning toward the malignant side (as no finding is 100%). This in combination with the Birads score should give you a good idea about what the rad is considering if in fact they did not speak directly to you about your results. Below that is a link for a downloadable guide which is more complete.

Favorable: Oval; parallel; circumscribed; anechoic; hyperechoic; isoechoic; posterior enhancement or good through-transmission; avascular; macrocalcifications include pop corn, large rod like, rim, milk-of-calcium.

Less Favorable: Irregular; non-parallel (can also be written as "taller-than-wide"); not-circumscribed margins includes indistinct, angular, microlobulated, and spiculated; hypoechoic; posterior shadowing; architectural distortion; internal vascularity; microcalcifications including amorphous, coarse heterogeneous, branching, fine pleomorphic.

Downloadable Quick Reference Guide PDF which also includes MRI terminology

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Comments

  • shellsatthebeach
    shellsatthebeach Member Posts: 50
    edited August 2017
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    This is great information. What does rare foci of lymphatic/vascular invasion noted mean? This was on my path report.

  • djmammo
    djmammo Member Posts: 1,003
    edited August 2017
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    was this from a core biopsy or excision? Would help to see it in context but it means there is evidence that tumor cells have entered the lymphatics and blood vessels but it is only evident here and there in the specimen. Can you PM me the entire report?

  • Jeah
    Jeah Member Posts: 2
    edited August 2017
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    Hi djmammo

  • Jeah
    Jeah Member Posts: 2
    edited August 2017
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    I tried to contact you thru pm,

    I got d result of my mammo

    Findings: the breast are heterogeneously dense, which may obscure small masses

    A lucent centered calcification is seen in the right periareolar area

    No dominant mass, abnormal microcalcification, skin changes/ nipple tetraction seen

    Assessment: heterogeneously dense, bilateral

    Benign breast calcification, right

  • txbluebonnet
    txbluebonnet Member Posts: 1
    edited August 2017
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    I downloaded the pdf I will be comparing my MRI results to this list, thank you so much djmammo. I will probably be a wreck until then (Sept 8th) I'll probably pm you then if you don't mind. again thanks for all you do for us on this site.

  • Beatmon
    Beatmon Member Posts: 617
    edited August 2017
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    Thank you for always being so helpful

  • sable081
    sable081 Member Posts: 1
    edited September 2017
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    I got my report of breast compression and ultrasound I was trying to post the report here if anyone can help (it told me I cant post links at this time but im not understanding what this means (( In the 9;00 axis 3cm from nipple there is an oval circumscribed benign-appearing mass with posterior enhancement measuring 8x5x8 MM this likely represents a complicated cyst and corresponds to the mammographic asymmetry)) and don't know what this means the 7MM left breast asymmetry (Breast compostion- the breast are heterogeneously dense -The 7 MM left breast asymmetry in the mid third depth, inner breast persists on spot compression Birad 3 probably benign 6 month follow up recommended to assess for stability no suspicious mass , no architectural distortion or group of microcalcifications( is the different between complex cyst and complicated cyst if anyone can help me with what this meansi was just left in the dark my OB/GYN is on vacation for 2 weeks and i just got my report from the hospital just nervous and with braid 3 i have a 6 month follow up do i have to go every 6 months for 2 years because its braid 3 any help or information i can get appreciate it again :(

  • Southernmess
    Southernmess Member Posts: 1
    edited September 2017
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    Hi I'm so glad I found this. I'm having a hard time reading my ultrasound report. Please help. 1.impression:in the axilla there is a benign appearing old inflammatory node and within the breast proper there are 2 small cysts. 2.Benign finding Sonogram of thecomplete left breast: In the tail of the breast there is a 6.0x6.0x5.0mm well demarcated solid nodule with an echogenic center, 3o'clockthere is a 2.0x1.0x2.0cyst and at 11o'clock 4.0x4.0x2.0cyst. I don't understand what an old benign inflammatory node is.

  • djmammo
    djmammo Member Posts: 1,003
    edited September 2017
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    Sounds like a normal report to me. Any description that starts with the word "benign" is a good description.

  • dressmaker
    dressmaker Member Posts: 4
    edited September 2017
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    Left early stage breast cancer 2003 age 45. Had 3D mammo yesterday with a call from nurse today saying I needed to return for compression views and ultrasound of my right breast because of a density. Isn't a density a normal finding.?

  • djmammo
    djmammo Member Posts: 1,003
    edited September 2017
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    Dressmaker

    “Density" is not an approved term especially without an adjective before it but we all have done it from time to time. I assume the actual report says a “new" or “asymmetric" density there would otherwise be no reason to call you back. Most turn out to be nothing but this kind of follow up is necessary to make sure.

  • dressmaker
    dressmaker Member Posts: 4
    edited September 2017
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    Thank you, I figured there was a word missing! Hopefully will turn out to be fine! It is great to see someone with knowledge here. Wish you had been here 14 years ago!

  • Dark13
    Dark13 Member Posts: 50
    edited September 2017
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    I need help to understand what this means how bad it really is

    ULTRASOUND GUIDED TRUCUT BIOPSY OF 1.7 X1.8CM LEFT BREAST 11O'CLOCK POSITION LOCATED 5CM FROM NIPPLE 2CM DEEP TO SKIN

    I did a needle biopsy and got the result: The biopsy has been embedded toto and examined at multiple deeper levels showing cores of a moderately differentiated mucinous adenocarcinoma demonstrating cyto-arcbitectural features consisten with a Nottingham Histologic Score of 7 (T ubule formation=3, Nuclear Pleomorphism=2 Mitotic Inde=2) The lesion is disposed predominantly as nests and cords of malignant epithelial cells with areas of mucinous differentation evident. There is no evidence lymph- vascular permeation and no micro-calcification are seen.

    Conclusion: Truecut biopsy at 11oclock left breast. - Mucinous adenocarcinoma, moderately differentiated.

    immunohistochemistry for homone receptor status and Her2/Neu over-expression is recomended. Pls advise.

  • djmammo
    djmammo Member Posts: 1,003
    edited September 2017
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    Dark13

    See my response under PM's

  • Harms1975
    Harms1975 Member Posts: 3
    edited November 2017
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    Hi djmammo,

    Can you please help me understand all of this? I just had my repeat today and there were 8 spots total they looked at.. all were black in color, except one. I wasn’t sure what that meant, so I referred back to my original results that I found in my online health chart. (Hadn’t seen the report, until today)... Below is the only part I really couldn’t understand.

    I’ve read from your posts that Hypoechoic is/could be bad, but what is bilobed? What does no vascularity mean?


    At the 6 to 7 o'clock location left breast 1-2 cm from the nipple is a bilobed area that is Hypoechoic. One area measures 0.5 x 0.4 x 0.4 cm and the contiguous area 0.4 x 0.3 x0.3 cm. This may be due to a complex cyst or two complex cysts. No vascularity. Followup recommended in 6 months to reevaluate


    Recommend ultrasound examination of 6 to 7 o'clock location 1-2 cm from nipple left breast at site of suspected complex cyst or cysts -cannot completely exclude solid lesions but no definite vascularity


    Thank you!!!

  • djmammo
    djmammo Member Posts: 1,003
    edited November 2017
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    Harms1975

    Hello

    The radiology report is the doctor to doctor communication of what is basically a medical consultation. It is not written for the patient, it is for your doctor and other radiologists. This is why a law was passed to send patients a lay letter in the mail with your findings. If your doctors did not explain the findings of your study to you, shame on them. Also unless you have had training in imaging there is no point in looking at the screen unless someone is pointing explaining to you what is on there and what all 512 shades of grey mean.

    No vascularity means there are no blood vessels feeding it, thats a good sign.

    Bilobed means it looks like an 8 on its side. The circles may or may not be attached. Neither good not bad sign.

    They used the word "complex" which can be bad but some readers confuse it with "complicated" which is usually good. I assume thats what they meant since they did not suggest a biopsy but I cant be sure. Either way it is very small. On a practical note, no rad would recommend a 6 month follow up if they thought it was a cancer.

    So that is an explanation of the portion of the report you shared above. Is there a report of the new study? Were the results explained to you before you left the imaging center? If not I would find another imaging center.

  • Harms1975
    Harms1975 Member Posts: 3
    edited November 2017
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    I

    Hi djmammo,


    I had a Bi-Rad of 3.... which lead me to the second mammogram and ultrasound that I had this past Friday, Nov 3rd. Nothing was explained to me. I was only told that the radiologist would go over it 'with a fine tooth comb and compare both mammograms and ultrasounds side by side', and was sent on my way. I told my husband over and over again that I thought someone should have come to talk to me to let me know what was going on?

    I haven't gotten the last study yet, but will definitely share when I do. (I was only watching the screen as they have a big tv up on the wall that you see while you're laying there....)

    Thank you so much for your quick response! I really appreciate it



  • Ozarkgirl
    Ozarkgirl Member Posts: 5
    edited November 2017
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    Hello djmammo! This was from my ultrasound -- I'm scheduled for biopsy on November 7 -- are there reasons to worry? Thanks in advance!

    ULTRASOUND FINDINGS: Targeted ultrasound of the right breast was performed. At the 5:30-3 position there is a parallel hypoechoic mass measuring 8.2 x 4.7 x 6.4 mm. It has some angular margins and internal vascularity. The mass has no posterior acoustic features. It corresponds in size and location to the mammographic mass. At the 6:30-7position and intramammary lymph node is identified which has been mammographically stable for many years.No suspicious lymph nodes are identified in the right axilla.


    CODE:B4_B4N_-1_B4NOLET(BIRAD4SuspiciousFindings)

  • na_na
    na_na Member Posts: 2
    edited November 2017
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    I'm on 6 month follow up schedule and already did 2 of those six month follow up MRIs. There is smth. that they refer to as fibroadenoma in each report, 5×7 mm. at the margin of outer quadrant of the right breast. This lesion is not growing as they say, so they don't want to biopsy it, and it is not visible on ultrasound. I have two enlarged lymphnodes in my right armpit, and the biggest was biopsied (trucut biopsy with ultrasound control). The right breast feels heavier and became bigger than the left one.

    Should I seek an imaging centre where MRI biopsy is performed?

  • djmammo
    djmammo Member Posts: 1,003
    edited November 2017
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    Ozarkgirl

    I wouldn't worry yet. Since a prior study was mentioned in the report I assume this finding is new. They didn't use any descriptive terms that sound specifically malignant which is encouraging. It does need to be biopsied though.

    The other good news is it is very small and the nodes under your arm on that side are OK so if it does turn out to be something bad it is very small and more treatable than if had been caught later. Let us know the path report when you hear. Good luck.

  • djmammo
    djmammo Member Posts: 1,003
    edited November 2017
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    na_na

    Fibroadenomas have a characteristic appearance on MRI usually very different from that of a cancer on MRI, so thats probably what it is. If it is not growing thats another reason not to biopsy it. They will continue to monitor it. If it doesn't change in 2 years they may not even mention it again. Are you alternating MRI and mammogram every 6 months or just the MRI?

    What was the path result on the lymph node biopsy?

  • na_na
    na_na Member Posts: 2
    edited November 2017
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    Thank you very much for your response, Dj Mammo.


    I undergo MRIs, as I have very dense breast tissue and mammogram is not informative - BIRADS 0. I'm 36 and tried mammogram once.

    The path report of lymphnode was hyperplasia.

  • Ozarkgirl
    Ozarkgirl Member Posts: 5
    edited November 2017
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    DJMAMMO

    Thank you so much for your quick reply -- I slept much better after your words. The good news is my biopsy shows benign however the bad news is that it also showed radial scaring with Atypia Hyperlasia which they indicated there could possibly be something hidden within. I have an appt with a breast surgeon on Nov 20 to discuss options. I'm still releived though! 😀

  • shazelwo
    shazelwo Member Posts: 4
    edited November 2017
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    DJMAMMO,

    I was hoping you can tell me more about my report. I am wondering if they may possibly be seeing scar tissue from a biopsy done to me in May that was benign . The clip did not show any issues on mammogram, but the area she describes is my previous biopsy site. I do not know if scar tissue could present the way she describes my area of suspicion. My report is LONG, so I hope you can find it in your heart to chime in. I dont know much about medical terms , my focus is in law so very different field of study! I do have a thread going in "waiting for results" but, I really wanted your opinion. Ofcourse, I will follow through with the biopsies she reccomends and they are scheduled for Monday. My anxiety is kicking up really good because of this whole thing.

    Here is my report:

    Standard images of both breasts in the CC and MLO projections using 
    tomosynthesis were performed. Magnification views of the
    calcifications in the right breast were performed and compared to
    previous magnification views as well.

    The breasts are heterogeneously dense, which may obscure small
    masses. The parenchymal pattern on the left is stable. Scattered
    benign calcifications are noted throughout the left breast.

    No suspicious masses, areas of architectural distortion or suspicious
    microcalcifications are identified in the left breast.

    A biopsy clip is noted in the lower outer right breast where the
    patient underwent a previous benign biopsy performed by Dr. McCroskey.
    No suspicious abnormalities detected in this area on the mammogram.

    Nonspecific dense tissue is noted in the area of palpable concern in
    the upper right breast at approximately 12:00 and a few lymph nodes
    are noted in the general area of palpable concern in the right axilla
    but they do not have a suspicious appearance.

    Generalized density is noted in the central and inferior right breast
    where calcifications are present. The calcifications have increased in
    number when compared to the prior examination. This area of the right
    breast was subsequently evaluated with ultrasonography and will be
    described below.

    A targeted right breast ultrasound was performed with attention to the areas of palpable concern, the area that was previously biopsied at
    7:00 and the inferior right breast in the location of generalized
    density include an increasing calcifications.

    Currently in the right breast at 7:00, 6 cm from the nipple, multiple
    cysts or possibly dilated ducts which appear to contain calcifications
    are noted. This corresponds to the increased generalized density and
    increasing calcifications on the mammogram. This spans up to 5 cm in
    its greatest dimension. While its possible that this could represent
    fibrocystic change with multiple calcifications, the possibility of
    dilated ducts containing calcifications consistent with DCIS cannot
    entirely be excluded and further evaluation with an ultrasound-guided
    breast biopsy using vacuum assistance is recommended. It is also
    recommended that the core samples be radiographed to ensure that
    representative calcifications are present in the sample.

    A round hypoechoic nodule measuring up to 4.2 cm is noted in the
    posterior aspect of the right breast at 10:30, 4 cm from the nipple
    which may represent a complex cyst or solid mass. Further evaluation
    with an attempted aspiration followed by core biopsy, if it will not
    aspirate is recommended in further assessment.

    In the area of palpable concern in the upper right breast at 12:00,
    benign-appearing tissue was noted at real-time. No suspicious
    ultrasonographic abnormalities were identified in the area of palpable
    concern in the right breast at 12:00 at real-time.

    In the area of palpable concern in the right axilla, multiple
    morphologically benign-appearing right axillary lymph nodes are noted
    with echogenic hila and non-thickened cortices. A note is made that no
    suspicious right axillary lymph nodes are identified.

    IMPRESSION:

    1. There is no mammographic evidence to suggest the presence of
    malignancy in the left breast at this time.
    2. There is increasing number of microcalcifications associated with
    generalized density in the inferior right breast with corresponding
    cystic change containing calcifications detected at ultrasonography at
    7:00, 6 cm from the nipple. Further evaluation with an
    ultrasound-guided breast biopsy using vacuum assistance and with a
    specimen radiograph of the core samples for verification that
    representative calcifications were retrieved is recommended.
    3. Low suspicion nodule in the right breast at 10:30 for which further evaluation
    with a cyst aspiration and possible core biopsy is recommended. BIRADS CATEGORY
    4: SUSPICIOUS - Biopsy should be performed in the absence of
    clinical contraindication - 4B (Moderate suspicion for malignancy)
    A right ultrasound-guided breast biopsy x 2 is recommended.


  • Red_Softail
    Red_Softail Member Posts: 1
    edited November 2017
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    Hi Everyone! I went for an ultrasound today for Rt and LtB as well as a lump inferior to the RtB (which was just a lipoma).Got called into docs at dinner time (more so i think so i dont worry waiting).

    No mention from my doc if a follow up would be recommended (a f/u ultrasound ). However, my gut tells me to. I know nothing to worry about but I'd like a second opinion if I should F/u.

    7x4x5 mm intramammary lymph node RtB and small coarse calcification on LtB.


    I'm 34. Thank you everyone😀

  • moderators
    moderators Posts: 8,081
    edited November 2017
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    Dear Red_Softail,

    We are sorry that these breast changes are causing you alarm. We are glad that you reached out to our members. Have you discussed the report with your doctor? Are you looking for some advice here as to whether or not you need a follow up ultrasound? Perhaps a discussion with your doctor about what the path report means would be helpful . Let us know what you learn. The MOds


  • djmammo
    djmammo Member Posts: 1,003
    edited November 2017
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    shazelwo

    I reviewed the report. It appears rather well written and complete in its descriptions compared to many I have seen here recently.

    They describe a mass in the upper outer quadrant on the right at 10-11 o'clock. You have it labeled as measuring 4.2 centimeters. Did you mean millimeters?

    They describe calcifications in ducts in the lower out quadrant in the region of your prior biopsy. This appearance does not suggest scarring from a prior image guided procedure. What was the target of your prior biopsy?

    Their conclusion and recommendations match with their findings.

    1) The calcifications in dilated ducts raise the possibility of DCIS and will need a biopsy to confirm or exclude that diagnosis.

    2) Any newly identified solid nodule or complex cyst also needs similar evaluation. This possibly solid nodule (at 10:30) is in a different quadrant from your prior biopsy (7:00).

    3) They apparently saw nothing that concerned them at 12:00 .

    Let us know the results of the biopsies.

  • shazelwo
    shazelwo Member Posts: 4
    edited November 2017
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    Thank you so much, as for the size i just copied her report so she may very well have meant mm since it is a long report. I have the biopsies tomorrow at 12:30 I will update when I know something. I looked at my other report where i had the nodule in May biopsied and it says that it was at 7 o'clock 6 cm from nipple.

  • renee_rn
    renee_rn Member Posts: 2
    edited November 2017
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    djmammo,

    I had my first ever mammogram on 11/1 and it's abnormal. I am 42 years old & a little nervous. I'm a RN but not real familiar with mammography terms. My specialty is critical care. Can you please tell me your impression of the results?

    Current study was also evaluated with a Computer Aided Detection system.

    No prior exams were available for comparison.

    The tissue of both breasts is heterogeneously dense. This may lower the sensitivity of mammography.

    There is a 0.9cm irregular density with an obscured margin in the right breast central to the nipple middle depth.

    No other significant masses, calcifications, or other findings are seen in either breast.

  • melissadallas
    melissadallas Member Posts: 929
    edited November 2017
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    What was the Birads rating and what were the recommendations? Are you called back for more views to be taken and/or ultrasound?

    It is really common to be called back on first mammogram, as there are no films to compare for your personal "normal." It very well may look benign on more views.