Interpreting Your Report
Comments
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Thank you so very much for your reply DJMammo!
Wondering with dense breasts...is it typical to do MRI after Mammo/biopsy or do Mammo/MRI before a biopsy?
Hope to have biopsy results from pathologist tomorrow and will let you know what they say.
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Breast Center called, pathology report has the biopsy samples show as benign! She said that Radiologist that did biopsy still has to review and he could call for further tests. He is on vacation this week so won't know until next week. I'm taking it as great news! Thanks again!!!!
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djmammo:
First thank you for all you do for the women of this board!
I just have a question about my ultrasound report. There was nothing found on mammogram.
My report states:
Underlying the palpable region of concern in the lower inner quadrant of the left breast, 7 O'clock position, 3 cm from the nipple, there is a circumscribed, heterogeneously echogenic nodule measuring 1.0 X 0.5 X 0.8 cm. Imaging findings are in keeping with a benign lipomatous lesion.
It was rated a bi rads 3 and I am just wondering if it is a lipomatous why do I need a follow up? Where is the concern in the report?
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Hello everyone!
I went through the entire thread, thank you djmammo for going through all the reports.
I just got my usg and mammo report. The mammogram showed extremely dense breast tissue and nothing else.
The usg report shows 3 probably benign hypoechoic nodules measuring 5 mm each in R breast. There were scattered bl benign cysts.. Almost 4 of them reported with the largest being 7mm in the R breast and one in the left breast.
The convulsion is probably benign lesions and bl benign cysts. Follow up targeted R usg. Screening breast mri may also be considered due to family history( mom was diagnosed at 40)
The bs wanted to do an mri right away.. But thought that Waiitng fr 3 months isn't a bad idea either. The genetic testing results are pending.
I'm worried that I will be anxious Waiitng fr the mri but at the same time I don't want to get an mri done as its a very sensitive test. I'm 30 yrs old.. And I lost my mom 4 months ago.
Any input that you might have will be greatly appreciated.
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If your genetic testing comes back positive most ins companies will pay for a screening mri every year or two so if its coming back soon might be advantageous to wait for that result before getting the mri.
The description of the "prob B9" nodules is not complete, there are other features they could comment on but at 5mm they may be too small to evaluate completely, hence the short term follow up. No adjectives indicating cancer were used in the report above. 5mm is also pretty small for MRI. We are taught to basically ignore things smaller than 5mm on MRI as at that size most just represent areas of normal glandular tissue.
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Thank you so much for the prompt reply. Of the three concerning lesions 2 of the probably benign lesions are 5 mm with one described as being ' probable cyst' of 7mm. They didn't describe it further as being simple/complex/nodular etc. The rest are scattered simple cysts.
The doctor said that since the radiology report mentions an mri the insurance will most likely cover it. I think I will wait another 3 months if the lesions are probably too small fr an mri also?
Thank you once more. It means alot.
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Had a MRI done last Friday. 4 years ago I had 3 breast biopsies at once in both breasts that showed fibroadenomas. My sister had breast cancer over 10 years ago, now she has it again and it is metastatic in her lung. I'm not sure what all this means. I got all of my stuff from the hospital that did my biopsies and sent to this place that did my MRI. Its been 2 days now since they received them and I haven't heard a word yet. I'm not sure what all this means.
FINDINGS: After administration of intravenous gadolinium contrast there is moderate physiologic background parenchymal enhancement throughout the breasts. There is a 15 x 11 x 16 mm rapidly enhancing mass in the upper outer left breast at middle depth. The mass demonstrates progressive enhancement kinetics on delayed sequences. There is a 12 x 10 x 10 mm moderately enhancing mass with progressive enhancement kinetics in the anterior medial right breast around the 3:30 to 4:00 position. There is focal metallic susceptibility adjacent to the mass that may represent a marker from a previous core needle biopsy. In the medial right breast at middle depth there is a 16 x 6 mm minimally enhancing mass. The morphology and enhancement pattern of this lesion favor a benign etiology such as fibroadenoma. There are no grossly enlarged or abnormally shaped axillary lymph nodes. No internal mammary nodes are detected. The STIR sequence demonstrates several small cysts scattered in both breasts measuring up to 7 mm in size. IMPRESSION: BI-RADS category 4, Suspicious. 1. There is a rapidly enhancing mass in the lateral left breast. In the absence of prior imaging to confirm stability, this is considered suspicious. Recommend correlation with old mammograms and any prior breast ultrasound examinations. If long-term stability of the mass can be confirmed then further imaging or intervention may be unnecessary. Otherwise core needle biopsy is recommended to rule out malignancy. 2. A moderately enhancing mass in the medial right breast appears to have been biopsied previously based on the presence of a metallic marker adjacent to the lesion. This is presumed to represent a benign lesion such as a fibroadenoma. Correlation with prior imaging and pathology records is recommended for confirmation.
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Had a MRI done last Friday. 4 years ago I had 3 breast biopsies at once in both breasts that showed fibroadenomas. My sister had breast cancer over 10 years ago, now she has it again and it is metastatic in her lung. I'm not sure what all this means. I got all of my stuff from the hospital that did my biopsies and sent to this place that did my MRI. Its been 2 days now since they received them and I haven't heard a word yet. I'm not sure what all this means.
FINDINGS: After administration of intravenous gadolinium contrast there is moderate physiologic background parenchymal enhancement throughout the breasts. There is a 15 x 11 x 16 mm rapidly enhancing mass in the upper outer left breast at middle depth. The mass demonstrates progressive enhancement kinetics on delayed sequences. There is a 12 x 10 x 10 mm moderately enhancing mass with progressive enhancement kinetics in the anterior medial right breast around the 3:30 to 4:00 position. There is focal metallic susceptibility adjacent to the mass that may represent a marker from a previous core needle biopsy. In the medial right breast at middle depth there is a 16 x 6 mm minimally enhancing mass. The morphology and enhancement pattern of this lesion favor a benign etiology such as fibroadenoma. There are no grossly enlarged or abnormally shaped axillary lymph nodes. No internal mammary nodes are detected. The STIR sequence demonstrates several small cysts scattered in both breasts measuring up to 7 mm in size. IMPRESSION: BI-RADS category 4, Suspicious. 1. There is a rapidly enhancing mass in the lateral left breast. In the absence of prior imaging to confirm stability, this is considered suspicious. Recommend correlation with old mammograms and any prior breast ultrasound examinations. If long-term stability of the mass can be confirmed then further imaging or intervention may be unnecessary. Otherwise core needle biopsy is recommended to rule out malignancy. 2. A moderately enhancing mass in the medial right breast appears to have been biopsied previously based on the presence of a metallic marker adjacent to the lesion. This is presumed to represent a benign lesion such as a fibroadenoma. Correlation with prior imaging and pathology records is recommended for confirmation
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I am new to all this, I’ve recently had a mammo/ultrasound of left breast and now I am scheduled for mri with contrast, no one has explained to my why I need the mri so I am hoping someone could help me understand, my report says a persisting irregular focal asymmetry deep which demonstrates interval increased density in comparison to previous exam especially on mlo view, associated mild architectural distortion and in addition there is irregular focal asymmetry in 6 position where possible cyst is. Any help understanding this would be greatly ap
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Some of the words used in that report like irregular, increasing density, architectural distortion, can be associated with cancer although there are benign explanations for these as well. I would have thought the next step would have been an ultrasound to see what is causing these findings and possibly biopsy them before an MRI is done but if your insurance will pay for the MRI then the US can follow the MRI.
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thank you for replying, what I had written was from the us report, I was given a birads 0 and on the report it states that if mri was not available then a stereotactic biopsy should be performed. I gather from your post that words like architectural distortion and increased density are cause for concern, what about focal asymmetry? What does it pertain to? Once again, I truly appreciate your response and extremely g
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focal asymmetry
As seen on a mammogram, the tissue in each breast is roughly similar in density and distribution, sort of like a Rohrshack ink blot, roughtly mirror images of eachother.
If there is something in one spot on one side that is not on the other, we call it a focal asymmetry. This can be the earliest sign of something growing in one breast, not present on prior exam. It is not specifically a good or bad sign, as benign things present this way too. When reading mammograms that is what our eye is drawn to first,
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I tried to link my report but I was unable to. This is not 100% word for word but close enough.
About me: 30, no kids, no breast cancer history
Right breast unremarkable. Axillary unremarkable. Left breast 5:00, 5cm posterior to the nipple is a lobulated 1.6 x 1.7 x 1.2 cm lesion with a small amount of internal Doppler flow and some heterogeneity of the internal echo texture including an area that may represent fluid as well as several hyperechoic regions.
Impression
1.6cm Hypoechoic nodule with some variability of the echotexture and small amount of vascularity at the area of the palpable finding for this 30 year old patient
BIRAD 4 suspicious
Ultrasound guided biopsy reccomended
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Is it possible that any of this can be benign? It just got reported to my online portal account. I dont get my biopsy until Thursdsy and my anxiety is through the roof.
MAMMOGRAM: A radiopaque marker is placed on the palpable abnormality in the 12 o'clock position of the left breast. There is a 2.6 cm ill-defined mass which is lobulated. In the 12 o'clock position of the right breast, there is a 1 cm nodule approximately 2 cm the nipple.BREAST ULTRASOUND: Ultrasound of the left breast was performed in the palpable region corresponding to the 12 clock position. There is a solid hypoechoic irregular mass with blood flow measuring 2.9 x 1.9 x 1.7 cm. In the 12 o'clock position, 6 cm from the nipple, there is a 0.9 x 0.7 x 0.4 cm hypoechoic nodule.
Ultrasound of the axilla is unremarkable.
Ultrasound of the upper right breast was performed. In the 11 o'clock position, 8 cm from the nipple, there is a 0.6 x 0.5 x 0.3 cm hypoechoic nodule. In the 11 o'clock position, 5 cm from the nipple, there is a 0.7 x 0.6 x 0.4 cm hypoechoic nodule with flow suggestive of a lymph node. In the 11 o'clock position 7 cm from the nipple there is a 1.0 x 0.7 x 0.4 cm nodule and 6 cm from the nipple, there is a 0.6 x 0.6 x 0.4 cm nodule. In the 12 o'clock position, periareolar, there is a simple cyst measuring 0.9 x 0.9 x 0.7 cm. In the 12 o'clock position, 4 cm from the nipple, there is a 0.7 x 0.6 x 0.3 cm complex cyst.
IMPRESSION: Solid left breast mass corresponding to the palpable abnormality for which biopsy is recommended.
Multiple subcentimeter hypoechoic and anechoic foci in the right breast likely representing cysts and benign-appearing nodules for which short-term follow is recommended.
RECOMMENDATION: Ultrasound-guided biopsy.
Recommend ultrasound-guided biopsy of the left breast palpable lesion, 12 o'clock position. Results were discussed with the patient and called and faxed into Heather at Dr. Frinjari's office on 5/22/2018.
ASSESSMENT: BI-RADS Category 4: Suspicious findingsThank you, Cindy
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The adjectives used (solid irregular hypoechoic with blood flow) are among the worrisome terms. Was this new since your prior mammogram? How long ago was the last mammogram?
If the biopsy comes back positive you will likely have an MRI which will shed light on all those other probably benign findings and may eliminnate the need for a short term follow up.
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My last mammogram was a year ago. The worrisome terms you mentioned, is that 100% certain or just increased chance?
Thank you
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djmammo here is to you
alt="">i follow this thread, and you are a true friend.
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thanks. I also agree that this report is missing a lot of terms that would either ease my mind or scare me even more. Neither the radiologist or the tech spoke with me and gave me any insight. I don’t even get my biopsy for at least a week. Sighhh. Thanks again
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I am a 50 year old female. My Aunt on my mother's side had breast cancer. I went in for a Screening Mammogram. Last Mammogram approx. 10 years ago. My screening Mammogram came back abnormal and I need to go back for a Diagnostic Mammogram with Ultra Sound. I do not understand the screening findings. I was hoping someone could explain. Also under magnification there was a microlobulated mass present.
Findings: CC, exaggerated CC and MLO views of the breast demonstrate heterogeneously dense breast parenchyma. There is an irregular asymmetry within the central left breast. Questionable associated architectural variation. There are overlying calcifications which are not suspicious in appearance. No mass or architectural distortion is identified within the right breast. No suspicious microcalcifications are identified. The axilla are unremarkable.
Impression: Irregular left breast asymmetry with questionable associated architectural variations.
Birad 0: Incomplete. Need additional imaging evaluations.
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Remember that a screening exam is just a way to tell if there has been a change since your prior mammogram. Most often only two views of each breast are taken for a screening mammogram, it is not meant to give you a definitive diagnosis, thats what the followup study is for.
The report indicates that when you compare one side to the other, there is more "white" in one spot on the left the there is in the same location on the right. It also mentions "architectural variation" by which I assume they mean "architectural distortion" which is a term meaning that that white spot looks different than the surrounding tissues in the left breast. These are legitimate reasons to call you back for additional imaging. It does not mean there is something bad there or indeed anything there at all. Keep us in the loop.
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I went for my Diagnostic Mammogram and Ultrasound today. Architectural distortion was still present on both views with no mass identified. The radiologists came in and did my ultrasound himself for a better view. He recommended a MRI due to the density of my breast tissue and asymmetry. My question is what will the MRI show that the ultrasound and mammograms did not?
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MRI is the most sensitive exam we have for the detection of breast cancer, more than mammo or US. It may show something the other exams do not.
If all three are negative, then the odds of having breast cancer is very near zero.
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Hello All - I hate seeing so many of us in this forum.
I had a diagnostic mammogram and u/s on Friday and am scheduled for a u/s guided biopsy (2 sites) this up coming Friday. I am hoping that someone can take a look at my mammogram report and help me understand it better so I can explain to my husband. I hate the fact that it feels like the testing center is leaving my husband out in the cold in all of this. In fact I had to specifically ask them to bring my husband in so the nurse could discuss the biopsy procedure with him also - a comment was made that they usually don't see men in that part of the center...sigh..... His work was even giving him problems because he wanted to go to this mammogram - His answer was - It's my wife....(yes I know I have a good one) and that is why it is important that I educate him also So here is a copy of my report: - and thanks again for all the help
HISTORY: 50-year-old female presents for evaluation of multiple lumps upper
outer quadrant of the right breast felt approximately 3 weeks ago. No
associated pain. Patient has history of hidradenitis suppurativa. Gail model
5 year risk estimated at 0.9% with lifetime risk estimated at 8.1%.
COMPARISON: 09/23/2017, 11/21/2016, 11/19/2015, 12/31/2013
MAMMOGRAM TECHNIQUE: Tomosynthesis views of the right breast were obtained.
Computer-aided detection utilizing ICAD reader has been performed.
MAMMOGRAPHIC FINDINGS:
The breasts are composed of scattered fibroglandular densities. Corresponding
to palpable marker is upper outer quadrant of the right breast at middle one
3rd depth are few superficial focal asymmetries which persist on spot
compression views. No defined mass is identified in these regions. In
addition there is an oval 1.0 cm asymmetry in the approximately 8 o'clock axis
left breast middle to posterior one 3rd depth which is only clearly seen on
MLO and ML projections. Both the palpable areas and lower-outer quadrant are
evaluated on ultrasound same day.
ULTRASOUND TECHNIQUE: Multiple real-time grayscale and color Doppler images
were obtained. Images were saved to the permanent record.
SONOGRAPHIC FINDINGS:
Targeted right breast ultrasound was performed.
-At 8 o'clock axis V cm from the nipple is an irregular hypoechoic mass with
indistinct margins, hyperechoic halo, and no significant internal vascularity
measuring 1.4 x 0.4 x 0.8 cm. This is suspicious. It is unclear whether this
corresponds to the oval asymmetry on mammography as this appears more
superficial.
-At 10 o'clock axis V cm from the nipple corresponding to area of palpable
concern is an oval circumscribed anechoic simple cyst measuring 0.5 x 0.4 x
0.4 cm. At the same axis is an immediately adjacent reniform shaped
intramammary node which measures 1.2 x 0.5 x 0.7 cm.
-At 11 o'clock axis VI cm from the nipple corresponding to additional area of
palpable concern is an irregular hypoechoic mass with slightly indistinct
margins and hyperechoic halo measuring 1.0 x by 0.3 x 0.5 cm. This is similar
in appearance to the mass at 8 o'clock axis and is suspicious.
-No visualized right axillary adenopathy.
IMPRESSION:
1. Suspicious masses at 8 o'clock axis and 11 o'clock axis right breast for
which two site ultrasound-guided biopsy is recommended. 11 o'clock axis mass
corresponds to an area of palpable concern per patient. The additional areas
of palpable concern at 10 o'clock axis right breast corresponding to a simple
cyst and adjacent benign-appearing intramammary node.
2. Oval asymmetry on mammography appearing to localize to the 8 o'clock axis.
This may correspond to the sonographic finding which can be confirmed on
postbiopsy mammogram. If it does not correspond then a six-month follow-up
mammogram is recommended as long as the above biopsies yield benign result.
BI-RADS 4: Suspicious
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The two things they are going to biopsy are described with adjectives that are associated with cancer more often than they are associated with benign masses. This does not mean they are cancer but it does mean the biopsy is necessary. The good news is they found no abnormal lymph nodes under your arm on that side.
When they do the bx, they will leave tiny markers at each bx site to show what has been biopsied. The routine mammogram after the procedure will show if one of the clips/biopsy sites corresponds to the mammogram finding they initially described. If it is then fine, if it isn't then it will require further evaluation. If the 2 biopsies come back benign, they will likely look at that other finding in 6 months. If either or both of the 2 biopsies comes back abnormal you will likely have an MRI which will answer the question of the mammo finding at that time.
The lymph node and the cyst they saw in the breast are described with benign adjectives and should not present a problem.
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jobrerry i cannot help you with deciphering the mammo. But the place you had it done sure gets my blood boiling. In this day to have people be so insensitive makes me ponder on the whole outfit. Who do they think they are to behave in this manner? On the opposite they should have asked you if you have someone with you to put you more at ease. Would you have another place where you could go to actually have the procedure done? You could get the CD and reports and go somewhere else, if you live in a big city etc... I once had an encounter with a very cold radiologist while doing the US and I called the main person of the place, and I told them what happened she was very upset, and I told her I better not be paired up w s/o like that again. You are dealing with enough just being there, you don't need this nonsense. (they could had have you go to a different area and explain there, if their excuse is no man allowed)
So you could find out who is the person actually doing this procedure(if you are staying with them), and take if from there. I would want a "light hand" and someone with a beating heart. It does matter, to me at least. I'll follow your outcome, good luck.
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djmammo - thank you for your response and explanation - and my husband says thank you too! Now we just play the waiting game. Thank you again.
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