Interpreting Your Report
Comments
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Hi djmammo:
Thanks for the reply. Yeah in hindsight I wish I had gone to the facility I had the first MRI at, just for my sake so I would have a good comparison. That facility was an outside facility though so when my doctor put in the new MRI order it just automatically went to their in house facility and they called me to set up the appointment. I just hope that if it poses a problem for the radiologist they will call me back for more imaging. Maybe they will do another before the surgery.
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Hello My name is Linda and I just had my first mammogram done and I was asked to return for more testing. I have attached my first results - may you please tell me what it means. I have been reviewing all the possibilities online.
Thank you and much appreciated
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Dear lindapineda05,
Your mammogram results do not show up in your post. Did you include them as an attachement. It is not possible to add links on your initial post. Can you tell us a bit about what your mammogram showed. The Mods
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djmammo,
Bless you for doing this. You are giving your time and knowledge to scared women knowing we can't give you anything in return butour gratitude.
Thank you for being so selfless.
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Hello,
This is my first time posting, although I have been visiting the forums a lot, reading posts and getting valuable help and information. Last week I had incisional biopsies performed on both breasts. I had been having discharge from both breasts since April, despite a 3D mammo that came back normal. An ultrasound turned up a mass in one breast and an MRI turned up a mass in the other. The pathology results came back after the surgery, and the mass in the right breast was a benign intraductal papilloma. On the left, this is what it said:
Fibroadenoma
Usual Ductal Hyperplasia with focal areas of intraductal papilloma
I’m not sure what the second line means, and my BS was in too much of a hurry to explain it to me. She said they were benign results, about which I rejoice, but that I would need to be followed closely, and see her in three months. Can someone explain how focal areas of papilloma differ from an actual papilloma? Was this area of hyperplasia associated with the fibroadenoma or was it separate? Any help would be appreciated!0 -
Hello - I am terrified and would appreciate so much any feedback on my report. Having a biopsy 9/13. Thank you.
HISTORY: Abnormal mammogram. Asymmetry and possible architectural distortion in the upper outer quadrant. TECHNIQUE:
Unilateral digital diagnostic mammography with tomosynthesis of the left breast was performed. Computer aided detection(CAD) was applied.
Focused left breast ultrasound was performed.
COMPARISON:
Comparison has been made to previous images.
FINDINGS:
There are scattered areas of fibroglandular density.
Upon additional views, there is persistence of the asymmetry in the upper outer quadrant. This area demonstrates possible architectural distortion that does not completely efface with compression views.
Targeted ultrasound evaluation of the upper outer quadrant demonstrated normal tissue planes without a sonographic correlate to the mammographic finding.
IMPRESSION:
Left breast assessment:
Suspicious. Asymmetry with possible architectural distortion in the upper outer quadrant.
Stereotactic core biopsy is recommended.
I discussed these findings and recommendations with the patient following the exam. I reported these findings and recommendations to [Maureen Holman] by epic inbox messaging as well as by telephone messaging service on [ 8/22/2018] at [4:30 PM]. The
patient will be scheduled for stereotactic core biopsy by the biopsy coordinator.
OVERALL BI-RADS CATEGORY: 4B Suspicious; subcategory- Moderate suspicion for malignancy.
This notice contains the results of your recent mammogram, including information about breast density. If your mammogram shows that your breast tissue is dense, you should know that dense breast tissue is a common finding and is not abnormal. Statistics
show many women could have dense or highly dense breasts. Dense breast tissue can make it harder to find cancer on a mammogram and may be associated with an increased risk of cancer. This information about the result of your mammogram is given to you to
raise your awareness and to inform your conversations with your physician. Together, you can decide which screening options are right for you, based on your mammogram results, individual risk factors or physical examination. A report of your results was
sent to your physician.
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Thank you for your response. I do have dcis,and she couldn't remove it all with the lumpectomy she said its roughly 8cm . I meet with the genetics dr Monday,Tuesday with the surgeon and oncologist then also the plastic surgeon. They are suggesting a mastectomy. I am pretty sure I don't want reconstruction at all. I dont just want to have one breast,I have to ask if I can have the other one removed as well. That one is just high risk. It's all so scary and I am having a hard time with it all.
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In my experience, if a mammographic abnormality is evaluated with US and no mass is seen, this decreases the possibility that the finding will be significant cancer, but it does not decrease it to zero. The fact that they want to do a stereo biopsy means there is nothing on the US they can use for targeting. Let us know what the biopsy shows.
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Djmammo, I sent you a PM with the report you asked for. I’m not very good at posting such things. Hope it comes through okay.
Estella
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Thank you for your time. I will let you know.
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DJmammo
I looked through this whole thread before posting. Thank you for being available to answer these questions! I have never asked for advice like this before. I am feeling very uneasy about my recent mammogram for two reasons: 1- my husband just finished 4 years of treatment for an acute leukemia and we are still dealing with aftermath and 2- I felt unsettled after talking with the radiologist who just gave off a strange vibe, like there was something I needed to worry about. Any advice is greatly appreciated! I guess I just want to know what the potential outcomes of this may be. I am scheduled for a biopsy in 2 weeks. I am 35. Family history of two aunts (both paternal) with breast and ovarian cancer. Here are my results (copied and pasted with identifying info removed):
IMPRESSION:
Indeterminate grouping of calcifications at the 12:00 position of the left breast. Stereotactic/tomographic biopsy recommended.DENSITY: The breast tissue is heterogeneously dense, which may obscure a mass. The breast tissue is unchanged in pattern and distribution since the prior study.
FINDINGS: There is a 16 x 10 x 14 mm grouping of pleomorphic calcifications located approximately 6 cm superior to the left nipple along the 12:00 radian. The calcifications are located at the superficial margin of the fibroglandular tissue. There are scattered isolated punctate calcifications randomly distributed throughout both breasts. The calcifications in the grouping looks different than the calcifications located elsewhere. There are no suspicious masses, microcalcifications, or areas of architectural distortion present in the right breast.
ULTRASOUND: Targeted whole breast ultrasound of the left breast was performed. The breast tissue is homogeneous. No solid masses, cysts, or sonographically suspicious findings are seen. Occasional echogenic punctate calcifications are seen. No specific grouping or cluster of echogenic punctate calcifications are equivocally seen to correspond to the grouping seen on the mammogram.
On physical examination, no specific palpable lump is appreciated in the superior left breast in the expected region of the calcifications seen on the mammogram.BIRADS Category 4 - Suspicious Bilateral Recommendation: Biopsy 0 -
They saw no mass so that decreases the odds of having an invasive cancer, so its down to the calcifications. The scattered punctate ones we are not worried about. The grouped calcifications are described as pleomorphic (different sizes and shapes) so these are the ones we worry about. Depending upon other features of their appearance, it could represent anything from benign fibrocystic changes to DCIS.
I am assuming you will be having a stereotactic biopsy. If the biopsy shows DCIS they may do an MRI prior to a lumpectomy to remove the calcifications and look for any evidence of invasive disease in the specimen.
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Thank you so much for your thoughts on this! I feel better after hearing this. It's a relief that my odds of invasive cancer is decreased. I wasn't sure what to make of that with the statement that the dense tissue can obscure a mass. Yes, I will have a stereotactic biopsy. Thanks again for your input!
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I would appreciate any feedback on this report. I will be having a stereotactic breast biopsy this week. Wondering also if the mentioning of the lymph node means anything substantial in this report. Of course worrying as I am waiting.
INDICATION FOR EXAMINATION: R92.8: Other abnormal and inconclusive findings on diagnostic imaging of breast. 49-year-old female returns for further evaluation of bilateral breast findings on outside screening mammogram.
MAMMOGRAM
TECHNIQUE: 2-D and 3-D tomosynthesis images of both breasts were obtained in the spot compression CC and MLO projections. Computer aided detection (CAD) was used to assist in the interpretation of the 2D mammogram.
BREAST COMPOSITION:
The breast tissue is composed of scattered fibroglandular densities.
FINDINGS:
RIGHT BREAST: There is architectural distortion at the 3:00 position, middle third, best seen on CC spot compression image 31 and MLO spot compression image 43.
LEFT BREAST: There is a persistent 7 mm oval mass in the medial anterior aspect of the breast. A 7 mm oval mass is also visualized in the inferior breast, at the approximate 6:00 position, anterior to middle thirds.
ULTRASOUND
TECHNIQUE: Real-time grayscale and color images were obtained and are reviewed. The breast(s) was/were scanned in its/their entirety including all four quadrants and the axillary, supraclavicular and parasternal region(s).
FINDINGS:
RIGHT BREAST: There is no sonographic correlate for the area of architectural distortion on mammogram. The radiologist also scanned the region of interest.
There is a 9 mm superficial lymph node at the 8:00 position 9 cm from the nipple.
There is subareolar ductal dilation. The axillary, parasternal and infraclavicular regions are unremarkable.
LEFT BREAST: There is subareolar ductal dilation.
A 5 mm cyst at the 6:00 position 3 cm from the nipple likely corresponds to the mass in the inferior breast on mammogram.
A 7 x 5 x 4 mm cyst cluster at the 10:00 position 3 cm from the nipple likely corresponds to the mass in the medial breast on mammogram.
There is subareolar ductal dilation. The axillary, parasternal and infraclavicular regions are unremarkable.
ASSESSMENT:
BI-RADS CATEGORY (4) suspicious. Biopsy should be considered.
RECOMMENDATIONS:
Right 3D stereotactic breast biopsy of the architectural distortion in the medial aspect of the breast.0 -
"Wondering also if the mentioning of the lymph node means anything substantial in this report."
We have to report everything we seen normal or abnormal and the size of the lymph node is fine so no real significance unless it was seen on the Mammo and the US finding of a LN explains it.
Arch. distortion without a corresponding mass on US may indicate a "radial scar" which is overall a benign finding but is removed due to a small malignant potential. Let us know what the path report shows.
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Hi djmammo:
I was just curious if you know if bone scans ever find lesions that a PET/CT has not detected.
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Great article with scans to compare. Thank
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Reporting back for others in the future with similar situations to mine... I asked a few days ago whether microcalcs can grow back, because mine appeared to between my stereotactic and incisional biopsy.
The biopsy results were negative, calcs within benign ducts, fibrocystic changes, etc.. Good news!
The surgeon said she didn't remove the radial scar, just confirmed that it was a radial scar, which I was confused by, but the language was almost identical to the first biopsy report and all benign findings.
Hopefully the full report doesn't have anything surprising in it... I'm almost hesitant to believe the surgeon until I see it for myself! DJ, thanks again for your opinion.
Tina
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djmammo:
Thanks for the link.
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Any insight you could give me on this very vague report would be greatly appreciated. Thank you djmammo!
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djmammo, I read on another thread that someone has had a biopsy made by a technician rather than the radiologist who originally found something suspicious. I've always had it done by the radiologist themselves immediatly (for diagnostic mammos). Makes sense to me that a radiologist would want to personally complete the job rather than have someone less trained poking around. Am I just spoiled? Thanks
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djmammo,
A little background: I found a lump approx. 3 months ago now and thought it was scar tissue from a reduction in 2007 or possibly a cyst that would go away on its own. Obviously it did not so I went to see my GP for a clinical exam and she scheduled me for a mammo/US to find out what was going on. In addition to the lump, there is a dull ache in my armpit that radiates into my shoulder/neck area and occasionally down my arm. I've convinced myself it's from this lump that is putting pressure on my nerves
I am anxiously waiting on my US guided biopsy appointment and trying my hardest to steer clear of dr. google. I would like you opinion on my diagnostic mammo and US (mostly to help calm my nerves) should I be concerned? Are my findings leaning towards the benign or malignant side? I'm convinced it's nothing serious but I want to be prepared in the event that it is. Thank you in advance!
Report Text: CLINICAL HISTORY:
Baseline mammogram.
35-year-old female with a palpable area of concern in the
right breast and right axillary tenderness.MAMMO DIAGNOSTIC TOMO BILAT: August 24, 2018 - Accession #:
0109-18329517 2D/3D Procedure 3D views: Bilateral MLO and CC view(s) were
taken. ML view(s) were taken of the right breast. 2D views: Bilateral MLO and
CC view(s) were taken.Comparisons: No prior studies available for comparison.
Findings: The breast tissue is heterogeneously dense, which
could obscure detection of small masses.MAMMOGRAPHIC FINDINGS: In the right breast, 10 o'clock
position, 7.3 cm from the nipple, middle depth, there is isodense, oval mass
with circumscribed margins measuring 4.0 cm. In the right breast, 6 o'clock
position, 5.0 cm from the nipple, middle depth, there is low density, oval mass
with circumscribed margins measuring 2.7 cm. In addition, there are multiple
bilateral round and oval circumscribed masses consistent with cysts or
fibroadenomas. No other suspicious findings are identified.SONOGRAPHIC FINDINGS: In the right breast, 10 o'clock
position, 6 cm from the nipple in the patient's palpable area of concern, there
is complex cystic and solid oval mass with circumscribed margins measuring 2.8
x 3.6 x 1.5 cm. The mass demonstrates parallel orientation, combined pattern
posterior features, and no internal vascularity on color Doppler images. In the
right breast, 6 o'clock position, 5 cm from the nipple in the patient's
palpable area of concern, there is complex cystic and solid oval mass with
circumscribed margins measuring 2.1 x 1.0 x 3.2 cm. The mass demonstrates
parallel orientation, no posterior features, and no internal vascularity on
color Doppler images. Targeted ultrasound of the right axilla in the patient's
area of pain demonstrates a benign-appearing lymph node. No suspicious
findings.IMPRESSION: Patient's palpable areas of concern in the right
breast, 10:00 position, 6 cm from the nipple and 6:00 position, 5 cm from the
nipple demonstrate a mildly suspicious complex cystic and solid mass. Recommend
ultrasound-guided biopsy for further evaluation.ACR BI-RADS Assessments: Suspicious (BI-RADS 4) (Overall)
Diagnostic Tomo: Suspicious (BI-RADS 4) abnormality.RECOMMENDATION: Ultrasound guided biopsy of the right breast,
2 sites. The patient was provided a written summary of findings and
recommendations prior to discharge. Findings and recommendations were also
discussed with the patient.Notes: 35 yo female
v/r,
with palpable tender mass right lateral breast at 6 oclock, sp right axillary
painTosh
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Techologists do not perform biopsies. If someone who was not a physician did your biopsy it was likely a Radiology PA or RPA. They serve the same purpose as a physician extender as other PA's. They now do most of the fluoro GI studies, arthrograms, myelograms, and some biopsies. They are specifically trained for this role.
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Thank you djmammo! Good signs are the kind I like
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djmammo I was only told that the radiologist believes it to be benign because they don't see a vessel feeding it and to come back every 6 months for two years to monitor it. The US tech did all the talking to me. She said fibroadenomas grow and shrink but couldn't answer why mine is growing and not shrinking. Is hypoechoic normalfor a fibroadenoma?
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FA's can vary in echogenicity. Some demonstrate vascularity on Doppler and some don't but they all have a blood supply and they can grow even though benign. The shrink when they are old and lose their blood supply at which time they develop large benign calcifications.
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