Interpreting Your Report
Comments
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On my screening Mammogram last week..
I did get called yesterday and scheduled a Diagnostic Mammogram and u/s for next week. I'm a little nervous. :-/ Would the screening report state if they saw something that may be suspicious in left breast?
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Comparison 2/17/12
Findings: The breasts are extremely dense, which lowers sensitivity of mammography. Benign calcifications noted. No suspicious findings in the Right breast. No significant changes in the Right breast.
There is an asymmetry in the posterior Left upper breast, seen only on CC view and projecting in the left lower outer quadrant. There is an asymmetry in the posterior Left upper breast, seen only on MLO view and projecting in the left upper inner quadrant.
IMPRESSION: Incomplete evaluation of the Left breast.
BIRADS ASSESMENT CATEGORY: 0
RECOMMENDATION: Unilateral left diagnostic mammogram; left breast ultrasound.
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Thanks djmammo!
Any clue what geographic shaped means? My best guess is he literally means shaped like a country haha! He used lobular on a prior report. I just know I’m glad I decided to get checked. I did a self exam and thought I felt something. Sure enough, the free Koman mammogram that I signed up for found the mass where I felt it. I had a prior baseline done 4 years prior. My gyn had told me I was good to go for another 5 years and then start going regularly. I just turned 42. Crazy how fast things can change in 4yrs. Anyway, I’m no too too terribly stressed. I know I have no control over the results and I will handle whatever it is.
Bless you for helping so many with this path.
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Hi CarFal21, I'm in the same boat as you, same report with the asymmetry. Going for my diagnostic mammogram and ultrasound tomorrow. I hope you have good news. Let's keep in touch.
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Hi Lovemyfam1, Sure thing. I wish my mammogram was tomorrow! Just want to move on. Hope everything goes well with you too!
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just got the biopsy results. IDC grade II in breast and lymph node. MRI tomorrow and then oncologist following. Terrified it’s moved past the lymph nodes.
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There has been a change on the left but a fairly non-specific finding at this point. The diagnositic will tell you more.
see link below
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When you have your surgery they will take a number of lymph nodes from the axilla and look to see how many are involved. They may also order imaging of chest, abdomen, pelvis etc. These will help them plan treatment.
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Thank you djmammo, I'm not a fan of the word "change" when it comes to a mammogram. :-/
Could it be something as simple as having a mammogram right before menstruation? Hm guess that would affect both breasts though. Trying not to jump to worst case scenarios, very hard for me. Thanks again!
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actually Djmammo I was wondering the same thing
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Thank you for your input. The biopsy showed a poorly differentiated mass. I asked about the hormone receptor status and the MD said it would be done after surgery, will be visiting Moffitt and will probably plan on treatment there, not happy with the local MDs thus far, I was told to “stay off the internet” when I inquired about an MR, 😤
Lynn
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Moffitt is in the Top 10 in the US for such things. Good luck.
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Hi DJMAMMO! I'm 37 and would appreciate your opinion on the below radiology report. I have had two mammograms and both say I have a density rating of D and nothing can be seen.
Ultrasound: "In one area of palpable concern there is a generally hypoechoic smoothly marginated nodule along the implant margin measuring 4 x 1 mm demonstrating shadowing. This questionably could represent localized calcification along the capsule of the implant as the implant reportedly has been present for the last 9 years. Given the presence of this shadowing structure against the margin of the implant, this lesion is not amenable to ultrasound -guided percutaneous core biopsy."
Under "Findings" the report restates the above note, but adds: "This is nonspecific though given the appearance."
Continued...
"In the other area of palpable concern there is an ovoid hypo to anechoic structure having the appearance of a cyst measuring 3 x 3 x 3 mm consistent with highly probably benign finding."
"Assessment category BI-RADS 3-probable benign findings."
Thank you in advance for taking the time to read this and offer your opinion
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Hi DJMAMMO,
I posted 6 months ago and now had a recheck for the 6 month follow up, new reports says this. anything to be worried about? I feel like I am just waiting for something bad to happen instead of being proactive. I did call a specialist to see what they say just to be on the safe side, I have read so many horror stories here. also have history of BC with maternal grandmother.... thanks in advance
The right breast is again composed of heterogenous fibroglandular tissue.
There are stable benign-appearing subcentimeter reniform nodules in the upper
outer right breast. There is a stable small benign-appearing oval
circumscribed nodule in the central right breast measuring 4 mm. No developing
suspicious mass or cluster of microcalcifications are identified. There is no
skin thickening or enlarged axillary lymph node.
Ultrasound of the right breast included the central portions of all 4
quadrants extending to the lateral margin of the upper outer and lower-outer
quadrants. In the 9:30 right breast at 9 cm from the nipple there is a deep
small oval hypoechoic nodule. This has the appearance of a small cyst which
may contain minimal debris. This is benign in appearance and measures 5 x 3 x
4 mm. No suspicious solid or cystic mass is identified in the right breast. No
other ultrasound correlate is identified for the mammographic findings.
Impression:
1. Stable mammographic imaging of the right breast. There are stable small
nodules as above which are again thought to be benign. No ultrasound correlate
is identified for the majority of these findings. In the 9:30 right breast
there is a small cyst likely containing minimal debris.
2. Six-month follow-up mammogram of the right breast is recommended to assess
stability. At that time the patient will be due for bilateral imaging.
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Hi Djmammo,
I am wondering if you would mind giving me your opinion on my recent mammo and US as per below. I have a couple specific questions about them I will post at the bottom. (Thank you in advance!!)
0908-0110 RADM/Mammogram Bilateral
EXAM TYPE: RADM Mammogram Bilateral
HISTORY: Gene RAD-51D Positive. High risk for breast cancer.
COMPARISON STUDIES: Mammogram Feb 8, 2017, December 11, 2015, Ultrasound February 8. 2017
FINDINGS:
Bilateral breasts are compromised of dense fibroglandular tissue which limits the sensitivity to mammography.
In the posterior upper outer quadrant on the right breast is a grouping of microcalficiations that has changed compared to prior mammograms. Magnification views were performed and the calcifications have a suspicious pleomorphic form. On the MLO view, there is subtle architectural distortion centered at the grouping of microcalcifications, which did disappear with spot compression view.
Otherwise, no mass is seen in the right breast.
No mass, suspicious microcalfications or architectural distortion in the left breast.
IMPRESSION:
Suspicious grouping of microcalfications in the upper outer right breast. Targeted ultrasound is recommended for further assessment. If no corresponding lesion is seen on ultrasound, I would recommend stereotactic guided biopsy.
BI-RADS 0
Report was generated in voice recognition system.
0609-0527 US/Breast Right
EXAM TYPE: US Breast Right
HISTORY: RAD 51D GENE POSITIVE ANNUAL SCREENING ADVISED
COMPARISON: Previous bilateral mammograms August 9, 2018
FINDINGS: Ultrasound of the upper outer quadrant of the right breast was performed. There is a cyst noted at 10 o'clock radian 6cm from the nipple with thin internal septations without flow. This measures 8 x 5 x 7 mm. No solid component are identified in the cyst. This cyst is seen corresponding to the palpable abnormality indicated by the patient.
IMPRESSION: Slightly complex cyst is noted in the right breast 10 o'clock radian 6cm from nipple. This does not require biopsy or follow-up. The pleomorphic calcifications described in mammogram would be best biopsied with a stereotactic technique and this should be organized.
BI-RADS: 4B (Moderately suspicious for malignancy)
BI-RADS: 4B: Referred to Virtual Breast Clinic
My questions:
What is "subtle architectural distortion centered at grouping?" and what significance is it if it disappears or not with the compression view.
Why is the mammo Bi-Rads 0 when the ultrasound is Bi-Rads 4b?
What are thin internal septations without flow?
This same cyst has grown since this ultrasound, and I have had a total hysterectomy (2011). What makes this a slightly complex cyst?
When my doctor read the no follow up piece, he laughed and said that was ridiculous and immediately called a breast surgeon to book me an appointment. His opinion is it should be removed. Not that you can give an opinion on that, but I am curious on any of your thoughts of the above.
THANK YOU so much, DJmammo!
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What is "subtle architectural distortion centered at grouping?" and what significance is it if it disappears or not with the compression view.
"subtle architectural distortion centered at grouping" = "Kinda looks like a cancer near those calcifications, but maybe not"
significance is it if it disappears or not with the compression view: if it stays = probably real finding; if it disappears=may not be a real finding
Why is the mammo Bi-Rads 0 when the ultrasound is Bi-Rads 4b?
B0 because the report contained a recommendation for US which at that moment was not performed yet so technically still "incomplete" at that time.
What are thin internal septations without flow?
Some cysts have septations . no flow=most likely benign . +flow = suspicious
What makes this a slightly complex cyst?
the septations without flow but the correct term would be "complicated" for just septations. A cyst containing solid elements is called "complex". Ask them which term they meant to use.
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hi. I have a fine needle aspiration biopsy scheduled but am hoping for some insight on my radiology results. I had a diagnostic mammogram and an ultrasound, and was told that this showed up on both.
Palable mass
10 to 11 o'clock position, 17.0mm irregular structure, dense breasts and/or mass. Surgical consultation recommended. Biopsy recommend. 9 o'clock position prominent duct.
Bi-rads 4
17.0mm maximum diameter hypervascular hypoechoic area in area of palable interest for which biopsy may be necessary to exclude malignancy.
Thanks for your help!
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Dj
Thanks DJ, that really clears it up! I hope you have a great day!
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Not a lot to go on in this rather abbreviated report from your mammogram and US. What little is said is suspicious and a biopsy is a reasonable recommendation considering the wording.
Personally I prefer to do core biopsies rather than an FNA's.
Let us know what they find.
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Hi DJMAMMO! I'm 37 and would appreciate your opinion on the below radiology report. I have had two mammograms and both say I have a density rating of D and as a result nothing can be seen.
Ultrasound: "In one area of palpable concern there is a generally hypoechoic smoothly marginated nodule along the implant margin measuring 4 x 1 mm demonstrating shadowing. This questionably could represent localized calcification along the capsule of the implant as the implant reportedly has been present for the last 9 years. Given the presence of this shadowing structure against the margin of the implant, this lesion is not amenable to ultrasound -guided percutaneous core biopsy."
Under "Findings" the report restates the above note, but adds: "This is nonspecific though given the appearance."
Continued...
"In the other area of palpable concern there is an ovoid hypo to anechoic structure having the appearance of a cyst measuring 3 x 3 x 3 mm consistent with highly probably benign finding."
"Assessment category BI-RADS 3-probable benign findings.”
Should I be concerned about the shadowing and does the hypo to anechoic mean the cyst is complex?
One radiologist recommended an MRI. Just trying to understand and decide what I should do/request
Thank you in advance for taking the time to read this and offer your opinion.
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Amazing help you provide here djmammo, hoping you can give me some insight.
Four years ago - normal mammogram.
Recent screening mammogram call back for an ultrasound to address a focal asymmetry. After the call back appointment was made - of course - I felt around a bit (well probably more than a bit - poor boob) and I found a lump in my nipple area (belowish)? Never occurred to me to look there. I called back to the nurse navigator and asked what quadrant the asymmetry was in and she told me it was in my nipple/aereola, exactly where I located the "oddness". She didn't have any text but could see the area indicated on the screen. She was very sweet and told me that call backs happen all the time and that I shouldn't worry too much. She said that the radiologist would tell me everything I needed to know (and I could call her back for the exact written report if I wanted).
To situate - I am 54 perimenopausal (still have fairly regular periods...grr) - so could be a benign duct issue?
Any thoughts?
Lori
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Hi again djmammo,
I just received results from my Diagnostic Mammo with U/S, hoping you could clear a couple things up if possible. I'm 40 yrs old.
It states:
Breasts are Heterogeneously Dense, which may obscure small masses. The asymmetry in the upper left breast persists on compression. No dominant or spiculated mass, clustered pleomorphic microcalcifications, skin thickening or nipple retraction.
LEFT BREAST ULTRASOUND: There is no cystic or solid mass lesion. There is a 8x7x4 mm well-circumscribed hypoechoic lesion in the 1 o'clock position 1-2 cm from the nipple which is stable in comparison with the prior examination. This correlates with mammographic findings.
IMPRESSION: Benign Findings BI-RADS 2, RECOMMENDATION: Annual Screening Mammogram
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My questions are... In my 2012 report, this particular lesion was called a Cyst. What is a hypoechoic lesion in comparison to a cyst?
Also, my screening mammogram was done in 3D, the Diagnostic one I had today was done in 2D (with an ultrasound). Is this just as reliable as the 3D Mam?
I'm just having trouble adjusting my thinking to "everything might be OK" for now. :-) Thank you for your help and time.
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Hi DJMAMMO! I'm 37 and would appreciate your opinion on the below radiology report. I have had two mammograms and both say I have a density rating of D and as a result nothing can be seen.
Ultrasound: "In one area of palpable concern there is a generally hypoechoic smoothly marginated nodule along the implant margin measuring 4 x 1 mm demonstrating shadowing. This questionably could represent localized calcification along the capsule of the implant as the implant reportedly has been present for the last 9 years. Given the presence of this shadowing structure against the margin of the implant, this lesion is not amenable to ultrasound -guided percutaneous core biopsy."
Under "Findings" the report restates the above note, but adds: "This is nonspecific though given the appearance."
Continued...
"In the other area of palpable concern there is an ovoid hypo to anechoic structure having the appearance of a cyst measuring 3 x 3 x 3 mm consistent with highly probably benign finding."
"Assessment category BI-RADS 3-probable benign findings."
Should I be concerned about the shadowing and does the hypo to anechoic mean the cyst is complex?
One radiologist recommended an MRI. Just trying to understand and decide what I should do/request
Thank you in advance for taking the time to read this and offer your opinion.
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In my 2012 report, this particular lesion was called a Cyst. What is a hypoechoic lesion in comparison to a cyst?
A cyst is a hypoechoic lesion like an automobile is a vehicle with 4 wheels. Its a category of things that include cysts.
Also, my screening mammogram was done in 3D, the Diagnostic one I had today was done in 2D (with an ultrasound). Is this just as reliable as the 3D Mam?
3D is a screening tool. No need for 3D if you have already located a target to examine further. Not sure you can acquire a 3D set of images when the breast is in compression for spots or mags.
I'm just having trouble adjusting my thinking to "everything might be OK" for now.
Statistically it is the more likely conclusion.
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Should I be concerned about the shadowing
Calcifications can shadow on US. If they are big enough to shadow on US they an be seen on the Mammo no matter how dense your breast tissue. If your implants have surface calcification it should be visible on the mammo and in the mammo report. It is usually smooth like an egg shell, but they describe a very small nodule. There needs to be a comparison of the two studies focused on that finding.
One radiologist recommended an MRI.
The ins company will need a reason for you to have one and that reason is usually put forth in the report. An MRI wouldn't hurt to exclude a decent size cancer but not sure it will be able to evaluate something that small (4 x 1mm). If it is a calcification it will show up as a very very small black dot set against a thin black line along the surface of the implant on most sequences. The 3x3mm cyst will show up as an equally unimpressive white dot on T2 images.
...and does the hypo to anechoic mean the cyst is complex?
anechoic means no echos at all like a simple cyst, only fluid. Hypoechoic means there are some internal echos but it is a neutral term not meaning good or bad: A complicated cyst can have debris and septations and still be benign. A complex cyst has fluid and solid elements and is looked at with more suspicion especially if the solid elements demonstrate internal blood flow.
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Djmammo, Thanks so much :-)
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Thank you so much for taking the time to answer my questions. Unfortunately, I now have more...
1) Can calcifications be felt? I ask because I can feel this particular nodule. It's hard and pointy.
2.) Both radiologist said they cannot see anything on the mammo due to my dense breasts. Based on what you stated, they should have been able to see the calcifications on the mammo. Would that indicate that it is not calcification?
3.) My insurance is willing to pay for the MRI, but if it will be too small to pick up, what other options do I have to figure out what this is?
4.) I don’t recall them checking for internal blood flow on the second US. I also have copies of the photos and they didn't save any. Aside from having a third ultrasound how would I find out if it was complex or complicated cyst?
Thank you again
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Hi,
I just had a quick question about clip placement during biopsy.
On my MRI images, the clip placed during my ultrasound guided biopsy is a good centimeter below the actual tumor.
Are they typically placed adjacent to the lesion or is this more likely a result of clip migration? I had the MRI a little less than a month after the clip was placed.
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