Interpreting Your Report
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Hello. Ive just joined the board as life is coming at me fast. I felt a lump on Tuesday morning and by the end of the day I had a diagnostic mammogram and ultrasound which yielded a report that I can’t seem to attach photos of. I'm 42 with small children and I'm quite shaken. I understand Birads 4c is no joking matter. 80% malignancy rate. Im just curious if there is anything to be gleaned from reading between the lines. I’d like to private message the report. I can’t seem to be allowed to post it.
Adding that the biopsy of three places yesterday gave us a better look at Left Breast 12oclock which wasn't seen on the ultrasound. Radiologist changed her visual assessment from 10% to more like 50/50.
I guess my question is : is there something that typically presents this way, whether benign or malignant. I'm a realist and steeling myself for the worst.
The palpable mass is the huge concern. You are so generous to help all of us who are in the learning curve to end all learning curves. Thank you sincerely for taking the time for this rattled newbie.
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It’s so hard to figure out what your report truly means. I google the words that I don’t know. It’s still hard, as google will truly make us crazy with thinking we have “C”. I have a birads 4b, which I am terrified. I had asymmetry on my mammogram, additional views, spot compression and ultrasound. Every night since last Tuesday I’m researching and it’s causing more anxiety. I am scheduled for a ultrasound guided biopsy the 27th. I have no idea why they chose this type of biopsy? I was told my mass is tiny 3-4mm at 12 o’clock. When google, reading a tiny mass doesn’t mean if it’s “ C” that it’s early. My heart hurts for all of us going through this and there is nothing we can do, but wait and pray for Benign.
I wish everyone the best.
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OK, I just had my first mammogram, I am 40 years old. I had it on 11/15 and got a call on 11/16 wanting more tests on my right breast. I never said anything about my right breast and nipple itching a lot because I just figured it was dry skin and hormones. I find it very coincidental that they want to check that breast and nipple area. I go 11/21 for an ultrasound and I'm very nervous now and can't stop researching and thinking about it. Did anyone have results and symptoms like this and not have breast cancer??
CONCLUSION:
BI-RADS Category 0: Incomplete: Needs Additional Imaging Evaluation
FBREAST COMPOSITION: Heterogeneously dense, which may limit the sensitivity of mammography.INDINGS: Asymmetric densities in the right superior quadrant and right central breast. Additional imaging recommended. No suspicious findings in the left breast.
RECOMMENDATION:
ADDITIONAL MAMMOGRAPHIC VIEWS REQUIRED. RIGHT BREAST
ULTRASOUND RIGHT BREAST beginning here targeting the nipple and right superior quadrant
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hello. I'm new here. I had my breast ultrasound on Tuesday for a lump thats been there since April. I have been nursing since January. I did lots of clogged duct protocol and nothing worked. No pain.I brought it up to OB who brushed me off twice so I saw a different Dr who ordered the US. Waiting to see him to decide what we do from here on Tuesday. The report says "area subjacent to skin line of medium echogenicity." "1.2cm mass at 5 o'clock 3cm from nipple" "nursing suggests possible galactocele" "well defined hypoechoic mass deep in skin line" "further evaluation can be done with aspiration or consideration for 3-6 months follow up ultrasound" "birad 3" so basically I'm aware that nursing can be a factor but I also have a strong family history of bc and I waited 7 months to get it checked out. I am over worrying to push for the aspiration if the Dr would rather wait the 3-6 months?
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"...and there is nothing we can do, but wait and pray for Benign"
- You can stop Googling. I have yet to read an entry here where someone Googled all the words in their report and immediately felt better about everything.
- The best use of Google in my opinion is to research your doctor's credentials on line. Usually you can see where they went to school and what specialized training they have had in the field of breast cancer diagnosis and treatment, if any. I will admit I do this when selecting physicians for myself and my family.
- If anyone on here has found something via Google that made you feel better about your report, I'd love to hear those stories too.
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Was that line in the report " deep IN the skin line" or "deep TO the skin line"? Would make a difference.
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"Did anyone have results and symptoms like this and not have breast cancer??"
Almost everyone. The report is vague and contains no information from which to draw a conclusion of any kind. It's too early to panic. Once again, Googling does not shorten the wait or provide consolation, it only makes people feel worse.
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Over and over I see women literally make themselves sick for weeks over things that don’t appear to be anything very concerning and, in fact, turn out to be nothing. Often they are encouraged in this by other posters on the not diagnosed” forums. I have seen posters urged to push for biopsy of literally a pimple. I have seen women who have definitively had problems ruled out encouraged to seek more and more testing. Drives me nuts..
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djmammo,
It's really great of you to volunteer your expertise here.
You can stop Googling. I have yet to read an entry here where someone Googled all the words in their report and immediately felt better about everything
My assumption would be that people who used the internet to research their report and felt better about it would not be posting this kind of post. Either they wouldn't be on the board at all, or they would be sharing other aspects of their experience, or support for others.
Almost everyone. The report is vague and contains no information from which to draw a conclusion of any kind. It's too early to panic. Once again, Googling does not shorten the wait or provide consolation, it only makes people feel worse.
This is really useful information to know! Most of us have no idea what's in a 'typical' or 'benign' biopsy report. When you get blood tests from the doctor, they usually include a reference for a normal level. We don't get that with a biopsy. It's super helpful of you to provide this context, and now, it will be at least somewhat findable via google searching! Which is great! And someone who uses google to find this forum and reads this post will hopefully feel better.
My understanding is that it's not nearly so clear cut, what people find comforting and makes them feel better. For a lot of us, just being able to share our worries on a forum like this, found via google, can make help. In other cases, maybe it's not a choice between doing restorative yoga in the sunshine and hunched over lonely googling in front of the computer, but a choice between unloading worries on intimates who have their own, or having a cigarette to calm down, etc.
I think it's really beneficial to assume that we are all doing the best we can with the resources (mental, emotional, logistical, financial, physical) that we have, and interact with each other on that basis.
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it is deep "to" skin line
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Salamandra et al
I am aware of the title of this group and who might and might not wish to participate. I am also aware of the title of the individual posts and their contents relating how their experiences on the web have affected them. It is also clear from the posts that discussing their concerns with other members of the forum provides a clear benefit.
To those members who may have been adversely affected by their on line searches for clinical information, I humbly propose the following as alternatives:
1) If you have a report from your doctor that you do not understand ask them to explain it to you. It is their duty and your right to have the results explained to you to your satisfaction and at no additional cost. It is no different than having them explain any other test they order for you. This applies to screening and diagnostic studies, biopsy reports and pathology reports. It is in my personal opinion that it is unethical to allow a patient to wonder what their reports mean and try to predict what may follow.
2) If your doctor cannot explain the findings to you adequately or if you have not yet seen a physician about your symptoms or are uninsured I highly recommend the Susan G. Komen Helpline: 1-877-GO-KOMEN . Having been a member of the board of directors of our local Komen organization I can vouch for the value of this service.
You can discuss the following with a real person on the other end of the line:
- Breast health and breast cancer information,
- Support and counseling to anyone with questions or concerns,
- Information about local organizations and resources near you that may provide financial assistance and other support services,
- Low-cost mammography resources; and
- Educational materials.
Support Groups:
Our Breast Care Helpline 1-877 GO KOMEN (1-877-465-6636) provides free, professional support services to anyone with breast cancer questions or concerns, including men diagnosed with breast cancer and their families. Calls are answered by a trained and caring staff member Monday through Friday from 9:00 a.m. to 10:00 p.m. ET and from 6:00 a.m. to 7:00 p.m. PT. You can also email the helpline at helpline@komen.org.
Our free, 12-week telephone support groups for men with breast cancer provide a safe place for men to discuss the challenges of breast cancer, get information and exchange support. To learn more, call the Komen Breast Care Helpline at 1-877 GO KOMEN (1-877-465-6636) or email helpline@komen.org.
(Here is the address of this site: https://ww5.komen.org/breast-cancer-helpline.html )
(see also: Women's Preventive Services at https://www.hrsa.gov/womens-guidelines/index.html )
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I know I post this often, The Radiology Assistant, but I find it helpful in decoding the US report and the reasoning behind the techs choice in vocabulary. Maybe this may be helpful to others here on this thread. Hopefully that will be the case. Wishing everyone the best.
Bi-RADS for Mammography and Ultrasound
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djmammo it says "deep to skin line"
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I posted this somewhere else but realized it’s not an active thread. I’m back for round three..
History below and my newest MRI which has me confused. It feels very lacking in info compared to my previous imaging place and when I go to several radiology sites it seems like there is descriptive info missing. I’m just a lay person with a medical background and not a dr so I could be wrong lol
ADH Right Dx Aug 17’ after excisional BX within an FA along with Apocrine Metaplasia and CCH and fibrocystic changes.
Had my implants (and a reduction) removed in May 18’ after realizing that the mammos in Feb 17’ ruptured the left which also caused silicone to track to my nodes. Mammo 3/18 picked up their enlarged size. Aprox 2cm x3 at the time. Had US a few weeks later which showed 2.4 cm x3 then an MRI x2 confirmed rupture and nodes now 3cm x3 which prompted the implant removal and reduction. Path from reduction showed ADH also in left now. I decided on a reduction partly because my last MRI had several left breast enhancements with questionable kenetics that we were watching and reimaging in six months (newest MRI) in my lower left inner/outer quadrants. I knew these would be removed in the reduction and it’s looks like I made a wise choice.
Also, recent chest CT shows nodes still quite enlarged and yet they state in this MRI that they’re unremarkable? There are no descriptors on the type of enhancement that I could see other than heterogeneous. No segmental, linear, branching, clumped, etc. I also have a sternal hemangioma listed on two previous MRI and it’s not mentioned here.
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I'm new to dealing with any Breast concerns. Went 11/16 for annual mammogram, thought I'd get the all clear. Instead I was sent for diagnostic mammogram, 3D and us-due to asymmetry in right breast at women's health imaging center affiliated w breast cancer center of excellence. The asymmetry was given all clear when copared to previoous us and mammogram supportedthaat but something was found on the other side of my right breast
My report, it's left me feeling in limbo. Birads 3 back in 6 months "Probably" benign isn't reassuring. I dont even know what they're watching-cyst, lump-Dr just says a "mass"
FINDINGS:
Mammogram:
An asymmetry in the inferior right breast has a similar breast
parenchymal pattern dating back to 2015 on additional diagnostic
imaging with no underlying suspicious findings on spot compression
tomosynthesis views. Findings are compatible with superimposition of
fibroglandular tissue. Due to dense breast tissue, targeted right
breast ultrasound was performed.
Ultrasound:
Targeted right breast ultrasound of the inferior half for the
mammographically detected finding was performed. No suspicious solid
or cystic masses are identified. No sonographic correlate for the
asymmetry seen in the inferior right breast. Incidentally identified
at 8:00, 6 cm from the nipple is an oval, circumscribed, hypoechoic
mass with no internal vascularity and parallel orientation measuring
0.3 x 0.2 x 0.3 cm. This is a probably benign mass.I've talked to my gynecologist, she said she'd be fine waiting 6 months if it were her mammogram but will give me breast specialist referral if that will help me with anxiety. Dr also said nothing she sees in radiologist report jumps out as concerning to her.
I'm not sure what to feel right now about this, I’d appreciate some help understanding this all
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This report looks familiar. Did I respond to this on another thread? PM? Posted under a different screen name?
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yes you did and thank you. It wasn’t a very active thread so I wasn’t sure if it would be seen. I responded to your post. Thanks again for your time on aholiday weekend.
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DJMAMMO - any thoughts on my report?
Here is my report...please help! I've read it 100 times. I wish it was more clear about how many calcifications are seen in left nipple/areolar complex. The sentence after about not seeing any micro calcifications clustered in the RIGHT breast makes me think that they are seen that way it seen on the left breast
If anyone can offer any advice I'd appreciate it! Seriously freaking out...can't sleep..."The breasts are composted of severely dense grandular elements reducing mammographic sensitivity. A few scattered benign appearing calcifications are visualized bilaterally. Several calcifications are visualized within the left nipple and areolar complex. Additional magnification views are recommended. No abnormal microcalcifications are visualized in the right breast. A benign appearing intramammary lymph node is visualized in the superior right breast. The skin appears unremarkable. No abnormal axillary adenopathy is seen. No suspicious appearing masses are visualized in either breast.
Impression: Severely dense breasts. Left breast calcifications within the nipple and areolar complex."
Birads 0
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The information is not specific enough to tell whats going on yet. The magnification views are needed to see the size, shape, and pattern of the calcifications, the number of calcs is of less importance in making a diagnosis. Most calcifications are benign and they dont mention a mass so I would not worry too much until the magnification views are evaluated.
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Thanks djmammo for responding. Do you know if breast feeding can play a part in this?
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Hello,
Can I get some clarity on what I am dealing with? My report is:
Procedure: Mammo Breast Screen Tomosynthesis Bilateral
Computer aided detection was utilized for the interpretation of the digital bilateral screening mammography with tomosynthesis.
Density: There are scattered areas of fibroglandular density. There are benign scattered calcifications. There is a focal asymmetry in the left breast posterior depth at 6:00 position associated with some architectural distortion on 3-D imaging. There is no other areas of suspicious findings.
Impression: Focal asymmetry in the left breast associated with possible architectural distortion.
Recommendation: Targeted left breast ultrasound is recommended.
BI-RADS 0: Incomplete - Need additional imaging evaluation and/or prior mammograms for comparison
Any information is greatly appreciated. I am basically freaking out as a 40-year old woman and mother of two young boys.
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Birads 4/5
I understand the Birads scale and what 4 and 5 are. My mammogram/ sonogram report showed 4/5. There was no designation of 4a, 4b, or 4c, just this 4/5.
Has anyone else encountered this? What's it mean
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Birads 4/5 is not an acceptable designation. It does not exist in the Birads lexicon. It is either 4 or 5.
The designation of a, b, or c with Birads 4 is optional. It is mainly used for internal peer review and as the finding will be biopsied anyway with a B4 designation, they are not clinically relevant. It will either be a cancer or not.
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In my opinion, how sure the radiologist is that something either is or is not a cancer, is only clinically relevant if they tell you NOT to biopsy something.
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Was this study compared to older ones and did they say the finding is new?
Either way, usually AD can be from a cancer, a radial scar, or an artifact related to compression and positioning. The last of those is less likely now with tomosynthesis (3D mammo).
They will take a few more mammo images and do an ultrasound and that should tell them what's going on. Many times nothing is found on either exam and they recheck it in 6 months as a routine. Let us know the results when you can. Too early to freak out.
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Thank you for your response. I'm trying to not be freaked out, but I will admit I am failing at that. I pray that it is nothing. But, as you said, an artifact is less likely with 3D now, and that is what I had. I do hope nothing is found on either exam. I am expecting to set up further appointments this week. I will let ya'll know.
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DJMammo. I’m still on my lymph node issue! I know MRI is outside your realm but... last weeks’ MRI says my lymph nodes are normal on the side I had an ALND? I was under the impression that all nodes are removed in an ALND? Any comment?
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The short answer to your question is no, not all nodes are routinely removed in an axillary dissection. The op report will tell you how many were removed and from which level. The surgical path report will tell you how many were positive out of the number nodes that were removed and sent to path.
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Thanks Dj, I see MRI is in your realm. Sorry for that. Here is a reply you gave me not so long ago:
“That's outside of my narrow field of expertise of breast imaging, I am not sure what is included in the field of view for that exam.”
- When I was asking about the brachial plexus Mri and area of view.
Thanks for clearing things up on the ALND. It would be nice if doctors explained a little more.
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