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Interpreting Your Report

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  • teachermomfl
    teachermomfl Member Posts: 13
    edited January 2018
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    Thank you

  • Lalalovestoread
    Lalalovestoread Member Posts: 2
    edited January 2018
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    Djmammo, I had a mammogram and ultrasound yesterday and I just got the results. It seems like all is well, except I am confused about something the radiologist said when he came into the room as I was getting the ultrasound. He mentioned some debris in the dilated ducts. Now as I am reading the report, I don’t see any mention of debris. Why is that? Is the “ lobular nodule” he saw on the mammogram actually a cluster of cysts? Thanks sooo much for taking the time to help me understand!Here is the report...

    DIAGNOSTIC BILATERAL MAMMOGRAMS AND LIMITED BILATERAL BREAST ULTRASOUND.

    INDICATION: Left breast nipple discharge.

    COMMENT: Routine mammographic views of each breast. Focal compression and true lateral views of each breast.

    In the central right breast there is a small lobulated nodule. Mildly dilated ducts in the right breast.

    In the left breast there is an asymmetry centrally which disperses with compression.

    In addition to Radiologist interpretation, computer aided detection (CAD) was performed.

    Real-time ultrasound of the breasts was performed with a high-frequency linear transducer. The subareolar and central regions of each breast were imaged.

    In the central right breast is a small cluster of cysts

    measuring 6 mm in longest dimension, likely corresponding to the mammographic asymmetry. There are mildly prominent ducts in the right breast without filling defects.

    In the central left breast, there is a small cluster of cysts measuring 7 mm in longest dimension, corresponding to the mammographic asymmetry seen in this region. No significant dilated ducts are identified.

    IMPRESSION:

    1. Small bilateral cyst clusters.

    2. No suspicious mammographic or sonographic findings.

    ASSESSMENT: BI-RADS 2 - Benign. RECOMMENDATION: Routine screening.



  • djmammo
    djmammo Member Posts: 1,003
    edited January 2018
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    lalapicco24

    yes they are saying the cluster of cysts corresponds to the lobutated (not lobular) nodule on the mammo. Think of a bunch of grapes. Picture a light shining on the grapes casting a shadow on the wall. It will look like one big mass with lumpy borders instead of a dozen or two individual grapes.

    debris in the ducts is quite common and not an abnormality

  • Lalalovestoread
    Lalalovestoread Member Posts: 2
    edited January 2018
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    Thank you for explaining that to me! It’s a relief to know that everything looks benign. You are an angel for helping everyone get answers!!! Thanks again!

    Laura

  • Beatmon
    Beatmon Member Posts: 617
    edited January 2018
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    DJmammo, I saw my onco today , routine visit. He reviewed the muga scan with the halo possible pericardial effusion, pulled up my previous muga and previous cat scan. He felt it was over-read. I have no symptoms and no friction rub. Going to repeat ct in Feb also and of course quarterly muga. I feel ok with his input. Of course I’m to call if any problems. Thank you so much.

  • astyanax66
    astyanax66 Member Posts: 223
    edited January 2018
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    Hi, DJMammo, and thank you for all you do here!

    I had my screening mammogram which showed an area of architectural distortion and microcalcifications. I went back for the diagnostic mammogram and ultrasound. It was frustrating because a) the technician sort of 'scolded' me for reading the screening report, saying "Reading those will scare you," and I found that pretty off-putting (Goodness, my doctor called me to talk about it herself and gladly sent me a copy!) and b) because the radiologist was at a different site than the mammography, there was a lot of test and wait, test and wait as films/notes were sent back and forth. Since then, the results are in--doctor called me and read them aloud and promised to send as soon as she could (the whole region is hard-hit by the flu). All I know is that she said the radiologist of record recommended an MRI since the architectural distortion appears to have "moved" and that my doctor thought going to the 'big town' breast study center was going to give me better results (the small, local hospital cannot do the MRI anyway). I don't know the BIRADS score, but my doctor said "Probably benign, but I concur--let's make sure, given your family and personal history. Everything is being sent onwards." And we have a good working relationship, so I trust her advice. I'm just waiting to hear from the specialist.

    So, can architectural distortions move around? That's interesting! What would that mean?

    Thank you!

  • tmbrogan
    tmbrogan Member Posts: 1
    edited January 2018
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    Djmammo,

    I am wondering if you can help interpret my report.

    At 12 o'clock 4-5 cm from the nipple, there is an amorphous hyperechoic
    nonshadowing area, probably representing an island of fibroglandular
    tissue. This finding corresponds to the area of focal asymmetry seen on
    the comparison mammogram.

    Thanks,

    Traci

  • justcallmeG
    justcallmeG Member Posts: 2
    edited January 2018
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    This is a great post. I just got my hands on my mammogram and MRI reports. I've been having tests since Dec 22. My mammogram was so "normal" that the doctor who read me the results handed me some literature about normal breast pain and told me to come back in a year or something. The radiologist that read the report thought I should have an MRI "based on my family history." My mom survived her multifocal carcinoma (dx at 45) and my great aunt had inflammatory carcinoma. She died from it but I have no idea how old she was. I'm only 35. My MRI report said "there is a focus of enhancement measuring 3mm seen in the posterior upper quadrant of the left breast. This finding probably represents in intramammary lymphnode, however it is not T2 hyper intense (good thing, I think). This is located at 2-3 o'clock 10-12 centimeters from the nipple.

    My symptoms/reasons I am having these tests is are because of pain and itching. More pain than itching lately. The pain extends into my left arm pit. The left feels very different than the right. I also have what looks like a dent in and above my areola.

    Bo-rads cat 3 but an ultrasound has been recommended. I'm going to be asking for biopsies to be done. I've got an appt with a breast specialist on Wed.

    My blood work was normal, so that's great!

    ETA: My breast are heterogeniously dense


  • djmammo
    djmammo Member Posts: 1,003
    edited January 2018
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    astyanax66

    No, AD cannot move around.

  • Raeleanne76
    Raeleanne76 Member Posts: 5
    edited January 2018
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    I made an appointment with my GP to get the results of my biopsy pathology. He said that the results were benign but that they still could not provide a diagnosis. I don't have a copy of the pathology report, but am meeting with my surgeon on next Friday and will get one then.

    I picked up copies of my radiology reports yesterday and this is what they say. Does anyone have any thoughts or feedback? I am not sure what I am reading here, other than the BI-RADS rating.

    Screening Mammogram - Asymmetric/focal Density abnormality seen

    Diagnostic Mammogram - Asymmetry persists. Spiculated margins with no calcifications or architectural distortion

    Ultrasound - Hypoechoic mass with irregular margins and posterior acoustic shadowing, 7mmx3mmx3mm. No increased vascularity. Concerning for malignancy. BI-RADS 4

    Biopsy - Technically successful ultrasound guided core biopsy of a small mass. The report also referred to 4 lesions.

    I wish I had the pathology report, but from what I gather they are saying that they can't say that they actually biopsied the "mass."

    Can anyone give me some insights into what I am reading here?

  • Sara536
    Sara536 Member Posts: 5,937
    edited January 2018
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    Yes, they did: “Biopsy - Technically successful ultrasound guided core biopsy of a small mass."



  • djmammo
    djmammo Member Posts: 1,003
    edited January 2018
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    Raeleanne76

    After the path report is issued, the radiologist compares that report to the images of the biopsy (and earlier studies) and issues an addendum indicating whether or not they feel the pathology diagnosis matches the radiologic diagnosis. A recommendation is then made for you to either come back in a year, come back in 6 months or have the area re-biopsied or removed. Ask for that report.

  • Shaazara
    Shaazara Member Posts: 1
    edited January 2018
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    It seems that a lot of ultrasound reports are very detailed and have a lot of descriptions. I feel like the one I just have didn’t contain a lot of information. The information is does have I don’t understand.



    ULTRASOUND OF LEFT BREAST: 1/22/2018
    Comparison is made to exams dated: 12/28/2017 mammogram -

    5/3/2016 mammogram, 10/24/2012 mammogram, 4/15/2010 mammogram, 2/24/2010 mammogram, and 6/6/2016 ultrasound -

    Real-time ultrasound of the left breast was performed.

    In the left breast, at the 11:00 position, 5cmfn, there is a complex mass measuring 1.7 x 0.4 x 1.2 cm in size. This may be related to a cyst containing debris, however, a breast neoplasm can not be excluded. Recommend ultrasound guided core biopsy.

    No other suspicious finding is identified.



    IMPRESSION: IMPRESSION: SUSPICIOUS OF MALIGNANCY
    BIRADS 4: Suspicious. Left Breast Mass at 11:00, 5cmfn, is suspicious and ultrasound guided biopsy is recommended.


  • djmammo
    djmammo Member Posts: 1,003
    edited January 2018
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    Shaazara

    Bear in mind when you read these reports they are communications between physicians, from consultant to referring physician. The vocabulary is not patient-friendly and it’s not meant to be.

    All masses called “complex” are biopsied. By definition a true complex mass contains both cystic and solid elements.

    Let us know how the biopsy goes.

  • Raeleanne76
    Raeleanne76 Member Posts: 5
    edited January 2018
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    Thank you djmammo. My doctor gave me the summary of the pathology report and he said that it was non-diagnostic. The surgeon has asked to see me again this Friday. I have googled the other words in the radiology reports and it sounds bad to me...

  • loliss1
    loliss1 Member Posts: 1
    edited January 2018
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    I'm new to this site and hope I'm doing this right. I specifically wanted to speak to a radiologist about the ultrasound I'll be getting tomorrow. This is scheduled because a mammogram showed: "there is a small, spiculated mass noted in the upper/outer right breast at the junction of the middle and posterior thirds." It also mentions that my breast tissue is heterogeneously dense. My question is: will the results of the ultrasound specify cancer or will it only show a tumor and the suspicion of cancer?

  • moderators
    moderators Posts: 8,055
    edited January 2018
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    loliss1, this is from our page on ultrasounds (Ultrasound):

    Ultrasound is not used on its own as a screening test for breast cancer. Rather, it is used to complement other screening tests. If an abnormality is seen on mammography or felt by physical exam, ultrasound is the best way to find out if the abnormality is solid (such as a benign fibroadenoma or cancer) or fluid-filled (such as a benign cyst). It cannot determine whether a solid lump is cancerous, nor can it detect calcifications.

    You may also find this page helpful: Tests: Screening, Diagnosis and Monitoring

    Hope this is helpful.

  • MayDayMelK
    MayDayMelK Member Posts: 25
    edited February 2018
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    I got my stereotactic biopsy report and I'm curious. Diagnosis was "Fibrocystic changes including fragments of cyst wall and patchy columnar cell change. Clinicoradiologic correlation is recommended." Does this mean they don't think it was done in the exact spot it needed to be biopsied in? We have a strong family history and I have symptoms that are driving me nuts, leaking and enlargement as well as pain out of nowhere. I don't understand the fibrocystic issues either considering I've been in menopause for 7 years.


  • Giselle20
    Giselle20 Member Posts: 4
    edited February 2018
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    I'm going in for an ultrasound soon, I had noticed a dimple/indent on the outer side of my breast. My doctor said it didn't look serious she did feel a small bump but said it felt/would most likely be a cyst as I just tuned 20 and have lumpy breast that runs in the family. I just wanted to ask if you have ever imaged, seen, or know if a cyst can cause a dimple/indent. Also can I ask for a biopsy on the spot if I want or it looks funny or does my GP have to order one after looking at the results.

    I'm really nervous, the only person in my family who had breast cancer was my mom's sister, luckily she found hers super early. I'm also nervous because in my teens I had like 3 spinal X-ray's to monitor scoliosis and I know that can increase your chances.

  • veeder14
    veeder14 Member Posts: 271
    edited February 2018
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    Hi Giselle20,

    See if it shows up on the ultrasound and whether radiology can determine what it is. If it can't be seen on ultrasound or can't be diagnosed that way you can ask for an MRI which is more detailed. If it looks suspicious then you would probably want a biopsy. Hopefully, it's easy to identify and only a cyst and you won't need further tests.

  • Nikki444
    Nikki444 Member Posts: 4
    edited February 2018
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    I went to the dr because I noticed a dimple/indent on my lower right breast when putting on deodorant. My Dr. sent me for a diagnostic mammogram and ultrasound. The findings of the ultrasound are below followed by the results of the mammo. My biopsy is scheduled for 2.12.1 - I'm just hating the waiting and worrying. Does spiculated usually mean malignant? I'd love to hear feedback.

    Exam: Bilateral mammogram targeted bilateral breast ultrasound, 1/25/2018.

    Clinical History: Area of skin dimpling along the lower inner quadrant of the right breast. Focal pain felt by the patient within the inferior and subareolar left breast. The patient had a prior history of benign right breast needle biopsy.

    Comparison: Comparison was made with prior outside mammograms and ultrasounds dating back to 2014

    Density: The mammary tissue is heterogeneously dense, which may lower the sensitivity of mammography.

    Technique: Low-dose tomosynthesis 3D views were obtained in combination with 2D images. 3-D spot compression image was performed of the right breast as well as a full lateral view.

    Findings:
    Within the inferior right breast at or slightly 5-6 o'clock there is an area of architectural distortion. Additional CC spot compression images suggest that there are 2 spiculated masses within the distortion measuring approximately 2 cm. The oval
    circumscribed mass within the 7:00 position of the right breast was previously biopsied and found to be benign is smaller on today's mammogram. Stable benign-appearing calcifications are noted bilaterally.
    No abnormality suspicious for malignancy within the left breast.

    Diagnostic ultrasound:
    A targeted ultrasound was performed of the patient's right and left breast.

    A left breast ultrasound was performed in the area of focal pain. At 5-6 o'clock, 4 cm from the nipple in the area of focal pain and thickening there is a hypoechoic mass with indistinct margins measuring 0.6 x 0.3 x 0.4 cm. Ultrasound-guided core biopsy
    is recommended. There is no mammographic correlate.
    Interrogation of the left axilla demonstrates normal lymph nodes.

    Within the area of dimpling involving the right breast at 6:00 4 cm from the nipple there are 2 adjacent irregular hypoechoic masses, one within the near field and the second within the far field measuring 1.6 cm in totality. The mass within the near
    field measures 0.4 x 0.7 x 0.8 cm. And the mass within the far field measures 0.7 x 0.6 x 0.8 cm. Both findings appear to be part of the same pathologic process and correlate with the area of distortion on mammography. Other scattered cysts and clusters
    of cysts are noted within the adjacent tissue. The patient has a very complex breast pattern.
    Interrogation of the right axilla demonstrates normal lymph nodes.

    Study Result Impression

    Impression:
    2 adjacent suspicious masses within the right breast at 6:00. Ultrasound-guided core biopsy is recommended of the larger mass.

    Mass within the left breast at approximately 5-6 o'clock 4 cm from the nipple with no mammographic correlate. Ultrasound biopsy is recommended.

    Recommendations:
    Ultrasound-guided core biopsy of the right and left breast
    If pathology yields a malignant entity, breast MRI is recommended due to the complex breast pattern.

    This mammogram was interpreted following analysis with Computer-Aided Detection technology.

    The patient has been notified of the results.

    BI-RADS: (4): Suspicious

    Narrative

    Exam: Bilateral mammogram targeted bilateral breast ultrasound, 1/25/2020.

    Clinical History: Area of skin dimpling along the lower inner quadrant of the right breast. Focal pain felt by the patient within the inferior and subareolar left breast. The patient had a prior history of benign right breast needle biopsy.

    Comparison: Comparison was made with prior outside mammograms and ultrasounds dating back to 2014

    Density: The mammary tissue is heterogeneously dense, which may lower the sensitivity of mammography.

    Technique: Low-dose tomosynthesis 3D views were obtained in combination with 2D images. 3-D spot compression image was performed of the right breast as well as a full lateral view.

    Findings:
    Within the inferior right breast at or slightly 5-6 o'clock there is an area of architectural distortion. Additional CC spot compression images suggest that there are 2 spiculated masses within the distortion measuring approximately 2 cm. The oval
    circumscribed mass within the 7:00 position of the right breast was previously biopsied and found to be benign is smaller on today's mammogram. Stable benign-appearing calcifications are noted bilaterally.
    No abnormality suspicious for malignancy within the left breast.

    Diagnostic ultrasound:
    A targeted ultrasound was performed of the patient's right and left breast.

    A left breast ultrasound was performed in the area of focal pain. At 5-6 o'clock, 4 cm from the nipple in the area of focal pain and thickening there is a hypoechoic mass with indistinct margins measuring 0.6 x 0.3 x 0.4 cm. Ultrasound-guided core biopsy
    is recommended. There is no mammographic correlate.
    Interrogation of the left axilla demonstrates normal lymph nodes.

    Within the area of dimpling involving the right breast at 6:00 4 cm from the nipple there are 2 adjacent irregular hypoechoic masses, one within the near field and the second within the far field measuring 1.6 cm in totality. The mass within the near
    field measures 0.4 x 0.7 x 0.8 cm. And the mass within the far field measures 0.7 x 0.6 x 0.8 cm. Both findings appear to be part of the same pathologic process and correlate with the area of distortion on mammography. Other scattered cysts and clusters
    of cysts are noted within the adjacent tissue. The patient has a very complex breast pattern.
    Interrogation of the right axilla demonstrates normal lymph nodes.

  • djmammo
    djmammo Member Posts: 1,003
    edited February 2018
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    Nikki444

    The descriptions are indeed worrisome. It is good that they are all being biopsied. It is also good that they indicate that the lymph nodes are normal in appearance. Let us know what the biopsy shows.

  • Nikki444
    Nikki444 Member Posts: 4
    edited February 2018
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    will do, thanks for taking a look at the reports.. the waiting is crazy!

  • astyanax66
    astyanax66 Member Posts: 223
    edited February 2018
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    Thanks! Indeed, I was referred to a breast specialist, and she found a lesion after my third mammogram and second ultrasound. Had biopsy and will get results Tuesday. I’m not sure what the general radiologist thought he or she saw, but I’m glad I got another opinion.

  • anb567
    anb567 Member Posts: 2
    edited February 2018
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    Hello! I am hoping for some help interpreting these results. I started feeling pain in my breast and side of body and below breast about a year ago. Dr. said it was a pulled muscle and mostly ignored it. Went to yearly check up with gyno and she said I had Fibrocystic breast disease and recommended an ultrasound. I am 31 with breast implants. I went in today and got an ultrasound and 3D mammo. The radiologist spoke with me and told me I had a score of 3 and should check back in in 6 months time. The gyno however recommended I see a specialist as one of the masses is palpable (I think. I'm honestly not sure if I am feeling a mass or just weird tissue). She said my results were reassuring though. However I see a few things that really scare me. Shadowing and calcification, they are all solid and oviod. I was under the impression shadows and calcification are a bad thing. Why would the radiologist tell me to wait on this? In the report he sounds pretty confident these are fibroandenomas. Do these sound like typical fibroandeomas? Does this seem likely to be breast cancer or am I over reacting?

    I made an appointment with the specialist but it wont be until Feb 14 to go over findings, and I will try to push for a biopsy if advisable and MRI due to density issues. I am having really bad anxiety. I am a young mom. My baby is turning 2 on the 10th of Feb. We just bought our first house and are barely starting to make our way in the world. I"m really not even remotely ready for the big C word. Scared! Many many people in my family have had cancers, so I honestly kind of expected this some day but I guess not today. My grandmother had breastcancer in her 60s and beat it like a champ. She is still around and doing well considering other health issues at 70. The score of 17 percent is also nerve wracking and I am not sure I understand what this means. It seems high to me. Should I get genetic testing? Please any insight while I wait would really really help me. Heck just people to talk to helps. My husband and parents are really worried so I am trying not to bring it up too much, but my mind is spinning. Thank you so much for listening and for having this space to vent. Thank you!



    BREAST BILATERAL COMPLETE Exam Performed at 
    CLINICAL HISTORY: Burning and broad breast tissue.
    COMPARISON: None.
    TECHNIQUE: MLO and CC projections of both breasts including 3-D tomosynthesis images were reviewed.
    Bilateral breast ultrasound was performed for further evaluation.
    FINDINGS: Within the slightly upper inner quadrant of the right breast there is a partially
    calcified mass that has coarse type dystrophic calcifications likely related to an underlying
    fibroadenoma. An ultrasound of this portion of the breast will be performed.
    Otherwise the breast tissue appears unremarkable bilaterally. No abnormal skin thickening is noted.
    There are bilateral subpectoral saline implants.
    <span class="redactor-invisible-space">
    </span>The CADx was reviewed.
    <span class="redactor-invisible-space">
    </span> Right Breast Ultrasound: All 4 quadrants of the right breast including the subareolar region and
    the axilla were imaged. At the 12:00 location, 3 cm from the nipple there is a shadowing
    ovoid shaped hypoechoic mass measuring 1.8 x 1.6 x 0.7 cm.
    This appears to be at least partially calcified and likely corresponds with the mammographic abnormality
    consistent with a fibroadenoma. There is also a well-circumscribed ovoid shaped hypoechoic mass at the 9:00
    location of the right breast, 4 cm from the nipple measuring 0.9 x 0.6 x 1.4 cm. This has well-circumscribed
    borders with increased through transmission. Otherwise the tissue on the right appears normal.
    <span class="redactor-invisible-space">
    </span>Left breast ultrasound: All 4 quadrants of the left breast including the subareolar region and the
    axilla were imaged today with ultrasound. There is an ovoid shaped hypoechoic mass with well-circumscribed
    borders at the 12:00 location of the left breast measuring 1.2 x 0.5 x 0.8 cm. This is just adjacent
    to patient's implant. This is probably benign but will require a 6 month follow-up.
    <span class="redactor-invisible-space">
    </span> BREAST COMPOSITION: Heterogeneously dense / C
    <span class="redactor-invisible-space">
    </span>IMPRESSION: 1. Probably benign masses in both breasts most consistent with fibroadenomas.
    I do recommend a 6 month follow-up ultrasound of both breasts.
    2. The patient will be notified by letter that her breasts are dense.
    <span class="redactor-invisible-space">
    </span>According to the Tyrer-Cuzick v8 breast cancer risk assessment tool, her lifetime risk of developing
    breast cancer is 17.0%.
    <span class="redactor-invisible-space">
    </span>NOTE: 1. A negative x-ray report should not delay biopsy if a dominant or clinically suspicious
    mass is present. 4-8% of breast cancers are not identified by mammography.
    If a clinically palpable mass is present and the patient has dense breasts, a bilateral breast
    MRI should be considered.
    <span class="redactor-invisible-space">
    </span>2. Adenosis and dense breasts may obscure an underlying lesion creating a false negative report.
    False negative reports average 6-10%. In compliance with MQSA regulations and ACR guidelines,
    a letter stating the findings of this exam is being sent to your patient. BI-RADS 3 Dense -- Probably benign,
    Short term follow-up


  • djmammo
    djmammo Member Posts: 1,003
    edited February 2018
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    anb567

    "....partially calcified mass that has coarse type dystrophic calcifications"

    This is a typical description of a fibroadenoma that has been around for a while. They develop calcifications over time but they are macro- (big) not micro- (tiny) calcifications and these big calcifications are big enough to shadow. One of the few findings on a mammogram where you can be certain what it is. It sounds like they feel that there are other FA's present and it is routine to keep an eye on them.

    "I was under the impression shadows and calcification are a bad thing"

    Stop Googling.

  • anb567
    anb567 Member Posts: 2
    edited February 2018
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    Thank you sooooo much Djmammo. I feel so relieved to hear that, its like all the blood suddenly came back into my body. It seems then the suggestion to visit a specialist is probably just over cautious and most likely bc my ob knows I'm an anxious mess. Really you are helping so many people. Thanks for your input!

  • Nikki444
    Nikki444 Member Posts: 4
    edited February 2018
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    My armpit area was very tender and sore during the ultrasound— is this normal

  • lorimsn
    lorimsn Member Posts: 5
    edited February 2018
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    Hi djmammo,

    First of all, thank you so much for posting such helpful information on this site. I am sure that you have helped a lot of people. I was wondering if you could help me understand some results. The physician that came back in to take some more images on my US seemed to have the impression that the findings were leaning toward malignancy. I had a different physician for my core biopsy (had it yesterday) and she seemed to think that it could possibly be a fibroadenoma. I am confused by the differences in opinion. I am providing my mammo and US results below. Which parts are worrisome? I also wanted to mention that I have very significant swelling following the biopsy and a lot of discomfort. Is this normal?

    Impression

    Somewhat vague region of mammographic asymmetry and density in the
    central lower outer right breast with associated abnormal sonographic
    findings----details above. This may represent a somewhat more focal
    region of "fibrocystic" breast tissue versus a degenerating
    fibroadenoma (which is poorly visualized mammographically) though the
    possibility of a malignancy with necrotic degeneration (which is poorly
    visualized on mammography) cannot be excluded. Ultrasound-guided biopsy
    is recommended.

    Visual abnormality of the patient's nipple as detailed above. Surgical
    consultation is recommended.

    Several dilated retroareolar ducts which may be related to the nipple
    abnormality.

    BI-RADS Category 4. Suspicious abnormality. Biopsy should be
    considered. This includes both the mammographic and sonographic
    abnormality in the central lower outer right breast as well as the
    nipple abnormality.

    RECOMMENDATIONS: Biopsy of the mammographic and sonographic abnormality
    in the central lower outer right breast and of the nipple
    abnormality----both detailed above.

    The findings were discussed with the patient following the examination.

    Narrative

    Bilateral diagnostic mammogram (with 3-D tomosynthesis):

    History: Small "bump" on the right nipple with possible discharge.

    Technique: Two views each of both breasts were obtained on 1/25/2018
    the standard mediolateral view of the right breast also obtained.
    Ultrasound evaluation of the retroareolar right breast and of the mid
    anterior lower outer right breast (due to findings on the initial
    images) was also performed. The examination was performed using digital
    technique with interpretation assisted by 3-D tomosynthesis and CAD
    analysis.

    Comparison: Outside screening mammogram from Lincoln County Medical
    Center in Troy, Missouri on 1/3/2013.

    Breast composition: Heterogeneously dense, which could obscure
    detection of small masses.

    Findings:

    There is a small dystrophic calcification in the lateral retroareolar
    right breast.

    There is a region of somewhat vague nodular asymmetry in the central
    lower-outer right breast at the approximate 8:00 position (7 cfn).
    There is otherwise no spiculated mass, parenchymal retraction,
    suspicious calcification, abnormal vascularity or skin thickening
    elsewhere in either breast to suggest malignancy.

    The ultrasound evaluation of the retroareolar and central lower outer
    right breast shows several dilated ductal structures in the right
    retroareolar region, some of which may contain a minimal amount of
    debris. A small calcification is seen corresponding to a small
    dystrophic calcification in the lateral retroareolar region on the
    mammogram.

    The ultrasound of the central lower outer right breast shows a complex
    solid and questionably fluid mass (corresponding to the parenchymal
    asymmetry) measuring approximately 2.8 x 2.7 x 1.2 cm with questionably
    hyperechoic tissue surrounding somewhat irregularly shaped hypoechoic
    components. This may represent a somewhat more focal region of
    "fibrocystic" breast tissue versus a degenerating fibroadenoma (which
    is poorly visualized mammographically) though the possibility of a
    malignancy with necrotic degeneration (which is poorly visualized on
    mammography) cannot be excluded. Ultrasound-guided biopsy is
    recommended.

    In addition, the patient's right nipple was visually examined with a
    small focal "bump" involving the mid distal aspect. This may represent
    an obstructing lesion and may account for at least some of the
    retroareolar ductal dilatation noted above. Surgical consultation is
    recommended

    Thank you so much. I should have the biopsy results Tuesday or Wednesday. I have an appt with a breast surgeon on Tuesday for the nipple abnormality and calcification. Also, the report says possible nipple discharge but I do have a discharge occasionally. It is milky and some times blood-tinged.

  • djmammo
    djmammo Member Posts: 1,003
    edited February 2018
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    lorimsn

    Breast imaging is more observer dependent than other areas of imaging/radiology since every breast looks different, like fingerprints, unlike chests and abdomens that all have basically the same identifiable structures. If you draw a long horizontal time line with "completely benign" all the way to the left and "clearly malignant" all the way to the right, you will find many varying opinions offered by radiologists on those cases that are in the middle of that line, like yours. From the way they describe the finding, it could go either way. No definitely malignant or definitely benign features are described with the exception of the term "dystrophic calcification" which is a benign finding. Let us know what the biopsy shows.