Interpreting Your Report
Comments
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Pretty sure they will sample your nodes at the time of the mastectomy. They will then do serial sections of the breasts to see if there are any areas of invasive disease and adjust your treatment accordingly.
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amacmec, I have had two melanomas AND breast cancer. Both my melanomas were in situ, caught early. But there is apparently a connection between skin and breast cancer -- people who get skin cancers are more prone.
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Thank you for the article link. It was very helpful and comforting.
I received the results from my US Guided Core Biopsy via my pathology report. It reads:
Clinical Data/History: Left breast, 10 o'clock 1.6 cm mass has history of melanoma diagnosis 12/2018.
Final Pathological Diagnosis:
Hyalinized fragments of benign Fibroadenoma with associated fibrocystic change. Negative for atypical change. Correlation with clinical and mammographic features is suggested.
Gross Description:
Specimen measured 1.5X.6X.2cm, inked black
Microscopic Description:
Cores are inked black. There is fibroadipose breast tissue with hyalinized fibroadenoma with fibrocystic change.
I'm very relieved by the results, but while I have a general understanding of what a fibroadenoma is, I can't find much information on what the term hyalinized means. Could you shed some light on that term?
I'm scheduled for a follow up ultrasound in 6 months. Is that too long for a follow up? Should I schedule a follow up for 3 months? The reason I ask is because I'm on a 3 month follow up schedule with my dermatologist to examine me for any moles that could be melanoma.
Thank you!
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Thank you for the simple explanation! I truly appreciate it!
Now that I'm over 40, when I hear creaking in my knees or an ache here and there, I joke with friends that I'm getting old. The result of the biopsy, with the old fibroadenoma, confirms it. Lol!
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Hello, I am unsure of what to make of the report regarding my left breast. While I do have an ultrasound appointment for this week I have been waiting for a call from my doctor to explain this further. The waiting is killing me. I appreciate any help. Thank you.
Procedure: MAMMOGRAPHY SCREENING BILATERAL W SCREENING TOMOSYNTHESIS
History: 40-year-old female who is asymptomatic.
Comparison: None
Findings: Bilateral 2-D and 3-D CC and MLO views were obtained.
The breasts are composed of scattered fibroglandular and fatty tissue. There are 3 masses in the posterior depth of the upper outer quadrant of the left breast. They measure 8 mm, 12 mm, and 15 mm. They are located between 7 and 12 cm from the nipple. There are isodense and have slightly lobulated circumscribed margins. There is no suspicious associated distortion or calcification. Targeted ultrasound is recommended for further evaluation.
No suspicious masses, calcifications or areas of distortion are seen in the right breast.
Impression:
1. Incomplete evaluation of the left breast, targeted ultrasound is recommended. We will call the patient perform the additional study and issue a final report.
2. Right breast negative for malignancy.
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Hi all,
I am freaking out. I am a new mom and was referred to ultrasound due to lumps in breast 6 months ago. I have had breast surgery in 2012 to remove a fibrodema.
The ultrasound came back with inhomogenous poorly defined irregular Hypoechoic nodule with some degree of posterior acoustic shadowing. This nodule is taller than wide. All red flags but birad was 0
I was referred to mammogram and the report says its a coarsely calcified fibrodema. No other dominant masses or significant calcifications or soft tissue distortion is seen. I was asked to follow up in 6 months.
I just got another ultrasound done and the mass is still there. Birad is 0 and another mammo suggested. Doc refuses mammo as I just had one 6 mnths ago. No change in size of mass though.
I have another appt with gp tomm, and i m scared out of my mind. I do not want to wait another 6 months. I have tried googling coarsely calcified fibrodema but dont get clear answers. Anyone knows what this is? Is it beingn? I am in Canada, and getting a specialist appt can take ages and I am freaking out. Pls help.
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Hi there I'm new here and hoping you can ease some anxiety for me while I await a call from my Dr.
Almost 41 years old, huge family history of BC (my mom was first diagnosed at age 41, and has had it twice, not a recurrence, and my grandmother also had BC) My mom is NOT positive for BRCA
I had a mammogram and was sent for a follow up and ultrasound that revealed the supsicious area was likely a lymph node. A visit to my specialist confirmed it, but she said to ease my fears I could start having yearly MRIs in addition to my mammograms. I went for an MRI last week and have yet to hear from her about the results but did look into my chart in the online portal and it appears she ordered an MRI Guided Biopsy of the Left Breast. I realize I need to actually talk to her but here's my original mammogram report... can you shed some light? I hate the "probablys" and the "Birad 3" sounds scary to me, and now with the whole biopsy thing I found.... ???
Thank you so much.
CLINICAL HISTORY: Additional imaging left breast for abnormality questioned on recent screening study.
COMPARISON: Additional imaging is obtained as a follow-up to the recent
screening study of 2/19/2019. Other mammograms are also reviewed of June 2015.
COMMENT: On that recent screening study, there was a nodular density in the
posterolateral left breast demonstrated on the craniocaudal view with possible
correlate on the left oblique view. Today a left lateral view was obtained
along with craniocaudal and oblique spot compression views. Additional imaging
utilized 3-D tomosynthesis.
Heterogeneously dense parenchyma is redemonstrated. A nodular density is
redemonstrated best on the craniocaudal view. It is well marginated and is of
relative low density. It is superiorly located on the lateral view. There is
suggestion of a fatty notch suggesting a lymph node. It measures close to 1 cm.
Ultrasound is recommended to assess.
Ultrasound was directed at the left upper outer breast. Ultrasound reveals a
nodular density of up to 9 mm in greatest transverse dimension with an echogenic
center and hypoechoic rim consistent with a lymph node. It likely corresponds
with the mammographic finding. It is at the 1:00 position 5 to 6 cm from the
nipple mid-depth.
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IMPRESSION:
A low-density nodule in the left upper outer breast is suggestive of a lymph
node with a corresponding abnormality on directed left breast ultrasound.
If clinically unremarkable, short interval mammographic follow-up in six months
is recommended to assess stability.
Results were discussed with the patient and were given to her in writing before
leaving the facility.
FINAL ASSESSMENT BIRADS CATEGORY 3 PROBABLY BENIGN FINDING, RECOMMEND SHORT
INTERVAL MAMMOGRAPHIC FOLLOW-UP - (6 MO LT) HETEROGENEOUSLY DENSE
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Dear darlacharmaine, scaredandworriednewmom and bruinjamie21,
Welcome to the BCO community. We are sorry about these breast changes and the worry that they bring. We are glad that you reached out with your reports. We are sure that djmammo will be along to offer some expert information but while you are waiting for him to respond you might also want to review some of these links and resources that he helped to put together for our members. Let us know if you need additional help in getting the information that you need.
The Mods
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Thank you for this, but I am still looking looking for information even after reading through most of the material in the link. Thank you.
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They couldn’t tell what they were seeing on the mammogram, and on closer look at the area with ultrasound it appears to be a normal lymph node is my take. The recommended follow up is just to confirm stability/no change
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A little soon to predict without compression views and an ultrasound.
If I had to choose however, fibroadenomas are frequently multiple, can have lobulated borders and appear isodense to normal tissue. No reason to panic yet. Let us know what the diagnositc studies show.
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Fibroadenomas calcify with time. They are usually big chunky calcifications that look like popcorn, that will cause posterior shadowing on US since they are basically little dense rocks. This appearance is probably the only finding in breast imaging when you can say you definitely know what something is. Pretty sure this is why they wont do another mammogram. Once they calcify like this they usually stop growing.
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Since the biopsy was based on the MRI, that report will be more helpful in figuring this out for you.
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Ok, thank you so much for the reply, djmammo. I will post results of the diagnostic studies as soon as I receive them.
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Thank you so much Djmammo.
The US report I recvd for the latest ultrasound says malignancy in the lump cannot be ruled out and that is what is freaking me out.
Are calcifying fibrodemas benign? Its characteristics when googled throw up only malignancy. Should I press for a biopsy?
Googling calcification also points to malignancy? Is this different from what my report states?
Also, the 6 month old mammography report states there are non calcified fibrodemas. Will those calcify similarly?
Sorry abt all the questions. I have no1 to ask. I tried speaking to my radiologist but he refused to spk to me. The technician doing the ultrasound asked me to press for biopsy as she didnt like how the lump looked (its at 6oclock position in all 3 reports - 2 US and 1 mammo and per the latest US hasnt increased in size.
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I had a mammogram and an ultrasound last week following a excisional biopsy last fall (biopsy was non cancerous). Results of the mammogram were "on mlo projection and 90 degree lateral projection of the right breast seen in the posterior breast near the level of the nipple, there is focal asymmetry identifying with slightly angulated margins. There is potential subtle correlate for this finding on the 3/20/17 mlo view, however, the findings on today's study is significantly more prominent and persists and becomes somewhat more pronounced with spot compression imaging. There is no clear correlate on craniocaudal view". Ultrasound did not correlate with mammogram. I'm a wreck waiting For the MRI that is scheduled for 4/8. All I know is that more info is needed before they give me a BIRADS score but what additional information can be taken from my report?
Thank you in advance, a million times over.
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Post the mammo report if thats the one that said calcified FA. If you feel the need to google look for "degenerating fibroadenoma". Should look like this on a mammo with shadowing on the ultrasound.
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We would need the complete mammo and US reports either cut and pasted or transcribed verbatim.
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I am unable to upload my reoprts. Can someone please help?
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Just read the 3 days and 5 posts rule for uploading images so typing this up.
Mammo report from oct last year
Bilateral mammo
Clinical indication: multiple nodules demonstrated on sn outside ultrasound of Sept 2018
Breast density: Heterogeneously dense
In tge right breast there are multiple partially obscured nodules in the upper outer quadrant predominantly. Many of these have coarse calcification and are in keeping with calcifying fibrodemas. No soft tissue distortion or suspicious calcification identified.
In left breast, there is a 1.8 cm coarsely calcified fibroadenoma at the 6 o clock position in the middle third of the breast. No other dominant masses, significant calcifications or soft tissue distortion are seen.
Opinion
There are coarsely calcifying fibroadenomas bilaterally. As the patient has other nom calcified nodules which were investigated sonographically Sept 29,18 they should have those followed up sonographically in 6 months time.
I had an ultrasound last week and this is the report
Bilateral breast ultrasound
No abnormal axillary lymphadenopathy on either side. Breast parenchyma is heterogeneous in echo texture.
Left side
Several oviod Hypoechoic nodules are again seen. These measures 20x13 mm at 12 oclock, 6x5mm at 2 o'clock, 8x4 mm at o'clock and 3x5mm at 3 oclock. A 4x3 mm nodule is seen at 7 o'clock. The nodules at 1 and 3 are similar to previous. Nodule at 7 oclock is smaller than earlier. Atlesst 5 benign appearing nodules were identified today, only 4 identified previously. These are wider than tall with sound attentuations. And may represnt fibroadenoma
Again noted is an inhomogenous poorlydefined irregular Hypoechoic nodule at 6 o'clock position. It measures approximately 1.5cm maximally but accurate measurements were difficult to obtain. It is taller than wide with some degree of posterior acoustic shadowing. This nodule is indeterminate as indicated previously and malignancy cannot be excluded. Overall size stable since previous study in sept 2018.
Right side
Multiple oviod Hypoechoic nodules arebagain seen. Largest at 9oclock measures 52x18mm. 11x9mm module is seen behind nipple. 2 nodules seen at 9-10 oclock measuring 19x11 mm and 36x19mm. One nodule at 11 oclock measures 25x19. These are well defined, wider than tall withoutbsound attenuation. I would favir beingn etiology. 4 nodules identified today, 5 seen previously.
I am rewriting my question pls
Are calcifying fibrodemas benign? Its characteristics (taller than wide, irregular margins) when googled throw up only malignancy. Should I press for a biopsy? Or is the mammography report enough to exclude malignancy?
The US report I recvd for the latest ultrasound says malignancy in the lump cannot be ruled out and that is what is freaking me out. Why is latest US report worried abt malignancy in that nodule? Is US better at detecting malignancy than mammogram?
Googling calcification also points to malignancy? Is this different from what my report states?
Also, the 6 month old mammography report states there are non calcified fibrodemas. Will those calcify similarly?
Thank you for taking time to read through my notes and answering my questions0 -
Scaredandworriednewmom,
I think you have to have been a member here for a little while before you can post images and links. I'm not sure how long though. Also, you may need to convert your reports to JPG. The easiest way to do that is probably to take pictures of them with your phone, but it should also be pretty easy with a computer. But I think most women here end up just laboriously retyping.
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NOTE: The reports are not complete, I see no Birads or follow up recommendations in your post. These would have been helpful in formulating my reply(s).
Are calcifying fibrodemas benign?
*** yes
Its characteristics (taller than wide, irregular margins) when googled throw up only malignancy. Should I press for a biopsy? Or is the mammography report enough to exclude malignancy? The US report I recv'd for the latest ultrasound says malignancy in the lump cannot be ruled out and that is what is freaking me out.
***the description of the one that says "malignancy cannot be excluded" bothers me. What did they recommend for that one? The way it is described I felt sure there would have been a recommendation for biopsy. The fact that it did not get larger from the last study is irrelevant given the other US features.
Why is latest US report worried about malignancy in that nodule?***because of its features that you looked up: taller than wide, posterior acoustic shadowing etc.
Is US better at detecting malignancy than mammogram?
***in my opinion, yes but one needs to know where to concentrate the US scan which is difficult without the mammogram.
Googling calcification also points to malignancy? Is this different from what my report states?***There many different types of calcifications which apparently Google forgot to mention. Those in a FA are very big and benign. Microcalcifications when abnormal are usually associated with DCIS or an invasive cancer and among those there are different patterns to be recognized but then again, not all malignancies have calcifications
Also, the 6 month old mammography report states there are non calcified fibroadenomas. Will those calcify similarly?
***given enough time they usually calcify. It is a sign they are getting old.
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NOTE: The reports are not complete, I see no Birads or follow up recommendations in your post. These would have been helpful in formulating my reply(s).
No Birads was mentionee in the mammography report. The US repprt gave a Birads 0
Are calcifying fibrodemas benign?
*** yes
Its characteristics (taller than wide, irregular margins) when googled throw up only malignancy. Should I press for a biopsy? Or is the mammography report enough to exclude malignancy? The US report I recv'd for the latest ultrasound says malignancy in the lump cannot be ruled out and that is what is freaking me out.
***the description of the one that says "malignancy cannot be excluded" bothers me. What did they recommend for that one? The way it is described I felt sure there would have been a recommendation for biopsy. The fact that it did not get larger from the last study is irrelevant given the other US features.
This is the same nodule that the mammogram called coarsely calcifying fibroadenoma. It had the same characteristics in the Sept 2018 US but that report did not say anything about malignancy. This report mentions the same nodule again and says malignancy cannot be excluded. They have recommended mammogram but radiologist says another mammogram cannot be done as the last one was done onlyb6 months ago.
I am sorry if I didnt make sense earlier, I am a mess atm. Let me try clarifying.
I had an ultrasound in sept which identified an indeterminate, irregular margin, taller than wide posterior acoustic shadowing nodule at 6 oclock in my LB. Mammo of this lump identified it as coarsely calcifying fibroadenoma. I was asked to follow up in 6 months.
I had another ultrasound last week and the nodule at 6 o'clock in LB was still present. This time the report defined it as 》Again noted is an inhomogenous poorlydefined irregular Hypoechoic nodule at 6 o'clock position. It measures approximately 1.5cm maximally but accurate measurements were difficult to obtain. It is taller than wide with some degree of posterior acoustic shadowing. This nodule is indeterminate as indicated previously and malignancy cannot be excluded. Overall size stable since previous study in sept 2018.
Again no Birads given and I was asked to get a mammo done. I cannot get an appt for mammo as i had one 6 months ago.
What I wanted clarification on was if calcifying fibroadenomas show the characteristics that this lump is showing? Or are the docs here not giving it as much concern as they should?
Another thing that I wanted to mention is that I had an Ultrasound first and then a mammo. Both were done in different facilities. While the radiologist who carried out this US had access to last US report, he did not have access to my mammo report.
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This will take a while to untangle.
There is really no way for me to know what your radiologist(s) thought process was about a particular finding since there seem to be some inconsistencies in your evaluation as you have presented it here.
Without rehashing all the findings the following should occur:
All your studies going back at least two years should be assembled along with their reports and given to a radiologist specializing in breast imaging for a second opinion. It may be one of the rads you already know or a third party willing to take this on. They will need to review and compare all your studies and afterwards render ONE report that includes an Evaluation of all your findings, followed by an Opinion and a set of Recommendations for follow up whether it be a biopsy or additional imaging.
Ideally this process should occur the first time around but sometimes you have to start the process over again to get a clear picture of what is going on. Alway keep copies of all your imaging on CD and all printed reports.
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Thank you for your time, but your reply freaked me out Djmammo.
Do you mean to say the mammography classification of coarsely calcified fibroadenoma could be inaccurate? In your initial reply you mentioned that calcifying fibroadenomas are usually big chunky calcifications that look like popcorn, that will cause posterior shadowing on US. So is the taller than wide characteristic worrisome and not typically associated with a calcifying fibroadenoma?
Does this characteristic in itself require biopsy?
I am not questioning your response, I am just trying to keep my hopes up that this nodule is indeed a calcifying fibroadenoma as the first mammo suggested. I worry I might have lost precious time from the last US to now (6months) if the mammography report was inaccurate.
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Check your private messages.
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Hi DJMammo,
I just had my yearly 3d mammo after an axillary surgery removing 3 lymph nodes on the left in December. Yikes that sucked lol. Anywho, I took photos of my images just for fun. I had never seen them before. I have two questions. First, my skin seems thick compared to images I’ve seen online. Like many of the images I’ve seen have a very thin somewhat bright line for skin on mammo. I have places where mine is pretty thick and bright, especially where my areola is and the underside of my breasts. Why might that be? Also, my report says I have several bilateral enlarged silicone filled lymph nodes (they just removed 3 of the largest; 5 cm in total). I had one small tear in my left implant. The implants have been removed as of May 18’. How common is this in your experience and can we be sure it is actually silicone on the right? My surgeon said this is very rare.
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Not all silicone implants spill silicone into the tissues when they rupture but when they do it goes right to the lymph nodes through the lymphatic system, since thats its job. Silicone in the nodes has a classic appearance on mammo and US readily recognized by breast imaging radiologists. It is not uncommon for us to see this every now and then since we read thousands of mammograms each year.
Areolar skin usually appears thicker on imaging than the remainder of the skin of that breast. We only look into it if it is thicker than the other side in the same spot.
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Thank you so much djmammo I just got the report and what is worrying me so much is that it’s so MANY areas of concern, none of which were seen on my mammogram OR ultrasound. Here’s what it says. Any insight would be very comforting. Thanks.
CLINICAL HISTORY: High risk patient, family history of breast cancer including a mother with premenopausal cancer, mammographically dense breasts.
COMMENT: A bilateral breast MRI was obtained utilizing a breast coil. Axial and
sagittal T1 and T2-weighted imaging was obtained on a 1.5 Tesla GE magnet. Fat
saturation technique was utilized. For the enhanced component the patient
received intravenous Gadavist contrast material. Following contrast
administration, serial enhanced dynamic sagittal imaging was obtained through
both breasts at incremental time intervals. Subtraction images were generated.
The study was reviewed on a PACS workstation with the benefit of computer
assisted detection.
There are no previous breast MRI studies for comparison. There are previous
mammograms with the most recent of February 2019 and another study of June 2015.
Breasts are partly fatty with patchy and confluent areas of parenchyma
throughout. There is mild background enhancement.
In the right breast there is no suspicious enhancing mass or suspicious regional
enhancement.
In the left breast at the upper outer aspect there is a nodule with peripheral
enhancement. It is well marginated. It is markedly T2 bright suggesting a
benign process. It measures close to 8 mm and appears to correspond with the
nodular density demonstrated on the recent mammograms. This was likely present
on the mammogram of 2015. Appearance as well as lack of change suggests a
benign process.
In the anterior to central depth upper outer left breast there is a focal area
of enhancement, somewhat elongated or bandlike. This is best demonstrated at
sagittal location -88.17 and corresponding axial location 2.27. This is
indeterminate and biopsy is recommended. In the slightly more central depth
more medial left breast there are additional focal areas of enhancement. This
includes an abnormality central to posterior depth at the -70.17 sagittal
location and corresponding 14.27 axial location. Slightly more lateral at the
same axial plane there is additional enhancement at sagittal location -78.17 and
again axial location 14.27. There is also a tiny nodular enhancement at the
-80.17 sagittal location corresponding with axial location 4.67. Biopsy of one
of these additional areas is recommended suggested of the most prominent which
is at the posterior upper outer breast at the -78.17 location. If these are
benign then other abnormalities can be followed in short interval with MRI to
assess further stability.
There is no bulky or suspicious adenopathy bilaterally.
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IMPRESSION:
There is a markedly T2 bright nodule in the posterior depth left upper outer
breast thought to correspond with a mammographic nodule thought to date back to
2015 mammograms. Appearance and the stability suggests a benign process.
Continuing imaging follow-up is advised in short interval to assess further
stability.
There are multiple enhancing abnormalities which are small and scattered within
the left breast and biopsy is recommended of the two most prominent to exclude
malignancy. This includes that located at the sagittal location -86.17 and
another located at the axial location 14.27. If these are benign than the
others can be followed in short interval to assess further stability.
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