Interpreting Your Report
Comments
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Usually, if there is a cancer present, when arch dist is seen on mammo, a small mass is usually identified on US but it could be extremely early. Is this a new finding on the mammo?
Did a surgeon do your stereo? I have seen some routinely use much larger gauge needles than we rads do and take much more material. Maybe they leave internal scars. The fact that no marker was left in place also suggests it was not a rad.
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Yes, this is a new finding. Biopsy was done many years ago and they had a very very hard time getting enough tissue. Took over an hour. Not sure but I think it was a Radiologist.Two in fact. After it became difficult a second Doctor was brought in to assist.
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Hi - Just had yearly mammogram and they asked me to come back to do Ultrasound and extra imaging. I received the report. Not much to it. Breast tissue is heterogeneously dense. Architectural distortion persists. Assessment was Suspicious BI-RADS 4. I go to surgeon tomorrow. What can you tell me about Architectural distortion? Thanks!
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HI Sattaylor, and welcome. We're so sorry you're here and worrying. Someone should be by soon to offer some advice, but in the meantime, we wanted to share this thread (also from Djmammo) explaining architectural distortion.
We hope this helps!
--The Mods
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Hello: What can you tell me about Architectural Distortion?
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Hi DJMammo. Could you possibly help interpret these results for me if possible? I went for both a mammogram and US last week, but I was told "nothing to worry about, see you in 6-months"
Mammogram: There are scattered areas of fibroglandular density and an intermammory node on the left breast. A mass with obscured margins 1.1 x 0.6 x 0.7cm is present in the posterior left breast upper outer quadrant. There are a few begign-appearing calcification in the left breast. BI-Rads - Category 3
USound: A septated cyst 0.5 x 0.3 x 0.7cm was imaged laterally in the 3 o'clock left breast. BI-Rads - Category 3
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A "simple" benign cyst is smooth round and appears totally black on an ultrasound image. If one were to draw a white line across it with a very sharp pencil that is what a septated cyst would look like. As long as the septation is extremely thin and uniform throughout its length, these cysts are usually benign. The cyst is no longer classified as simple if it has a septation, it is now called "complicated" and these are routinely rechecked at 6 months. If there is no change they will probably leave it alone.
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Thank you! They have labelled it "complex", so I assume that's the same as complicated in this respect also.
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Hi, djmammo, I have another 14days to go before I will know anything ,but I have a question. I have a STRONG family history of Breastcancer (mother,aunts, and cousins))and I have MS. Last year my report read with no Tomo:
FINDINGS: The breast tissue is extremely dense, which could obscure a lesion on mammography. There are no new masses, suspicious microcalcifications or focal areas of architectural distortion present to suggest malignancy. There is a benign-appearing
nodule seen in the far posterior left breast seen on the MLO view, unchanged since prior exam of 3/20/2017.
ASSESSMENT:
BIRADS: 2 - Benign.
RECOMMENDATION:
Routine screening mammogram of both breasts in one year.This year report done with a Tomo and it reads
FINDINGS: The breast tissue is extremely dense, which could obscure a lesion on mammography.
There is a possible nodule at the 3 o'clock position of the left breast 9 cm from the nipple. Recommend spot tomo. The patient will be contacted. The remainder of the parenchymal pattern of each breast appears stable.
ASSESSMENT:
BIRADS: 0 - Incomplete: Need additional imaging evaluation.
RECOMMENDATION:
Special-view mammogram of the left breast.Could this be the same nodule found last year or is this considered new? If it is ,if the 2D view last year looked benign, why after doing this years with a Tomo wouldn't it have been even more clear . The word “possible nodule" makes me think this is new. Last year the position was not given it just said “far left Posterior nodule". Please help. I have no other symptoms , but I know that means nothing
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Both reports are incomplete as regards the details of the finding.
It was the responsibility of that last reader to compare your studies and tell you whether it was there before. Give them a call and make sure they were compared, it might save you a trip. If they were not compared ask them to make the comparison and issue an addendum and new recommendation if necessary. Then find another center for next year.
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hello, new here.
djmammo, was hoping to get input from you on the findings below, as i'm trying not to go out of my mind with worry. i'm having my follow up mammogram & u/s tomorrow.
birads = 0. i'm 40 with a history of idiopathic granulomatous mastitis.
what are the chances of this being cancer? previous mammograms have all been negative...i was trying to research axillary lymph nodes, and came across the illustration you posted--thank you!
tia,
nenshi________________________________________________________________________________________________________________
TECHNIQUE:
The following 3D digital breast tomosynthesis with 2D composite views were obtained: bilateral
craniocaudal with tomosynthesis, mediolateral oblique with tomosynthesis and nipple in profile with
tomosynthesis.Computer-aided detection was utilized by the radiologist in the interpretation of this examination.
MAMMOGRAM FINDINGS:
There are scattered areas of fibroglandular densities (density
.There is an oval mass measuring 15 mm seen in the lateral aspect of the right breast located 9
centimeters from the nipple, probably a benign lymph node but incompletely visualized. Recommend
additional mammographic views and if indicated, breast ultrasound.0 -
Thank you for your help! I will definitely contact the center and go elsewhere next year.
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thank you!
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Hi DJMammo,
Had my MRI. Asymmetric area of clumped non mass enhancement. Can you explain this? Is this a malignancy? Biopsy next. Scared and hoping for better news. Thank you.
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Hello, I am windering if you could help me interpret my mri report while I am waiting for my mr guided biopsy results. I am wondering if I need to be concerned or not. My oncologist wanted me to not get the biopsy and to come back in 6 months for another mri, but I wanted the biopsy for peace of mind.
Findings
The breasts are composed of extreme fibrogladular tissue with minimal background parenchymal enhancement that is symmetrical between both breasts.
Right Breast: There is no suspicious enhancement or lymphadenopathy.
Left Breat: At 10 o'clock, posterior depth, 6cm from the nipple, there is a clumped non-mass enhancement in a linear distribution, measuring 1.2cm. Worst curve kinetics are inital phase slow and delayed phase persistent.
There are benign findings of lumpectomy in the left upper outer quadrant. There are no other suspicious enhancement or lymphadenopathy.
Impression:
Right Breast: BI-RADS1. Negative. Recommend age and risk appropriate screening with mammography.
Left Breast: BI-RADS 4A, Low suspension for malignancy. Linear non-mass enhancement at 10:00, posterior depth. Although this is gradually enhancing, given the patient's history, biopsy is recommended. Specifically recommend MRI guided core biopsy, as ultrasound is unlikely to demonstrate a correlate.
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Hi, I had a 6 month follow up mammo and ultasound this week. I spoke to the Dr in the ultasound room but I want to understand what he wrote versus our conversation. Here's the report:
US 0014 - BREAST LIMITED INCL AXILLA:
INDICATION: ABNORMAL MAMMO LT
NO FAMILY HISTORY.
COMPARISON: 9/24/2018
TECHNIQUE: Unilateral left full-field 3-D tomo digital MLO and CC images were obtained. 2-D C-views were reconstructed from the 3-D data with CAD applied. Targeted left breast ultrasound was performed in the posterior medial region and anterior lateral area.
BREAST DENSITY: breast parenchyma consists of heterogeneously dense fibroglandular tissue, which could obscure malignancy.
FINDINGS: There is a persistent nodular opacity in the posterior medial left breast on CC imaging shown to be interior in position on 3-D imaging. Targeted ultrasound in the 7:00 left breast shows a possible vague hypoechoic nodule measuring 8mm in maximum diameter. This was difficult to visualize at real-time images were saved documenting the possible nodule.
IMPRESSION: Possible solid nodule posterior medial inferior left breast, difficult to visualize on ultrasound. Breast MRI without IV gadolinium contrast is recommended for further assessment.
There's some info about a simple cyst I left out cause I've had those and not worried.
Thanks for your feedback!!
Betty
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Hi to all of you! I was just wondering if I could get some help with my radiology reports.
Mammogram showed Left breast 8mm partially circumscribed asymmetric density outer one half cc view requiring further evaluation....
Ultrasound conclusion:
1.3 lobulated hypoechoic mass with shadowing at the 2:00 position 8 cm from the nipple. This finding is indeterminate. It likely correlates with the mammographic finding Biopsy recommended. BIRADS 4
Just had biopsy done today, feeling nervous, anxious, and like I'm going a little crazy:/
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This is where we see how MRI is much more sensitive than it is specific. It could be nothing, it could be cancer. Most if not all of these kinds of indeterminate findings are biopsied. The fact that there is no description of a solid mass is encouraging.
MRI is never read in a vacuum however, one has to sit down and read it with the US and Mammo in the same field of view as the findings on the Mammo and US will strongly affect the interpretation of the MRI findings. There is also the kinetics of the enhancement, slow, fast, lingering, fast washout etc. Timing of the scan re: menstrual cycle will also affect the findings. Often an US is done to evaluate these areas specifically even if there is a recent US previously.
Let us know what the biopsy shows.
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First read my reply to Llgma above for the general concepts.
Linear pattern raises the possibility of DCIS. The level of suspicion is higher for you since you have already had breast cancer (higher pre-test probability). If there are suspicious calcifications on your mammo in the area of the linear enhancement, that would further raise the probability.
Sometimes you can identify DCIS on US but that requires the best US equipment, and a rad that has had experience with the subtle findings thereof so it would be more practical just to do the bx with MRI like you had done.
There are those clinicians that feel "so what?" when it comes to DCIS. If there is no mass on any modality its less likely IDC, and since DCIS doesnt really spread, "we can just watch it."
Let us know what the path report says.
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Well, it sounds like they are not sure its even real let alone a bad thing.
The other problem is I have never seen a breast MRI done without contrast. I believe it would be worthless. Check the report to make sure thats what it said.
Also see if the rad reading your studies does only breast imaging or does it now and then.
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Are there prior mammograms for comparison? Is it new?
In general, lobulated is a little better than spiculated in the scheme of things but the shadowing is the part that bothers me. Unless a mass contains large calcifications, few benign masses demonstrate posterior shadowing.
Better to have these things biopsied and know whats going on. I find that knowing what it is brings a sense of calm no matter which way the diagnosis goes.
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First I want to thank you so much for all of your help on this discussion board! This was my first mammogram, I am 45 years old. I did get biopsy yesterday. Just have to wait it out:/ I am so glad to have found this place, it helps to know others fell like this!
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I had my breast MRI today in follow up to a concerning area seen on mammo but not on ultrasound. Below are the MRI results. I haven’t spoken with the doctor yet but I’m assuming that the results are great. Is there any bad news I am missing? Thank yo
IMPRESSION:
1. No suspicious correlate for the mammographic finding of concern which
presumably represents bland fibroglandular parenchyma.
2. No evidence of breast malignancy.
ASSESSMENT: BI-RADS 2, benign
Reading Radiologist - Kitchin, Douglas
Releasing Radiologist - Kitchin, Douglas
Dictation Date Time - 04/08/2019 10:36
Transcriptionist - NANarrative
MRI BREAST BILAT WWO CONTRAST, 4/8/2019 10:12 AM, Dean Clinic
INDICATION:
R92.8: Abnormal finding on breast imaging
N64.4: Breast pain, right
ADDITIONAL CLINICAL INFORMATION:
Ordering Provider Reason for Exam: Abnormal breast mammogram and ultra sound;
Radiologist re commends breast MRI to evaluate the asymmetry in her right
breast;compare both breasts
Technologist Note: History of biopsy of right breast. Follow up prior Mammo
and US.
Additional: None
COMPARISON:
Mammography and ultrasound 3/20/2019 and prior
TECHNIQUE:
MRI of the bilateral breasts was performed utilizing multiple pulse sequences
in multiple planes before and after intravenous gadolinium contrast. Dynamic
postcontrast technique was utilized. Images are reviewed and processed on a
CAD Stream workstation.
CONTRAST:
GADOBUTROL 1 MMOL/ML IV SOLN:10 mL
FINDINGS:
Examination is mildly compromised by motion.
Right breast:
Tissues are composed of scattered fibroglandular tissue. Background
enhancement is mild.
No suspicious findings in the right breast. There is no suspicious correlate
for the mammographic finding of concern which presumably represents bland
fibroglandular tissue. There are postbiopsy changes in the outer right breast.
Left breast:
Tissues are composed of scattered fibroglandular tissue. Background
enhancement is mild.
No mass or suspicious foci of nonmass enhancement are seen to suggest
malignancy.
Axillae:
No abnormally enlarged lymph nodes are seen in either axilla.0 -
The Birads says it all.
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djmammo I had 2 MRI guides biopsies last week - the first ones I’ve ever had. I have a strong family history. They came back benign thankfully but on the pathology of one of the spots it classifies it as “benign breast tissue - pregnancy like change”. Can you explain what that means? I’ve had 3 boys in the past 6.5 years, the last almost 2 years ago. Thank you!
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And your little fur babies love each other --- so cute when they snuggle.
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djmammo, I was wondering if I could ask you a question about my biopsy report? It came back "birads 3, possibly benign "
Findings: pathology reports benign breast tissue with nodular fibrosis and pseudoangiomatous stromal hyperplasia.
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hello! I was wondering if anyone can help me understand what this all means
Here are my results idk how to read them
Exam; right breast ultrasound limited
Indication : 27-year-old with a palpable lump
Comparison: none
Technique: Gray scale and color Doppler imaging of upper outer quadrant 9 o'clock through 11 o'clock position
Findings: an oval circumscribed, parallel, hypoechoic mass with posterior enhancement measuring 2.3x2.4x1.9 cm is noted in the upper outer quadrant of the right breast, 10 o'clock, 3cm from the nipple there is internal vascular flow
Impression : vascular mass with in the 10 o'clock position of the right breast that is palpable recommendation biopsy
Bi-rads : 4 suspicious
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