Interpreting Your Report
Comments
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Thank you for your reply. It’s a relief to know that this is the normal protocol. I will be sure to ask if they were identical when I go for my results.
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I had my ultrasound guided core biospy today and had a poor experience that led me going to the ER. I not sure if this is the right place to post but I would like DJMammo's input. Is it normal for the radiologist to put the same amount of lidocaine in each patient regardless of size? I am a small petite woman(100 pounds). When I asked much lidoicane she said it would be the same amount regardless of the size of a person(a 200 pound person would get the same amount of a 100 pound person). She told me she likes to put in a massive amount of lidocaine to keep the person comfortable (she told me she had completely infiltrated my breast tissue with it. I was just getting a small area (.8mm *5mm*8) sampled that had some type of blood vessel near it (so she couldn't assure me she wouldn't hit it). She went in twice the first time got no sample the second time got a small amount. I started feeling very strange and upon sitting up I was extremely dizzy and had a difficult time moving my eyes or head without being dizzy and feeling very off balance. I would compare it to being very intoxicated. My throat also got somewhat numb feeling and I started to have palpitations. They weren't sure what was going on and sent me to the ER. The ER felt that maybe the lidocaine went into one of my veins and produced a systematic response since I was given so much. I was there for about five hours and the breast center wanted me to come back for a mammogram this afternoon to make sure the clip was in the right spot(this area did not show up on mammogram to begin with and was only found on ultrasound. I was extremely sore at that point with my breast tissue and said I wanted to wait until next week for the mammogram (they agreed but not happily) I apologize for the long narrative but am just wondering if is normal or necessary to get a mammogram immediately following a biospy and if the amount of lidocaine should be specific to the patient weight? Thanks for your input.
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hello,
I’m hoping that someone can help me. I’m writing on behalf of my mom, who lives in Taiwan. She had a suspicious abnormality finding rating of BIRADS 4 and immediately had a biopsy done. I’m wondering if it’s possible to tell from the images (I have the 3D ultrasound images) if it’s 4A, B, or C? Also she has “dense” breast tissue and this 1.7 cm tumor did not show up on her mammogram!
Please let me know where I can send the ultrasound photo. Thank you so much.
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Sunset5585 and everyone else
Good question, important topic. Grab a chair and a beverage.
2% Lidocaine is the local anesthetic I have used for interventional procedures/biopsies since the early 80's. It's better than 1%, cheap and plentiful (usually) and It has only in extremely rare cases not worked as advertised. It is supplied in 2 forms, one with extremely small amounts of epinephrine (adrenaline) and one without but more about that later.
I have found over time that the secret of good "numbing" is time and placement, not volume. The nerves that supply the breast come from branches of the intercostal nerves that travel from the ribs/chest wall forward through the breast to the skin and provide pain/touch/autonomic fibers to the entire breast. Lidocaine works by inhibiting the uptake of sodium into the nerve endings thus preventing them from "firing" and passing pain signals on to the brain which would be perceived as pain in the breast. One therefore has to put the lidocaine where it will do the most good and that is between the target and the chest wall so that the pain signals generated by the nerves in and around the target during the procedure never reach the brain. It needs time to work and that time varies from patient to patient but it works very quickly in the majority and the amount needed is completely independent of the patient's weight and body habitus.
The procedure trays I used came with a 10cc syringe preloaded with lidocaine. I like to use the "buffered" version which contains a little bicarbonate which reduces the amount of stinging during injection. The needle would be 25g or thereabouts, the standard length about 2.5 inches. The approach would be parallel to the chest wall, and looking at the US screen with the patient supine I would flood the area "under" the target with the anesthetic. If the breast was large in diameter at the level of entry I would use a very thin gauge spinal needle measuring twice that long to insure the lidocaine made it all the way past the target. On the way out I would make sure a good amount was placed in the intended path of the needle to the target leaving a goodly amount within the skin making a little wheal where I would subsequently make a small skin nick with a #10 blade to facilitate entry of the core biopsy needle.
The first thing I asked my patients was "how well did the lidocaine work the last time you were at the dentist?". The answer was either "good" or they related some horror story which would give me an idea of what to expect. After administering the anesthetic I would ask them to tell me when the stinging went away, the nurse would then engage them in a scripted conversation while I prepped the biopsy device. When the conversation was done I'd ask about the stinging and if it was gone I would make my skin nick. 90% of the time they could not feel the scalpel entering the skin and I would begin the procedure without a problem. It kills the pain but they can still feel pressure and movement so I would explain that. Also I would count to three each time I fired the spring loaded biopsy device as some people are startled by the "loud snapping sound" it produced.
If they were not sufficiently numb by then, I would administer the remainder of the lidocaine in the syringe, not in the exact same spot but in a wider distribution to involve additional nerve branches that might also be supplying that area. I would then leave the room for a while as these individuals can take longer to get numb than others. When I returned a while later 99.9% of patients would be numb enough to continue with the biopsy. I had one patient that had "congenital insensitivity" to local anesthetics. One in 30 years so its uncommon for that to happen.
Epinephrine ("epi") is a vasoconstrictor. It makes vessels constrict and limits the flow within them. It is felt that the decrease in overall blood flow in the area prevents the administered lidocaine from being washed away as quickly as it would without the epi thereby prolonging its effects. There may also be other chemical effects of the epi on the nerve itself that enhance the lidocaine's effects (https://www.ncbi.nlm.nih.gov/pubmed/12502995). In addition to helping the lidocaine work, it also decreases bleeding from the tiny arterioles inevitably severed during the biopsy as they have smooth muscle in their walls and respond to the epi by closing off the flow.
When is it appropriate use lidocaine with epinephrine (commonly referred to as "2% with")? This is my rationale. It may not be everyone's, but my reasoning is based on the following physiology. Recall that arteries both large and small have smooth muscle in their walls to control blood flow. When injured an artery will constrict to decrease flow and encourage clotting in an effort to prevent one from bleeding to death. This is particularly true with blunt force/ripping type injury as in a motor vehicle accident. It is a fact however that if an artery is severed by a very sharp instrument like a very sharp scalpel, it will not constrict and the blood will flow with delayed clotting (the mechanism involved in this phenomenon is chemically mediated and is a different long story).
With that bit of physiology trivia in mind let's look at the gadgets used for breast core biopsies. For US guided biopsies I used a spring loaded core biopsy device called the BARD® MAX-CORE® Disposable Core Biopsy Instrument. I do not represent nor am I otherwise involved with this company, it is similar in design to others, I just like the simplicity and reliability of this product. The needle itself has two parts: an inner needle with a sharp point and a 2cm notch to hold the sample, and an outer sheath with a sharpened edge that slides over and closes the notch. When the device is fired within the breast, the inner needle rapidly extends 2cm into the target, immediately followed by the sheath. In a split second the tissue of the target that finds itself in that notch is quickly sheared off from the rest of the target by the action of the sheath closing over that notch. This sequence of events is so fast the two actions produce only one discernible snapping sound. Now recalling the arterial wall's response to trauma, this biopsy leans more toward the blunt force type of trauma and produces relatively little bleeding so I do not use the lido w/epi for these. Also it only takes me 3 minutes to collect 5 samples after the skin nick is made so I do not need the lido's action to be prolonged. In the supine position when there is some bleeding, there is little that is visible which is a plus with some patients.
Stereotactic biopsy is different. While the overall inner/outer needle/sheath design is basically the same the cutting mechanism different. It is basically a drill, controlled by a small electric motor. The very sharp inner needle is spring loaded and it pierces the target similar to the other device but the sharp outer sheath rotates like the drill attachment used to cut holes in doors for door knobs. It advances slowly through the target area severing the vessels much like a scalpel, allowing them to bleed freely and in the prone position with the breast hanging through an aperture in the table it is clearly visible and towels are often deployed on the floor below. This is where I use the lidocaine with epi. In addition to better control of bleeding, it prolongs the effects of the lidocaine as stereo biopsies are much more time consuming. They are not done in real-time, with a live image on the screen like US biopsies where we can see the location of the needle and how its performing 100% of the time. Stereo biopsy targeting is done by computer using 2 static x-ray images and math. We only get a glimpse of what is transpiring each time we take a set of images which have to be reviewed each step of the way including the images taken of the samples themselves to make sure we got what we came for.
During administration of the local anesthetic, crossing small arterioles and veins in the breast is unavoidable as most are not seen at US and we are working blind in this regard with stereo's. If we can see them at US we alter our approach to avoid them but we can't avoid all of them so even though we pull back on the plunger before we inject to check that its not in a vessel, it is possible for lidocaine to enter the bloodstream in very small amounts. This does not cause any symptoms that I have ever been aware of, in fact significant quantities are administered intravenously to calm irritable cardiac muscle in people with arrythmias so I doubt it could cause palpitations. The epinephrine however will cause the heart to speed up (it's used during cardiac arrest/codes for this express purpose) and it will cause generalized vasoconstriction making you shiver/feel cold and sometimes to feel a little panicky too. This is why I use the lidocaine with the smaller amount of added epi. The effects are not harmful at these low doses but the patient's reaction to these symptoms can be unsettling. Also I do not use epi in patients with any kind of cardiac history just to be safe.
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I have to assume that the symptoms you experienced were due to the epi and not the lidocaine itself unless of course you have a sensitivity to some component of the lidocaine (if that is what was used) or that there was an interaction with meds you were taking or perhaps there was a degree of hypoglycemia involved if they told you not to eat before the biopsy. I would discuss everything that happened with your PCP to determine the cause of your symptoms so this can be avoided in the future. I would tell the next person doing a procedure what happened and that you would at least like to avoid the epi. There are many different local anesthetic preps other than lidocaine (there are many different "caines" available) perhaps they can use something different next time.
It is always necessary to get a post biopsy mammogram to document the placement of the marker. Markers are placed during all breast biopsies with few exceptions. The mammo done afterwards with the breast still numb, will show that the clip is present in the breast, and whether it was placed in the intended location which is of particular importance after stereo biopsies as we cannot see it being placed in the target like we can in US. The markers are used to locate the target for the surgeon in order to plan any surgery so documenting their position is critical.
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djmammo, thank you for the explanation. Now I understand why I bled so freely after a stereotactic biopsy; after the follow-up mammogram there was blood dripped on the floor, smeared on the machine, etc. At the time I think I was more concerned about the mess I was making than they were but apparently it was completely within the norm. They were very reassuring that it was OK.
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Hi djmammo!! I am so thankful to find this post and wondering if you can help breakdown my report. I have a core biopsy scheduled for next week. Looking for some clarification, my doctor was very unclear on what this means and didn’t give me much clarification when reading this report.
Exam: Bilateral diagnostic mammogram with computer-aided detection and right breast ultrasound. Date Of Exam: 10/31/2019. Date of comparison: None. Findings: Digital mammographic images of the breasts in the CC and MLO projections with CAD shows a moderately dense fiber glandular pattern bilaterally. Nipple markers are noted. A triangular marker is noted over a palpable concern in the right breast at approximately the 5 to 6:00 position. There is a circular opaque marker over raised mole on each breast. At the site of a triangular marker in the right breast, there is no focal abnormality. There are areas of ground increased density in the right breast laterally approximately the 9:00 position posteriorly measuring 2.8 cm and there is a similar focus at approximately the 11:00 position in the mid breast measuring 2.3 cm. Ultrasound imaging in the area of palpable concern and the areas of mammographic density was performed. In the area of palpable concern, there is a cutaneous nodular focus measuring 6 mm with low-level echoes and well-defined margins and through transmission. There is no vascularity. The appearance suggests a sebaceous cyst although a hypoechoic nodule is not excluded. At the 9:00 position, 5 cm from the nipple, there is a 2.2 cm cyst which is simple in nature. The 9:00 position, 1 cm from the nipple, there is a 2.4 cm simple cyst. There is also a hypoechoic nodule at the 9:00 position, 4 cm from the nipple measuring 7 x 8 x 6 mm with no detectable blood flow and well-defined margins. Impression: 1. The area of palpable concern in the right breast correlates with a cutaneous focus of hypoechogenicity suggestive of a sebaceous cyst. A nodule is not completely excluded and one might consider tissue sampling. 2. Incidentally noted are large cysts in the lateral right breast. There is also a solid avascular nodule at the 9:00 position, 4 cm from the nipple measuring 8 mm. While this likely represents a fibroadenoma, ultrasound-guided core biopsy is recommended. 3. BIRADS Category 4, suspicious finding. Recommendation: Ultrasound-guided core biopsy of the right breast.
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Did you transcribe this line exactly as it appears in the report? : "...areas of ground increased density..." Maybe "ground glass"?
Either way, none the adjectives used in the report suggest the presence of a cancer. All their assumptions and conclusions refer to benign entities. The B4 is necessary to allow a biopsy and does not necessarily imply there is a malignancy. Biopsy is reasonable to prove something is benign.
The solid nodule suspected to be an FA will likely be the main target of the biopsy. The (presumed) sebaceous cyst is a common dermatologic finding and on US should be shown to be wholly within the skin, not within the breast per se, and show a small channel leading to the skin surface to make a definitive diagnosis. These are filled with a semi-solid, terribly foul smelling material. If anything is to be done with it, it is better to attempt an aspiration rather than a biopsy. The material inside can incite an inflammatory reaction in the breast tissue if a biopsy needle is directed through it into the breast tissue.
See this article: https://radiopaedia.org/articles/breast-sebaceous-cyst?lang=us
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Thanks very much for the detailed about Lidocaine! I really appreciate it. Theydidn’t contain an epi(I’ve had issues in the past with epi giving me really bad racing heart/palps and the breast center said they did discontinue using epi for the whole center because many women were having palpitations from it). I got a 20cc of lidocaine in my right breast. She did one syringe and then immediately did the next syringe. I have had lidocaine in the past and have not had issues with it. I thought 20 cc seemed liked a bit much to me? I also had significant tremor from (in addition to vertigo and palps). I will post my results when I get them .Thanks again for all your help
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Now I'm curious, since there was no epi. The anesthetic effectiveness of lidocaine is not calculated by weight, but toxicity is. Symptoms of 2% lidocaine toxicity start at a total dose of 4.5mg/kg of body weight and is dependent on the speed of its introduction into the bloodstream. The speed at which it is absorbed is variable from tissue to tissue and patient to patient. The addition of epi slows the absorption enough to raise the amount needed for toxic side effects to 7mg/kg body weight. The key is did they use 2%, 1%, 0.5% lidocaine? Was it diluted with a buffer solution? Either way this is something to tell people on subsequent visits or add to your medication allergy list. For those who have had problems we ask the hosp pharmacy what they have that's a good substitute. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4112262/
The other question is was it lidocaine at all? If the target of a stereo is very far posterior where it cannot be reached by the needle, experienced breast rad's who do lots of stereo biopsies will occasionally inject large quantities of saline into the breast behind the target to displace it away from the chest wall down to the level of needle entry. I have seen as much as 50cc of saline injected for this purpose. https://www.techvir.com/article/S1089-2516(13)00092-9/pdf
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Hi Djmammo,
So grateful that you're here with us. If you have time, can you please look at My mammography & Ultrasound results?
I've been told that I have BI-Rads3 PROBABLY benign and should just keep following up every 6 months for 2 years.
My biggest concern is the word "probably". Why wouldn't they be able to know for sure, is it because my breasts are dense?
They're also mentioning some irregular findings that raise suspicion, but in the report it sounded like they're "assuming" I am okay just because of my age and other factors like having multiple lumps? I want to make sure that if there's anything I can do, I do it ASAP, not in 6 months.
Ultrasound Report:
Mammography Report:
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Thanks for the additional info! I have been in touch with the breast center hoping to figure out exactly what I was given. (I have had lidocaine in the past and have had no issues with it so I was surprised when my body reacted that way. They couldn’t find a record of what was given to me so they are looking into it. I should hopefully know by tomorrow as I feel like it’s important to know what it is going forward. It has honestly been a nightmare of a process. On the plus side I got my results back and they came back as benign!
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Hello all, my name is Leah and I'm 39 turning 40 this coming February. Last Saturday (November 2nd) I found a what feels like pretty round hard like lump about the size of a blueberry in left breast on the inside at about the 11 o'clock position. Depending on the position I am sitting or laying are standing in it's easier to feel some ways than others. I saw my pcp who did feel what I was feeling,she didn't feel that it was anything to be too concerned about , but she decided to send me to the breast center to get a screening 3-D mammogram on my right breast, and a diagnostic 3-D mammogram on my left as well as an ultrasound on my left. With my family history ( my mom had post menopausal BC at the age of 64) and me being so close to 40 that she felt I should get in now. Got my tests done, says they found nothing concerning, on mammogram and ultrasound noted A ridge of benign breast tissue, that they classified as Benign fibrofatty tissue in the area of my concern where I am feeling the lump. My question is being they say I have very fatty breasts As opposed to dense and they say they see nothing concerning but some normal breast tissue,I am still very scared and concerned because I honestly feel a lump. should I be pushing For further testing, like an MRI or biopsy or what have you. Any advice would be greatly appreciated as I am still pretty nervous and scared about this whole thing.
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Hi Djmammo,
First time post here - I was hoping you could give some insight. They don't say on the report what the mass is but radiologist came into room and verbally said he thought they were FA's. My reports read as follows:
Examination:
BI DIAGNOSTIC MAMMOGRAM BILATERAL
BI ULTRASOUND BREAST LIMITED RIGHT
History:
Patient is 37 year old and is seen for: Masses of both breasts. Patient
reporting an indentation in the right breast. Family medical history
includes breast cancer in mother. No relevant hormone history has been
documented for this patient. No relevant surgical history has been
documented for this patient. No relevant medical history has been
documented for this patient.
Computer-aided detection (CAD) utilized.
Comparisons: This is patient's baseline exam.
Findings:
The breasts are heterogeneously dense, which may obscure small masses.
Right
BI DIAGNOSTIC MAMMOGRAM BILATERAL
A palpable marker was placed over the area of clinical concern, and no
mammographic abnormality was identified.
There is an 8 mm mass at 11 o'clock, anterior depth, 2 cm from the nipple.
BI ULTRASOUND BREAST LIMITED RIGHT
Targeted ultrasound demonstrates no sonographic abnormality at the site of
the clinically palpable area of concern in the subareolar region with
associated overlying indentation.
Targeted ultrasound demonstrates an 8 x 3 x 5 mm oval circumscribed
hypoechoic mass at 11 o'clock at a distance of 2 cm from the nipple, which
correlates with the mammographic finding.
Targeted ultrasound also demonstrates a 7 x 3 x 6 mm oval circumscribed
hypoechoic mass at 12 o'clock at a distance of 4 cm from the nipple.Left
BI DIAGNOSTIC MAMMOGRAM BILATERAL
There is no evidence of suspicious masses, calcifications, or other
abnormal findings.
The retropectoral silicone implants are normal appearing.Impression:
RIGHT BREAST 8 mm oval circumscribed hypoechoic mass at 11 o'clock at a
distance of 2 cm from the nipple.
RIGHT BREAST 7 mm oval circumscribed hypoechoic mass at 12 o'clock at a
distance of 4 cm from the nipple.
These masses are probably benign.
Recommendation:
Short interval follow-up ultrasound 6 months - Right
Follow-up at age 40 or based on current ACR guidelines - Left
BI-RADS Category:
Left: 2 - Benign
Right: 3 - Probably Benign
Overall: 3 - Probably Benign0 -
DJMammo, I'm wondering if you can dumb this down for me? I had a couple spots biopsied after my first ever MRI 6 months ago. They were benign. Last week had my 6 month follow up which they said was "fine". Reading the report it sounds like all that "stuff" is still there but unchanged. Can I ask what all the "masses" and "enhancement" IS if it's not cancer? I have a really strong family history. Just curious with all that still showing up, how they can be sure. Thanks so much!
CLINICAL HISTORY: High risk for breast cancer. Z 91.89. Greater than 20% lifetime risk. History of recent MRI guided left breast biopsies.
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IMPRESSION: Little interval change in the multiple focal areas of tissue
enhancement throughout both breasts. This stability continues to suggest benign
etiologies, as indicated by recent left breast MRI guided biopsies. See
comment.
COMMENT: Bilateral breast MRI was performed in the sagittal and axial planes
using both T1 and T2-weighted imaging techniques. Sagittal T1-weighted imaging
was performed at 2.0 mm intervals both prior to and following intravenous
gadolinium contrast administration. A total of 7 cc of Gadavist contrast
material was administered intravenously. Several series of post enhanced images
were obtained with subtraction technique. The study was interpreted using the
PACS workstation and CAD stream software.
The current examination was compared to the prior MR examination dated
3/21/2019.
Since the prior MR examination, two areas of the left breast were percutaneously
biopsied under MR guidance yielding benign findings.
The heterogeneous breast parenchymal tissue pattern remains unchanged.
T2-weighted imaging demonstrates no evidence of cystic breast masses. As noted
previously, there is a left breast mass measuring approximately 6 mm in greatest
dimension within the posterior upper outer quadrant of the left breast that
demonstrates low-level enhancement. This remains unchanged since the prior exam
and is consistent with a benign etiology.
There are several additional focal areas of tissue enhancement within the left
breast, as seen previously. The bandlike area of tissue enhancement has been
biopsied since the prior examination with some residual enhancement persisting
in this region. The second area of tissue enhancement located medial to the
plane of the nipple within the superior left breast, sagittal image location
-72.51, remains essentially unchanged, despite its recent biopsy. This measures
6 mm in greatest dimension. Its stability is consistent with a benign etiology.
Other focal areas of tissue enhancement within the left breast are unchanged
since the prior examination as well. No new areas of enhancement within the
left breast are demonstrated.
Examination of the right breast demonstrates similar small multiple foci of
tissue enhancement. These areas of tissue enhancement, compared to the prior
study of 3/21/2019, remain unchanged as well. No increase in number or size of
these focal areas of enhancement are seen. The stability is consistent with
benign etiologies.
No new areas of right breast tissue enhancement are present.
Assessment of the included axillary lymph nodes demonstrates morphologically
benign appearing axillary lymph nodes bilaterally.
Considering the patient's high risk for breast cancer, additional annual MR
imaging is recommended for surveillance purposes.
Final assessment: BIRADS Category 2: Likely benign findings, continued annual
surveillance recommended.
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The report sounds reasonable in that they have drawn a reasonable conclusion from the findings they describe in the body of the report.
The catch is they will want you to come back every 6 months for two years to measure them to make sure they are stable. Some people opt for the biopsy just so they don't have to think about them every 6 months for two years. If there are multiple identical findings in a breast it is usually sufficient to biopsy one and make an assumption that the rest would have the same pathology.
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Can you post the report here?
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There are no adjectives used in that report that would suggest cancer. From the description in the report I can see why the rad mentioned fibroadenomas.
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Result Narrative EXAM: MM MAMMOGRAM DIAG BILAT W 3D TOMO, MM US BREAST LT
LOCATION: REGIONS HOSPITAL
DATE/TIME: 11/5/2019 2:41 PM
INDICATION: 39-year-old female with palpable concern involving the medial left breast.
COMPARISON: Mammography 12/12/2013.
MAMMOGRAPHIC FINDINGS: Bilateral full-field digital diagnostic mammograms performed. The breasts are almost entirely fatty. Images evaluated with the assistance of CAD. Breast tomosynthesis was used in interpretation.
A BB marker denotes the palpable concern involving the medial left breast at approximately the 11:00 position.
There are no suspicious mammographic masses, areas of distortion or calcification. Focused sonography in the region of palpable left breast concern was subsequently performed.
ULTRASOUND FINDINGS: On exam, no discrete palpable breast masses are appreciated. A ridge of benign tissue is noted at the 11:00 position left breast in the region of the patient's concern.
Focused sonography at the 11:00 position left breast 6 cm from the nipple in the area of palpable concern demonstrates benign fibrofatty tissue. No cysts, masses or other suspicious sonographic findings are identified.
IMPRESSION:
No suspicious mammographic or sonographic findings.
ACR BI-RADS Category 1: Negative.
Results given to the patient. Return to annual screening schedule is recommended.0 -
Do you have the path reports from the biopsies? That might help me to answer your questions.
Normal glandular tissue enhances and the degree to which it enhances is in part dependent on hormone status so MRI is usually scheduled by the LMP if the pt is still cycling. If no irregular enhancing mass is described then the likely hood of IDC is extremely low. Stability is key in followup studies in all of radiology not just breast.
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That is a normal report. If the breasts are almost all fat there is really no place for a mass to hide plus the US showed nothing suspicious but does suggest that what you are feeling is a ridge of normal tissue. If there is no abnormality seen on Mammo and US an image guided biopsy would not be possible. If it still concerns you perhaps your PCP can refer you to a breast surgeon.
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thanks you so much
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Thank you, Djmammo.
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Thanks Djmammo. I am reluctant about the biopsy, but don't want to take chances either. If I wait for 6 months for the next tests and it does turn out to be cancerous, wouldn't that 6 month period make a difference in my stage and/or treatment options?
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also, one more question, I've been hearing a lot of about Invasive lobular cancer, is that something I should be concerned with? I've read a lot that is a much harder one to pick up on with mammogram and ultrasound, I guess what am asking is, could that area I feel, what feels like a round lump, on imaging shows as normal breast tissue, or fibrofatty as they put it. Could ILC be sneakily be the causing factor?
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Not necessarily. The standard 6 month followup period is used so that there is enough time to see a difference if there is going to be one but short enough not to change the patient's overall prognosis in a majority of cases . Talk it over with your docs .
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I received my final radiology report and have posted below. My question is: Is it a good thing that nothing was seen within the duct? What would be your guess?
Enhancing duct in the retroareolar left breast seen on the recent breast MRI. Targeted ultrasound demonstrates a mildly prominent duct in the retroareolar left breast, but no intraductal mass seen sonographically.
I was given a BIRADS score 4 or 5. Is this normal?
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On the MRI was a length of the duct enhancing or did they describe seeing an enhancing mass inside the duct?
US is good for seeing masses in ducts if they are large enough and close enough to the nipple to be in the field of view of the US .
What is their recommendation? There has to be one if they are giving it a B4 or B5 .
My preference for evaluating a duct is a ductogram . More accurate than the other two exams .
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Hi DJmammo- just wanted to give an update that I spoke to breast center and was given 1%percent lidocaine with no epi. I was given 22 CC of 1% lidocaine at the same time. I am 100 lbs. Do you think given this amount would have been reason for the symptoms I experienced?
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