Interpreting Your Report
Comments
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djmammo:
Can you please, please, please help interpret my ultrasound report? I am literally having a panic attack right now. So, so, so frightened!
“INDICATION: Right upper-outer quadrant lump and female.
BREAST ULTRASOUND, RIGHT: High resolution linear transducer ultrasound is performed with attention to
FINDINGS: Comparison: 12/10/2015 right breast upper-outer quadrant.
Ultrasound of the entire right breast is performed. In the upper-outer quadrant there are 2 small cysts identified measuring 5 and 6 mm.
In the upper inner quadrant 2 o'clock position 1-2 cm from the nipple there is a 1.0 x 0.7 x 0.9 cm ovoid hypoechoic nodule versus complex cyst. Ultrasound-guided biopsy is recommended.
In the 2 o'clock position 4 cm from the nipple there is a 0.5 x 0 and to a 0.5 cm hypoechoic lesion with internal echoes probably a complicated cyst versus a tiny fibroadenoma. This is wider than tall with benign sonographic features. The remaining right breast is unremarkable.
IMPRESSION: BI-RADS: -4A. Suspicious (but low suspicion for malignancy).
RECOMMENDATION: Ultrasound-guided biopsy of the 2:00 retroareolar lesion.
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- Just got back, the Dr said it was a catagory 4 A. I didn't ask a lot of questions.
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Sounds like they feel these are probably benign but they want to prove that they are benign. Let us know how the biopsy goes.
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djmammo:
Thank you for your quick reply. When the radiologist was scanning the area where he is recommending biopsy, he showed me the screen and told me “see how this is black but has a little bit of gray? Simple cysts are all black. It looks to me like a complex cyst, fibroadenoma or possibly an intraductal papilloma. See how the edges are round and smooth? That’s a good sign.” When he was pressing the transducer on that area it hurt too. It usually always hurts.
I just turned 35 and he started telling me that the majority of these tend to be fibroadenomas. I’m so afraid of this being cancer
I have no family history of cancer but fibrocystic breasts on my mother’s side of the family. Have you ever seen a Birad 4a (but low suspicion for malignancy) on a report before?
Thank you so much for all of your help
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You were fortunate to have a radiologist that took the time to explain all that so you would not worry, and in addition put in the report that the likelihood of cancer is very low. You should choose to believe him while you are waiting for the biopsy.
I have seen and also used that designation 4a in my reports. It is very common.
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Thank you so much djmammo for your response. I really appreciate it
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I just received my spot magnification report. How common are "far posterior" group of pleomorphic microcalcifications? I think the far posterior alarms me because I am having some local pain under my shoulder blade area.
DIGITAL DIAG MAMMO UNILATERAL
15Feb2018 02:15PM
Test Name
Result
Flag
Reference
DIGITAL DIAG MAMMO UNILATERAL
(Report)
Patient History
No known family history of cancer.
Last mammogram was
performed 1 month ago.
Reason for exam: screening (asymptomatic).
MG-PMG
MAG/SPOTS/ADD VIEWS L: Left Breast - February 15, 2018 -
Exam #:
CC and MLO view(s) were taken of the left breast.
Technologist:, Mammo Tech
Prior study comparison: January 20, 2018, bilateral
MG-PMG MAM SCREEN BILAT.
SPOT MAGNIFICATION OF LEFT BREAST:
The left breast is heterogeneously dense, which may reduce the
sensitivity of mammography.
The spot magnification demonstrates a group of mildly
pleomorphic microcalcifications in the far posterior aspect of outer
portion of left breast. A stereotactic biopsy, is advised.
ASSESSMENT:
Category 4: Suspicious
Recommendation
Stereotactic biopsy of the left
breast.
CONCLUSION: Stereotactic biopsy of microcalcifications of left
breast, is recommended. Suspicious abnormality - Biopsy
recommended. ACR Class IV.
I am heading out to the imaging office to obtain the radiologist's report (hopefully more indepth than the summary above) and a disk of the magnified views.
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"How common are "far posterior" group of pleomorphic microcalcifications?"
No more common than any other location within the breast. Post the reports when you get them
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So, I'm preparing for the worst and hoping for the best! I got a copy of my diagnostic mammogram/ultrasound report. Researching these findings doesn't look good to me. Am I correct in thinking that this is not a good report? Biopsy is tomorrow. Thanks for your input!
Sonography:
"Sonographic examination of the right outer breast demonstrates a focus of hypoechoic, shadowing breast parenchyma, measuring 2.5 cm, I'll-defined, with possible associated architectural distortion."opinion:
"Focus of Sonographically abnormal breast parenchyma at the 9-o'clock position of the right breast, 12 cm from the nipple, with I'll-defined margins and posterior acoustical shadowing, in the region of vaguely increased breast parenchyma density..." and "there is question of a lymph node in the lateral breast."0 -
just returned and signed my release but all I received as a report is what I posted above.
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Thanks djmammo for all the help you provide everyone here. We are lucky to have you.
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I dont see any connection between the calcifications and your symptoms. Let us know what the biopsy shows.
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They used a few worrisome adjectives in that report you posted, so the biopsy seems to be indicated. Does the report mention if that lymph node they saw is abnormal in its appearance?
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re: the lymph node, they noticed it on the screening mammo and highlighted it, then, under sonography, it says, “Nearby, there is a sonographically unremarkable mammary node.” Finally, in the report opinion, is where they mentioned it again saying, “ given the sonographic findings, sinographically guided core needle biopsy of the sonographically breast, and potentially, the adjacent lymph node is recommended.”
Seems a little contradictory. I guess they just want to check it out while there?
Thanks
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I would consider biopsying both to be good practice. Saves time, saves a second biopsy. If they're close enough to eachother they might be able to sample both through one entry site.
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Djmammo
I need help interpreting my US and mammogram results. I am having a biopsy on Thursday. Background, I'm 37 with 3 small children. My youngest is 5 months old. Noticed a puffy spot in my armpit and thought it had something to do with pregnancy. Finally told my dr about it and she thought it ws a lipoma but said we would do an ultrasound but to make sure.
US report
There is a poorly circumscribed ovoid shaped macrolobulated isoechoic mixed cystic and solid mass corresponding the area of clinical concern. There is a faint hypermia as surrounding the mass. The mass measure 1.9x0.8x2.1cm
Mammogram results
The heterogeneously dense fibroglandular tissue demonstrates a diffusely nodular configuration bilaterally felt to most likely represent fibrocystic changes bilaterally. Breast density limits sensitivity of the mammogram exam, but no definite suspicious masses, architectural distortion, malignant appearing calcifications, skin thickening or nipple retraction is demonstrated within the breast bilaterally
A large, lobulated, incompletely circumscribed, dense mass is demonstrated with the right Axillary region. This persists on appt compression magnification images. No associated archtectural distoration or malignant appearing calcifications are present in this area on spot compression maginification images. This correlates well with the recent ultrasound finding in the right Axillary region.
Recommend biopsy or 6 month follow up
Birads 4
I opted for biopsy.
Please help me understand what they may be thinking this is.
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If I understand correctly you are 5 months postpartum. When did your underarm become puffy? Is it on both sides?Do you have any old mammograms done before the current one?
Some people have areas of additional normal breast tissue under their arms and it responds to pregnancy hormones just like the tissue within the breast. It will enlarge with pregnancy and in some people become large enough to be seen from across the room. If you have an old mammogram showing this kind of tissue under that arm (usually both) that would be helpful.
Let us know how the biopsy goes.
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this was my first mammogram due to my age I was planning on starting them at 40, so I don't have a comparison. I have had 3 kids in four years and have nursed all of them. I am currrently nursing the 5 month old. I don't see the puffiness in my left armpit. I noticed the puffiness during my last pregnancy when I was about 5 month a long...so last May
Do the reports seem alarming to you
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They took 8 cores. They did not biopsy the lymph node. They felt it was fine...within parameters, or something like that! Now we wait!
Thanks for your input!!
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"No associated architectural distortion or malignant appearing calcifications are present in this area on spot compression magnification images"
The report says there are no alarming findings, see sentence above. It will still need to be biopsied but you need not panic while waiting for the biopsy.
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thank you...biopsy is tomorrow
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Hi! I know your original pos is from 2010 but is there a current quick reference guide as the original is no longer available. Thank you
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That's a great guide DJMAMMO you deserve accolades
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hi Djmammo,
Can you help me interpret the following report:
REPORT
ULTRASOUND OF THE LEFT BREAST
REASON FOR EXAM: Left breast asymmetry
COMPARISON: Prior mammogram dated 02/01/2018
TECHNIQUE: Real-time radial and antiradial sector scans were performed of the left breast.
FINDINGS: Heterogenous dense fibroglandular breast density. Hypoechoic density at the 11:00 position asymmetries the nipple measuring 1.4 x 0.6 x 1.0 cm in size. This has irregular margins with no internal vascular flow. Posterior acoustic enhancement is identified. Hypoechoic mass at the 11:00 position 10 to 12 cm from the nipple. There is internal calcifications measuring 1.8 x 2 x 1.6 cm in size. No internal vascular flow. Angular margins are identified. No evidence of axillary lymph nodes.
IMPRESSION:
The heterogenous dense mass with angular margins at the 11:00 position 10 to 12 cm is in the site of patient's previous known cancer with lumpectomy and radiation. Underlying recurrence cannot be ruled out.
Additional hypoechoic appearing nodular density at the 11:00 position 8 cm from the nipple.
With patient's last previous surgical history and history of previous cancer with lumpectomy and radiation a MRI of the bilateral breasts are recommended. Off of enhancement characteristics possible ultrasound-guided needle biopsy of these lesions might be performed. Overall case and findings were discussed at length patient at bedside.
ACR CODE (0): INCOMPLETE - NEEDS ADDITIONAL IMAGING EVALUATION.
IN THE INTEREST OF EXPEDITING PATIENT CARE, WE WILL CONTACT THE PATIENT TO COMPLETE THE EXAMINATION.
ADDENDUM
Correction: Please note, ACR code below should read as follows:
ACR CODE (0): INCOMPLETE - NEEDS ADDITIONAL IMAGING EVALUATION.
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I posted with my report a few weeks ago and wanted to return to update everyone reading, though unfortunately with bad news. My original report from the radiologist at my health clinic was BI-RADS 4, but when radiologists at the hospital I went to next re-read the images, they assigned it BI-RADS 5. The morning of my biopsy I had more mammography and ultrasounds done, including of two enlarged axillary lymph nodes the original radiologist had missed, and they essentially told me I have cancer before even doing the biopsy. I had a needle core biopsy of the mass and one of the lymph nodes and as expected, both of them came back positive.
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I’m so sorry to hear that bear! Prayers to you
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Not the clearest report is it? Wording is odd in spots. Descriptions are incomplete.
There are two areas of concern, one which might just be the scar at the site of prior lumpectomy, the other has calcifications in it but they didn't say what kind, which makes a big difference. Good that they didn't blood flow in the masses.
Bottom line given your history MRI is your best bet followed by a 2nd Look ultrasound if there is something on the MRI they want to biopsy.
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Thank you Djmammo. I appreciate you providing some clarity for my ultrasound report. I've been reading the outcomes of others on these boards and it has been extremely helpful. I've learned much more than I knew when I had my first bought with cancer 21 years ago. I'm hopeful that further studies will reveal b9 findings. Also of note, I had a 3D mammogram on 2/1/18. The mammogram prompted the ultrasound because the area near the scarring was further enhanced when compared to the 2D mammogram I had in Oct 2016. Also, the 3D mammogram idid not pick up the second mass described as having calcifications. Thoughts?
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Hi Newenglandrn,
How did your biopsy turn out. Your ultrasound report sounds very similar to mine
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