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Interpreting Your Report

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  • jjjry
    jjjry Member Posts: 5
    edited June 2020
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    So a slight Asym spot would lean towards a malignant outcome?

  • jcp
    jcp Member Posts: 42
    edited June 2020
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    djmammo, the last mammogram I had said I had moderately dense breasts. I believe that was the mammo or could have been MRI. The mammo about four months prior to the MRI said said fibroglandular referring to density , or I think that was how it was spelled. So would you say I have heterogeneous density or high density or the second one closest to not much density? Thank you.

  • jcp
    jcp Member Posts: 42
    edited June 2020
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    Djmammo, sorry this is JCP again. * I updated the prior message so if you can please answer one when possible. Thank you!

    I wrote the wrong word. One mammogram said fibroglandular I believe not fibroadenoma. Other was miderate density. I dont know why they didn't classify In one of four categories. What does this refer to possibly concerning density? Thank you, JCP


  • robinorbit
    robinorbit Member Posts: 23
    edited June 2020
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    djmammo,

    I wanted to give an update about the 7 mm nodular asymmetry with indistinct margins found in my screening mammo results I posted in late May, which you helpfully interpreted for me.

    Diagnostic mammo and ultrasound were today. The radiologist recommends biopsy. She reported the unfavorable characteristics of the mass as solid, having indistinct margins, and some "concerning" shadowing. It looked non-parallel to me on the US, but she didn't mention this.) I don't even know what shape it is. But at least it's small and the lymph nodes appeared normal on ultrasound.

    The radiologist described "malignancy" (maybe tendency toward malignancy or proliferation) as a spectrum, and mentioned radial scar being about in the middle. She said (only after prompting) that her differential diagnoses were conditions beginning with radial scar and going toward the "malignant" end of the spectrum, including cancer of course. No report to post yet; I would guess Bi Rads 4b based on what the radiologist told me.

    Thank you again, and thanks to the whole community for helping me be informed and for sharing your experiences and support.

  • djmammo
    djmammo Member Posts: 1,003
    edited June 2020
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    jjjry

    That might just be their routine for diagnositics.

  • robinorbit
    robinorbit Member Posts: 23
    edited June 2020
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    I got my diagnostic mammogram and US report today—it’s 4C: spiculated, ill-defined, hypoechoic, shadowing mass with a few punctuate calcifications. Interesting no one mentioned spiculated when I was there.

  • Munalula1
    Munalula1 Member Posts: 3
    edited June 2020
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    Good news!!!!

    The biopsy results are as below.

    The breast shows a fibroadenoma. There is no DCIS. There is no invasive malignancy.
    CORE BIOPSY RIGHT BREAST AT 10 O'CLOCK
    FIBROADENOMA(B2)

    My doctor would like me to consult with a breast surgeon still and explore the idea of a lumpectomy just to be sure and also to remove the requirement for future increased screening.


  • rain88
    rain88 Member Posts: 160
    edited June 2020
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    So happy for you! 🤗

  • robinorbit
    robinorbit Member Posts: 23
    edited June 2020
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    Munalula! Congratulations!

  • robinorbit
    robinorbit Member Posts: 23
    edited June 2020
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    I was finally able to schedule my biopsy today; it's scheduled for this 6/12. Since my mass was described by the radiologist as low density and not classic for cancer, I'm hopeful it might turn out to be radial scar, sclerosing adenosis, or something similar.

  • momto3sons
    momto3sons Member Posts: 68
    edited June 2020
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    Hello djmammo! I'm hoping you can maybe shed some insight on my recent breast MRI:

    Interpretation:

    Breast tissue is heterogeneously dense. Moderate background parenchymal

    Right breast: There are several nonenhancing T2 hyperintense foci in the right breast which are consistent with cysts. The largest measures 14mm in the lower outer quadrant approximately 3.5cm from the nipple

    In the right upper slightly inner breast posterior depth, there is an irregular asymmetry measuring 16 x 10mm with intermediate kinetics. The kinetics are similar to the remainder of the breast tissue. This may correlate with partially imaged asymmetric breast tissue is seen in the upper inner right breast on mammogram of 12/19/2017. On the CAD stream workstation, there are several areas of suspicious enhancement kinetics in the lateral aspect of the right breast which do not correlate with tissue on the actual MR postcontrast images, there are to be artifactual.

    There is also a 4mm focus of enhancement along the cutaneous surface of the right upper outer breast, indeterminate. This is approximately 6.5cm frrom the nipple.

    Left breast: There are several nonenhancing T2 hyperintense foci in the left breast which are consistent with cysts the largest in the central upper left breast measures 3.1 cm approximately 4 cm from the nipple.

    Other: No enlarged axillary lymph nodes. Chest wall is unremarkable. No suspicious extramammary findings

    Conclusion:

    1. Multiple cysts bilaterally, measure up to 3.1 cm on the left

    2. Indeterminate asymmetry in the right upper inner breast posteriorly. This is favored to represent normal fibroglandular tissue, partially seen on the prior mammogram. However, additional imaging is recommended for confirmation.

    3. Nonspecific focus of enhancement in the skin in the right upper outer breast.

    4. Areas of suspicious kinteics in the lateral aspect of the right breast do not correlate with any tissue or enhancement on the MR images and are favored to be artifactual.

    Recommendation:

    Diagnostic right breast mammogram and ultrasound (this would be to further evaluate the asymmetry, enhancing cutaneous focus and to confirm the absence of any abnormal findings in the lateral aspect of the right breast).


    I had this MRI done at a different location than where my previous imaging was done, and for some reason they were only able to get access to my mammogram from 2 1/2 years ago. I did drop off CDs and reports from my last two mammograms, last June's MRI, and an ultrasound I had completed in October 2019.

  • djmammo
    djmammo Member Posts: 1,003
    edited June 2020
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    momto3sons

    Its important that the two MRI's be compared, as all of those findings may have been there before. Nothing in the report suggests cancer at this point but it looks like they'd like to clarify a few things with the additional imaging.

  • momto3sons
    momto3sons Member Posts: 68
    edited June 2020
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    Thank you for the info! Hopefully I'll hear back from them soon.

  • djabi53
    djabi53 Member Posts: 97
    edited June 2020
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    Confused by recent annual mammo letter and recommendation. Was told would get a letter in a week or a call next day if it was urgent. Got this letter day of mammo in portal saying all good. Next morning gyn's nurse called and said I needed bilateral ultrasounds. Nothing was explained to me, no risk assessment explained - just get it done. Researched and found ultrasounds are high in false positives and unnecessary biopsies.


    I've always asked techs about my density and told my density "isn't too bad." Genetic testing was negative. 12% lifetime risk/Gail model. Had diagnostic mammograms every 6 months for 2 years for bilateral faint calcifications. One was biopsied - fibrocystic breast changes. no abnormal cells.


    i'm 67, live in state with 2nd highest positive cases of covid. At risk for covid bc of age. I live with my daughter who was told she needed a lumpectomy in March but couldn't schedule it until july 29 bc of covid.


    Don't want to be irresponsible with my health - don't want to bring covid home from doctor office after ultrasound. The "day after call" meets the urgent explanation. The letter said all is good.


    Letter:

    Indication: Annual screening mammography. There is a positive family history of breast caner in her mother (age 75), maternal aunt, and cousin.

    Comparison: Multiple prior studies including 4/22/19, 4/16/18, 3/20/17, 1/3/15

    Breast Composition: c. The breasts are heterogeneously dense, which may obscure small masses.

    FINDINGS: Routine and tomosynthesis images of bilateral breasts were obtained. There is no suspicious mass, area of architectural distortion, or group of calcifications in either breast to suggest malignancy.


    ________________________

    Later I got this report.

    RECOMMENDATIONS: Routine annual mammography is advised beginning at age 40, as supported by the American College of Radiology.

    Supplemental screening with ultrasound in the setting of dense breast tissue should be a thoughtful choice after complete risk assessment and weighing the risks and benefits. We encourage women to seek more information from their doctors.

    My gyn didn't weigh risks and benefits with me...… just get it done. Why all of a sudden is my density a concern when I've been asking about it for 2 years - they weren't worried about it in when I was followed every 6 months for 2 years.


    ACR BiRADS 1: Negative

    Thank you for any thoughts about how concerned I should be.


  • momto3sons
    momto3sons Member Posts: 68
    edited June 2020
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    A bit of an update from my previous post - I dropped off the past imagining CDs and reports last Tuesday. Yesterday I received a call from the imaging center - they said the radiologist did notice changes from my last set of scans, and she would like additional imaging. So I'll be going on 7/3 for a diagnostic mammogram (possibly followed by u/s). They did say that it wasn't urgent - mainly it's so she can confirm the changes are normal.

  • Frenchiegal83
    Frenchiegal83 Member Posts: 2
    edited June 2020
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    DJ I hope you can help with a couple questions, I will be going in for a stereostatic biopsy under mammogram next Tuesday after finding concerning calcifications in my left breast. I have a long history of fibroadenomas, a few had been removed back in 2008-2009, some biopsied in 2018. I've never had problems with calcifications before and from what I've researched, these pleomorphic changes aren't the greatest news but nothing is cancer until they tell you it's cancer, so i'm trying to settle my nerves w/ education and that's why I've come to ask the expert. He showed me the imaging, there didn't appear to be a ton of these, they looked like bent rods, "c" shapes and specks of rice. So my questions are: Could calcifications be caused from removal of fibroadenomas or previous biopsies? What causes an increase in calcifications? What is a concerning amount time or # of increased calcifications to need it biopsied? Where is the "inferior posterior left breast location" exactly? How can something be "masslike" but not be a mass?! :D

    Ok that's all my questions I think, I appreciate your time and help! Below is my report.

    Mammogram report: FINDINGS: Parenchyma is heterogeneously dense. Surgical clips are noted in the inferior and medial right breast. Biopsy marker clip is present in the lateral left breast. The inferior posterior left breast demonstrates a partially visualized up to 12 mm masslike area which appears to be seen on previous outside studies. The skin marker for palpable abnormality is immediately adjacent to this. Further assessment recommended with repeat ultrasound. The upper left breast demonstrates focus of pleomorphic calcifications increased compared to previous. Magnification views confirm clustered mildly pleomorphic nature. Given progression, clustering, and mild pleomorphism, further assessment is recommended with biopsy.

  • Ciarratron
    Ciarratron Member Posts: 3
    edited June 2020
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    Hello everyone,

    Super grateful to find a forum like this - it's much better than Reddit, which always fills me with a sense of dread...

    I'm a 30 year old female with VERY minimal family history, and a mostly clean bill of health - until now.

    Found a mass in my left breast about a month ago. I was in the middle of figuring out moving specifics (my roommate dropped a bomb on me and decided to move out of state, giving me 3 weeks' notice), so I figured I'd wait and get it checked out after I got settled. I kept it to myself.

    Boyfriend found the lump last Wednesday. Went to urgent care (I'm one of those uninsured people, but not for long), and was told it was “probably benign" by the doc who checked me out. We ordered an ultrasound anyway on Friday (the 19th).

    Ultrasound results were BIRADS 4. Indistinct lobulated oval, 2cm x 1.4 cm. None of that sounds awesome at all. Biopsy is scheduled for June 30.

    It's...a lot to process. I'm expecting malignancy, but feeling mostly calm right now. I'm under a lot of pressure at work (we're still in the office), and feel AWFUL about moving into a new place with new roommates. I should have gotten it checked right away, but I stupidly decided that moving was the priority. 30 year olds, jeez. Am I right?

    Oof. There is so much information in this community, and I thank you all so much. The strength in this forum is admirable, and if this turns into something bad, I'm staying here and holding onto that strength.

    I’m sorry if I’m not posting this in the correct place, but...I guess I just needed to air it out in a place with women who know what they’re talking about.

  • Bea89
    Bea89 Member Posts: 1
    edited June 2020
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    Hi :) I was glad to stumble across this after getting my fine needle biopsy results back, however can’t find any of the words on my report. Any chance you can help me decipher this please? I go back for a core biopsy next week for further investigation. Thanks so much!!

    "The specimen is moderately cellular. Debris, foam cells and cohesive epithelial cells in a bimodal pattern, some showing apocrine differentiation and fragments of adipose tissue are present. There are some atypical epithelial cells. The features are atypical and malignancy cannot be excluded."

  • moderators
    moderators Posts: 8,184
    edited June 2020
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    Ciarratron and Bea, we are sorry that you are here and waiting for more tests to be done, but wanted to say welcome! We know how hard the waiting is, but try to take a deep breath and stay calm while you wait for your results to come back. And please remembers that most breast changes are not related to cancer, specially in young women.

    Good luck to you both and let us know how it all goes!

    The Mods


  • JustAsIAm
    JustAsIAm Member Posts: 1
    edited June 2020
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    I was wondering what “There is multifocal moderate to marked multinodular lateral breast enhancement” means if anyone knows? This is from my mri. I’m still waiting to talk with my surgeon.

    Thank you

  • djmammo
    djmammo Member Posts: 1,003
    edited June 2020
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    Djabi53

    The report is a basic normal report. The followup lay letter, the one you called a second report, contains the information now required in most states to tell patients that more than just a mammogram could be done if the breasts are dense.

    Please send me links to the articles your found indicating the degree of false positives on breast ultrasound that your referenced in your post.

  • djmammo
    djmammo Member Posts: 1,003
    edited June 2020
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    Bea89

    This is the path report that goes to your doctor, the one that ordered the biopsy. That doc is responsible for explaining this report to you, in detail.

  • everythingwillbefine
    everythingwillbefine Member Posts: 35
    edited July 2020
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    Hi,

    Glad I found this place. I am 47 and 2 young kids and I am so scared now.

    2018 I went for my screening mamo and called back for diag mamo and was recommended biopsy but was clearly told that >95% is benign and it was ALH.

    I then consulted two breast surgeons both said just watching which I did.

    2019 screening mamo was fine.

    This year 2020 June mamo they found new calcifications then I was called back for diag mamo right after. The report says as follows

    FINDINGS:
    The right breast is extremely dense, which lowers the sensitivity of
    mammography. There is a 7 mm new group of coarse heterogeneous
    calcifications in the right upper likely outer posterior breast. The X
    biopsy clip marking the previous biopsy site which showed ALH is anterior
    and inferior to these calcifications. There are no suspicious masses or
    areas of architectural distortion.

    I took the report and films to another breast center and came back slightly different report but seems even worse.

    There are linearly distributed pleomorphic calcifications in the central posterior right
    breast posterosuperiorly adjacent to the X-shaped clip, measuring approximately 1.4 cm in
    maximum AP extension.

    IMPRESSION: Suspicious calcifications in the central upper posterior right breast adjacent
    to the X-shaped clip. Stereotactically guided biopsy of the right breast is recommended.

    BIRADS: 4 - Suspicious Abnormality.

    I am now waiting for my biopsy which is on 7/10

    I am so worried. I am prepared for the worst IDC. I just want to know how big chance is that it invades to the lymph nodes already. Since my breasts are very densed that I am concerned that the cancer might be there for some time already.

  • 12jessie04
    12jessie04 Member Posts: 1
    edited July 2020
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    I hope I’m putting this in the right spot (new here). DJ MAMMO, if you could provide some feedback on my ultrasound report, I’d really appreciate it. Biopsies are scheduled 7/21/20. Appointment with breast specialist 7/31/20. Thank you so much in advance.

    BILATERAL BREAST ULTRASOUND LIMITED

    INDICATION: 49-year-old woman presents for second look ultrasound post MRI for evaluation of new densities seen on mammography. Breast MRI demonstrated lobulated regions of predominantly persistent enhancement associated with mildly increased signal on T2 in the right inferior breast 6-7 o'clock and left lateral breast 3-5 o'clock.

    COMPARISON: Breast MRI 6/19/2020, mammography and breast ultrasound 6/9/2020, 5/26/2020, 3/19/2019

    TECHNIQUE: Grayscale interrogation of the RIGHT and LEFT breasts was performed. The region scanned included right inferior and subareolar breast and left lateral breast. Doppler interrogation was performed as necessary.

    FINDINGS:

    RIGHT BREAST: In the right inferior breast adjacent to the chest wall and corresponding in location to lobulated enhancing region, there are hypoechoic irregularly marginated and lobular foci which demonstrate bleeding vessels and appear to represent different vibration characteristics on power Doppler vocal fremitus evaluation. In the right breast in region of involvement measures approximately 1.4 x 1.1 x 0.7 cm.

    LEFT BREAST: Sonographic evaluation of left lateral and lower outer breast demonstrates shadowing region which is ill-defined, taller than wide with irregular margins measuring approximately 1.6 x 2 x 1.9 cm. Power Doppler vocal fremitus evaluation confirms this to represent a real finding.

    IMPRESSION: Bilateral regions of sonographic shadowing, ill-defined, centered in the right posterior breast at 6:00 and left lateral breast 3-4 o'clock, corresponding to regions of increased lobular enhancement on MRI and more nodular asymmetry on mammography. Differential considerations include: stromal sclerosis/fibrosis, Pseudoangiomatous Stromal Hyperplasia (PASH), lobular and other neoplasia. While benign etiology is favored, definitive diagnosis would require tissue sampling.

    BI-RADS: 4 Suspicious

    RECOMMENDATION: Biopsy Bilateral Bilateral ultrasound guided biopsy of right inferior breast region of shadowing at 6:00 and the left lateral breast 3-4 o'clock.


  • jothegreek
    jothegreek Member Posts: 8
    edited July 2020
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    Subject: birads 3 needing biopsy exactly 2 years after (benign) excisional biopsy 58 yo

    Hi guys, hi djmammo! Heart Haven't posted in a while as last year's breast routine tests were ok and I pushed the whole issue to the back of my mind not that the rest of my health problems allow me to be very carefree anyway (diagnosed with borderline MGUS/smouldering myeloma last year, just watch-and-wait still, no chemo or other therapies)...

    Fast forward to present summer's breast imaging where a new finding is observed in both the digital mammogram and the 3D/4D ultrasound. As I'm translating the terminology from Greek please bear with me! The mammogram states that in the posterior tertile of my right breast an asymmetry is observed which constitutes a new finding compared to last year's mammogram. The 3D/4D U/S confirms that at the posterior breast region @ 6.00 h of my right breast there's a solid spindle-sized nodule 0.9 cm which is well defined, has poor vascularity and medium stiffness in elastography (BIRADS 3) and a biopsy is recommended as it is a new finding and I'm 58 yo (which, I guess, means that no finding is considered benign anymore and everything has to be checked out through biopsy...).

    Mind you that this is the exact spot in my right breast where a wide excisional biopsy took place back in July 2018 with the histology findings being listed below in the description of my lesions.

    I'm consulting with my doctor/breast surgeon this Thursday and, of course, getting prepared for yet another summer surgery which doesn't make me very happy but what can I do, not much other than adhering to my doctors' guidelines...

    I would love to have the input of both djmammo as well as anyone else's who has had a similar experience with a new lesion in the exact spot of a previously biopsied area so as to know what I should expect this time...

    Thank you so much for listening and I'll be grateful for any responses.

    Happy summer wishes to all of you,

    As ever,

    Jo

  • GracieLulu
    GracieLulu Member Posts: 3
    edited August 2020
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    Seeking your wisdom again djmammo. Here is my latest MRI report. My provider and the radiologist are both “surprised" by new enhancements 6 months after my last screening MRI and biopsy. Not very reassuring to hear. Thank you in advance for any input


    BILATERAL BREAST MRI WITH AND WITHOUT CONTRAST

    CLINICAL HISTORY: 39-year-old woman with a family history of two sisters with breast cancer. She underwent right breast MRI guided biopsy in January 2020 revealing benign breast tissue with nodular adenosis and secretory type changes. Six-month follow-up bilateral breast MRI has been recommended.

    COMPARISON: Prior breast imaging dating back to 7/15/2019.

    LMP: 7/13/2020

    TECHNIQUE:

    TSE T1 coronal images, inversion recovery axial images, T1W TSE axial images, pre contrast 3D-T1W fat-saturated axial images at 1 mm slice thickness, dynamic 3D-T1W fat-saturated axial post-contrast images at 1 mm slice thickness, and delayed 3D-T1W fat-saturated axial post-contrast images of both breasts were obtained. Axial subtraction images were obtained from the precontrast T1W and the dynamic post contrast T1W images. Intravenous administration of 9 cc of Multihance for this study was administered uneventfully. Dynacad computer aided detection was utilized in the interpretation of this breast MRI examination.

    IMMEDIATE ADVERSE EVENT: None

    FINDINGS:

    BACKGROUND PARENCHYMAL ENHANCEMENT: There is minimal background parenchymal enhancement.

    TISSUE COMPOSITION: Heterogeneous fibroglandular tissue.

    RIGHT BREAST:

    There is new, linear nonmass enhancement with associated rapid initial and delayed persistent enhancement along the 12:00-2:00 axis and extending into the nipple, measuring up to 6 cm anterior to posterior. There is no associated T2 hyperintensity.

    Biopsy marker signal void is present at the upper outer right breast at the site of previous benign biopsy. There has been interval resolution of the associated nonmass enhancement.

    There is no evidence of right axillary lymphadenopathy.

    LEFT BREAST:

    12:00 N5: Nonmass enhancement with mild associated T2 hyperintensity measures 0.4 x 0.5 x 1.2 cm. Finding may be more conspicuous on today's exam due to an interval decrease in background enhancement since previous exam.

    There is no evidence of left axillary lymphadenopathy.

    MEDIASTINUM/LIVER/CHEST: Trace layering right pleural effusion is likely physiologic.

    IMPRESSION:

    1. Right breast: Suspicious nonmass enhancement centered upon the upper inner quadrant-measuring up to 6 cm and extending into the nipple. Right diagnostic mammogram and targeted right breast ultrasound recommended. If sonographic correlate not identified, MRI guided biopsy would be indicated.

    2. Left breast: Mildly suspicious left nonmass enhancement, 12:00 N5 position. Diagnostic mammogram and targeted left breast ultrasound recommended. If correlate not identified, MRI guided biopsy would also be indicated.

    BI-RADS ASSESSMENT CATEGORY 4 SUSPICIOUS

    RECOMMENDATION:

    1. Bilateral diagnostic mammograms and targeted ultrasound.

  • Mangosan99
    Mangosan99 Member Posts: 38
    edited July 2020
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    Djmammo; thank you in advance for any info/insight you can shed on this results of my MRI. I have been on this journey since early June (had screening mammo, diagnostic mammo, and biopsy which led to genetic testing and this MRI before any more surgery. Still pending results of genetic testing and followups with first and second opinion breast surgeons so wanted to get any info I can while waiting. Just FYI, reason for collapsed implants is I was preparing for cosmetic revision when COVID hit--left had ruptured, right was drained to determine volume; delay led to annual mammogram, and now here!

    My main questions are whether these findings are definitive for upstaging and, if so, are the indicative of DCIS? or are we looking at invasive BC?

    CLINICAL INDICATIONS: D48.62 (Neoplasm of uncertain behavior of left breast)
    R92.0 (Mammographic microcalcification found on diagnostic imaging of breast)
    Z80.3 (Family history of malignant neoplasm of breast) . 52-year-old with history of left atypical ductal hyperplasia from stereotactic biopsy. She is premenopausal and is not on hormones. Maternal and maternal grandmother history of breast cancer.
    History of breast augmentation

    TECHNIQUE: Axial T1 nonfat saturated, T2 fat saturated, and precontrast fat saturated sequences were obtained. After the uneventful intravenous administration of 15 mL MultiHance, 5 total dynamic post-contrast sequences were obtained with subtraction
    axial and sagittal subtracted and axial MIP reconstructions. A post contrast oblique series was acquired. Imaging was evaluated with DYNACAD software on an independent workstation for kinetics assessment.

    COMPARISON: Prior mammograms back to 2016

    FINDINGS: The breasts are composed of heterogeneous fibroglandular tissue. There is moderate symmetric background parenchymal enhancement.

    LEFT BREAST: There is a T2 hyperintense chamber containing a clip on T2-weighted image 25 corresponding to T1 weighted nonfat saturated image 25. This is immediately deep to the skin in the lateral slightly lower left breast. On this examination, the
    nipple is folded to the left. There is a deflated implant shell in the subpectoral left chest wall. There is a small amount of T2 hyperintense fluid within the capsule without associated enhancement.

    In the left lateral slightly lower breast, adjacent to the biopsy clip, there is mass enhancement which measures 1 x 1 cm on image 27. There is segmental nonmass enhancement which extends about 2.3 cm as seen on image 28. These areas show plateau
    kinetics. In the left central breast, on image 33, there is more confluent nonmass enhancement which spans 1 x 0.7 cm and appears more unique in the background enhancement. In addition, in the upper outer posterior left breast, there is confluent mass
    enhancement on sagittal oblique image 36, corresponding to axial image 42 on the sagittal oblique sequence, this has angular margins. No left axillary or internal mammary chain adenopathy. Skin and chest wall structures appear unremarkable.

    RIGHT BREAST: In the background of moderate enhancement, there is an area of clumped nonmass enhancement in the right breast at 12:00 measuring 0.9 x 0.8 cm on image 46 with a correlate measuring 1.1 cm on sagittal reconstructed image 40. No right
    axillary or internal mammary chain adenopathy. Skin and chest wall structures appear unremarkable. Deflated subpectoral saline implant shell.

    EXTRAMAMMARY SOFT TISSUE AND OSSEOUS STRUCTURES: No abnormality identified.

    ASSESSMENT: BI-RADS 4: Suspicious

    Adjacent to the clip in the left lower outer breast, there is confluent mass enhancement which measures 1 x 1 cm. There is clumped segmental nonmass enhancement which extends posteriorly over an additional 2.3 cm.

    In the background of moderate enhancement, there is unique enhancement in the right upper central breast at 12:00 (image 46), in the left central breast (image 33), and in the left upper outer breast (image 42) as described above. Patient was imaged in
    the luteal phase. This could be hormonally mediated. Consider MRI directed biopsy.

    Collapsed saline implant shells. Small amount of fluid surrounds the left shell within the capsule. No abnormal enhancement.

    MANAGEMENT: Biopsy is recommended.

    Bilateral breast MRI directed biopsy should be considered for the findings described above.

  • irina7k
    irina7k Member Posts: 1
    edited July 2020
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    Djmammo, could you please interpret my US results.. I am freaking out as I am currently pregnant (first trimester). I have "irregular shape mass, non parallel orientation" which fall under "less favorable". I am preparing myself for the worse but just wanted to hear your opinion.. THANK YOU SO MUCH!!!

    -------------------------------------

    FINDINGS:
    BREAST ECHOTEXTURE: There is a homogeneous background echotexture - fibroglandular.

    Right 10 o'clock 4 cm from nipple area of palpable lump as per the patient, 1.1 x 0.6 x 0.7 cm septated cyst, benign-appearing. Benign right axilla. Left 7 o'clock 2 cm from nipple nonparallel orientation irregular shape mass, indistinct margins, 0.5 x 0.5 x 0.5 cm, suspicious. Benign left axilla.

    IMPRESSION:

    1. Suspicious left breast 7 o'clock 2 cm from nipple ultrasound lesion. Monitoring stability over time will not be able to confirm a benign etiology in this case. Ultrasound-guided core biopsy left breast x1 recommended. Bilateral mammography would usually be recommended in this situation prior to biopsy. However, given the current pregnancy, mammography should only be performed after the first trimester with abdominal shielding, if left breast ultrasound core biopsy shows an indication for surgical intervention.

    2. Right breast 10 o'clock 4 cm from nipple shows a benign-appearing cyst corresponding to the clinically palpable lump.

    FOLLOW-UP: Ultrasound guided biopsy.


    ASSESSMENT: BI-RADS Category 4: Suspicious.

  • RosaMystica
    RosaMystica Member Posts: 1
    edited August 2020
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    Feeling anxious about my 3D screening mammogram results. I've had several mammograms, ultrasounds, and MRIs over the years, but this was my first 3D mammogram and unfortunately I got a callback. I'm wondering how common benign findings are for asymmetry found on a 3D screening mammogram. Everything I've read online says that 3D mammograms significantly cut down on diagnosis of superimposition of normal breast tissue (summation artifcant), which seems to be most common "good" finding that can come of this.

    About me: previous diagnosis of 'ALH within fibroadenoma' (left breast) back in 2011 at age 26. Since that diagnosis I have seen a breast specialist every six months for clinical exams, yearly mammograms, and occasional MRIs. No other significant findings since the ALH diagnosis.

    Redacted report is below (I excluded the personal information):


    IMPRESSION: INCOMPLETE: NEEDS ADDITIONAL IMAGING EVALUATION

    The asymmetry in the right breast is indeterminate. Additional views are
    recommended.

    letter sent: Additional Imaging Needed
    Mammogram BI-RADS: 0 Incomplete: needs additional imaging evaluation

    BILATERAL DIGITAL SCREENING MAMMOGRAM TOMOSYNTHESIS WITH CAD: 7/24/2020

    HISTORY: Multiple Diagnoses /Screening Mammogram-patient reports no
    symptoms.

    RESULT:

    TECHNIQUE: The study was acquired using full field digital technology and
    interpreted from soft copy.
    Digital Breast Tomosynthesis (DBT) images were obtained and used to
    assist in the interpretation of this examination.
    Current study was also evaluated with a Computer Aided Detection (CAD).
    Comparison is made to exams dated: 3/14/2018 mammogram - Beachwood
    Family Health Center, 10/19/2018 breast MRI - The Women's Health & Breast
    Pavilion, 10/22/2018 ultrasound, 10/22/2018 ultrasound biopsy, and
    4/11/2019 mammogram - Beachwood Family Health Center. The tissue of both
    breasts is heterogeneously dense. This may lower the sensitivity of
    mammography.

    There is an asymmetry in the right breast anterior depth lateral region
    seen on the craniocaudal view only.
    No other significant masses, calcifications, or other findings are seen
    in either breast.

  • moderators
    moderators Posts: 8,184
    edited July 2020
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    Hi all --

    Our wonderful, helpful, and much-needed djmammo has reached out to let us know that he's having some back issues and is in bed recovering for some time and will not be able to weigh in with assistance on reports for a little while. So, we are going to lock the thread for now.

    We know this thread helps so many, and we are sorry to shut it down for a little while.

    If you've posted here and are waiting a response from djmammo, we encourage you to copy and paste your post into a new thread here in the Not Diagnosed but Worried forum, where others can hopefully weigh in with their thoughts. We do have many other very helpful members who are always happy to help!

    So sorry for the inconvenience, and we, along with you, are sending djmammo lots of healing vibes for a quick and full recovery!

    --The Mods