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Indentation Left Breast, Clear US and Mammogram

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Pugmama83
Pugmama83 Member Posts: 11
edited September 2020 in Not Diagnosed But Worried

Hi, I am 36yo 2 months postpartum and currently breastfeeding. I noticed a lump on my right breast while breastfeeding my daughter two weeks ago. Upon noticing this I preceded to examine both breast and noticed a indentation when raising my arm under my left breast. I was initially ordered a ultrasound by my OB for the lump which was listed as a node. They added a 3D Mammogram and Ultrasound of the effected areas on both breast. Below are my results which are apparently clear but do not address what the indention is. I have dense breast and am currently breastfeeding, still anxious about the indentation which points everywhere as negative

TECHNIQUE:

Routine 2D CC, MLO views, and true lateral views of both breast were obtained with tomosynthesis imaging.

FINDINGS:

Diffuse dense glandular breast tissue is present.

There are prominent ducts compatible with lactational change.

No irregular mass, architectural distortion, or suspicious microcalcification in either breast.

BREAST ULTRASOUND:

RIGHT Breast:

Evaluation over the upper outer quadrant right breast shows diffuse glandular breast tissue intermixed with fatty breast tissue. No solid mass lesion or cyst. No abnormal area of shadowing.

Evaluation over the lower inner quadrant right breast in regards to the area palpable concern shows normal underlying breast tissue. There is mild nodularity on exam typical for fibroglandular breast tissue. No firm or fixed mass.

LEFT Breast:

Evaluation over the lower inner quadrant left breast in regards to the palpable area of concern shows normal underlying breast tissue. There is mild nodularity on exam typical for fibroglandular breast tissue. No firm or fixed mass.

How should I go forward as my concern was not really addressed

Comments

  • beesie.is.out-of-office
    beesie.is.out-of-office Member Posts: 1,435
    edited June 2020
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    Pugmama, have you discussed the results with your OB? Did your OB indicate that the dimple could just be from changes in your breast from breast feeding?

    Anytime a dimple is found, it should be investigated because it could be a sign of breast cancer, so your OB did the right thing by sending you for imaging. But with the mammogram, ultrasound and physical exam all coming back showing no abnormalities, it's most likely that the cause of the dimple is the breastfeeding. The report you received is very specific in saying that there is "normal underlying breast tissue" and "no firm or fixed mass" in the area of concern - and that is what they would be looking for as a cause for the dimpling if it was breast cancer. It sounds as though you had a thorough examination.


    "Dimple In the breast: A wide, shallow dimple in the breast is a sign of skin retraction. Dimpling can be caused by the shortening of the Cooper's ligaments, which may be a sign of inflammation or breast cancer."


    If you read up on Cooper's ligments, you will see that they are greatly affected by breast feeding - and changes in these ligaments are often the cause of the appearance of dimpling.

    "I was initially ordered a ultrasound by my OB for the lump which was listed as a node." Was this in a different report or are your referring here to the comment in your ultrasound report that said "There is mild nodularity on exam typical for fibroglandular breast tissue." Mild nodularlity is not related to lymph nodes, it just means that there are small lumps, which is perfectly normal for most of us who have fibrocystic breast tissue.

    From the reports it sounds as though you have normal healthy breasts that are being affected by breast feeding.

  • Pugmama83
    Pugmama83 Member Posts: 11
    edited June 2020
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    No, my OB has never seen the indent. I did not discover it till after my appointment regarding the lump. I called the nurse prior to my ultrasound and they adjusted the order for both breasts. It’s the indent that concerns me most as I was told by a surgeon friend that there should be a underlying cause and I was not given anything by the radiologist

  • Pugmama83
    Pugmama83 Member Posts: 11
    edited June 2020
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    Bessie, I just got back from the OB she was concerned and ordered additional imaging she said she needs to review what is best for breastfeeding

  • Each_day_2018
    Each_day_2018 Member Posts: 66
    edited June 2020
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    HI -when I initially went to the doctor for a palpable lump, we could see a tiny indentation when my arm was at certain angles and feel the lump, but ultrasound and mammogram were clear...as in not even showing the lump we were all able to feel. While I did follow up with a breast specialist, they did not recommend a biopsy at the time due to my age (29) and changes due to the fact that I had recently stopped breastfeeding my third child. Since they weren't concerned, why should I be? Anyways, fast forward nearly two years. The indentation is what made me go back. It was much more pronounced and didn't matter if my arm was up or down.

    Since it looks like you are going back for additional imaging, I would push for a biopsy. If it's nothing, then you have no reason to be concerned. If it's something, you're getting a super head start. But either way, you'll have an answer. Keep in mind, the chances are in your favor that everything will be fine, but there's always the chance it might not be. I don't like to give people a false sense of security...I fell for that and was diagnosed Stage 3 at age 31. Everyone told me chances are it's nothing...but that's not always the case and it's best to get all the answers that you can! Best wishes, and keep us updated!

  • Pugmama83
    Pugmama83 Member Posts: 11
    edited June 2020
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    Each-day, thank you. I am petrified that something will be missed cause I am breastfeeding it does not help that I am looking at an holding my breast all day during this

  • beesie.is.out-of-office
    beesie.is.out-of-office Member Posts: 1,435
    edited June 2020
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    Pugmama, I didn't realize that your OB had not seen the dimple. Do you know what additional testing she is requesting? Since you've had a 3D mammogram and an ultrasound, next up I guess would be an MRI. MRIs are very sensitive so it would hopefully pick up anything that's there, but it can also pick up benign harmless stuff.

    If nothing shows up, then there really is nothing to target for an accurate/meaningful biopsy. While I understand what your surgeon friend said about an underlying cause, it doesn't mean that the underlying cause is necessarily something that would be seen on imaging. For example, if the cause is related to breast changes from breastfeeding, that's not something that would likely show up a mammogram, ultrasound or MRI. So if you have additional screening that is clear, at that point the recommendation might be to continue to monitor the dimple, to see if it gets worse or goes away on it's own. Breast dimples must be checked out, but they certainly can have benign causes. Sometimes the cause is never discovered. If the dimple remains for a period of time after you've stopped breast feeding, and/or become worse, then obviously you'd need to go back for more testing.

    The odds are that this is benign. And the good news is that Radiologist and your doctor are taking this seriously.

    Let us know what happens.



  • Pugmama83
    Pugmama83 Member Posts: 11
    edited July 2020
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    Thanks Bessie, I am currently spiraling I can’t find any good indent outcomes and with the possibility of it being Pregnancy Associated Breast Cancer I am aware of the negative prognosis if cancer. How do you deal with the waiting

  • Pugmama83
    Pugmama83 Member Posts: 11
    edited July 2020
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    I have a appointment next Wednesday with a breast surgeon any advice an what to ask

  • beesie.is.out-of-office
    beesie.is.out-of-office Member Posts: 1,435
    edited July 2020
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    Since your mammogram and ultrasound screening was clear but the dimple is evident, I'd suggest you ask for an MRI.

    And if the MRI is clear (or if the breast surgeon insists that an MRI is unnecessary), I'd ask whether, given the clear imaging results, you can feel confident that the dimple is not caused by breast cancer. And if so, what would be benign causes for a dimple and what does the breast surgeon think the benign cause is for yours? And how common are benign dimples, specifically in breast feeding women?

    You want to leave the appointment feeling comfortable either that the dimple is harmless, or that more testing will be done to find the cause and/or ensure that it's not caused by breast cancer.

  • Pugmama83
    Pugmama83 Member Posts: 11
    edited July 2020
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    Beesie, I had a follow-up with the BS today. He did a breast exam and ultrasound there in the office he said he did not see a underlying cause and was less concerned that it took me being at a specific position to show it. Acknowledged the ILC does not present with lumps but does show shadowing typically. He ordered a MRI for my comfort but is unsure on what difference it might show and if insurance will cover it. He also said he wants me to do exams monthly as a go forward, keep monitoring and let him know if it is worse of still there after breastfeeding. Your advicewas much the same. Thank you for this. I will update if there are any changes.

  • beesie.is.out-of-office
    beesie.is.out-of-office Member Posts: 1,435
    edited July 2020
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    Good luck with the MRI. I hope that it's clear - that wouldn't explain what's causing the indentation, but it would be reassurance that you don't have breast cancer. And a clear result is always better than having something show up on an MRI.

    Hope there is no problem with insurance coverage for the MRI.

  • Pugmama83
    Pugmama83 Member Posts: 11
    edited July 2020
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    Update, over the past few days I have discovered a new indent on the lower outer left quadrant of my breast. I have one on the inner lower. This one is smaller but they seem to be forming a half moon together. It is seen when I lean over and you look under neath my breast. I don’t know what to do to get answers, I have emailed the BS with a update and will be getting the MRI now even if I have to pay out of pocket. Can a MRI show info during breastfeeding or should I quit cold turkey

  • Pugmama83
    Pugmama83 Member Posts: 11
    edited July 2020
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    My MRI was not approved by insurance. I am going to stop breastfeeding to see if the dimples clear up. If not I will get a MRI out of pocket. The BS said if things stay the same he will have me come in for another mammogram and us in 6months

  • Pugmama83
    Pugmama83 Member Posts: 11
    edited September 2020
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    Update to the post. The breast surgeon called me today and said the results of my MRI looked normal. I just needed to follow-up in 3 months for a Mammogram and Ultrasound to keep an eye on things. Thank you, Bessie I am very very appreciative for your insite.

  • minustwo
    minustwo Member Posts: 13,119
    edited September 2020
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    Pugmama - great news. Thanks for coming back & posting the results.

  • beesie.is.out-of-office
    beesie.is.out-of-office Member Posts: 1,435
    edited September 2020
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    You're welcome!

    Congrats!