Please help me understand these results.
Hi I am scheduled for a Biopsy on Monday. I don't really understand alot of the language in the results I have gotten so far. Not sure how worried I should be. So any help would be appreciated. Thanks!
EXAM: Diagnostic right breast ultrasound
CLINICAL HISTORY: Unspecified lump in breast. N63
COMPARISON: Bilateral diagnostic mammogram of the same day
TECHNIQUE: Targeted ultrasound of the right breast was performed. Grayscale and color Doppler evaluation was
utilized.
FINDINGS:
In the area of palpable clinical concern, corresponding to the solid palpable region on clinical exam at the
6:00-9:00 retroareolar region, there is an asymmetric fibroglandular density seen without distinct borders.
The area of clinical interest is distinct from the other quadrants of the right breast and the left breast
which was scanned for comparison purposes. No discrete mammographic abnormality seen within the background
density of the fibroglandular tissue.
IMPRESSION:
Asymmetric fibroglandular density in the lower outer quadrant right breast corresponding to the palpable
clinical concern.
Follow-up MRI breast examination with and without contrast is recommended. In addition, targeted biopsy of
the clinical palpable abnormality should be considered. Consultation with breast surgeon advised.
Federal regulations require all breast imaging reports to have an overall final assessment. Based on the
above findings, this examination is classified as:
EXAM: Bilateral diagnostic mammography
CLINICAL HISTORY: Palpable lump right breast
BREAST DENSITY: Category 4: The breasts are extremely dense, which lowers the sensitivity of mammography.
The patient may benefit from supplementary screening tests, which can include a breast ultrasound screening
or breast MRI examination, or both depending on the individual risk factors.
Breast tissue density was determined by objective volumetric assessment utilizing Volpara version 1.x.
TECHNIQUE: Digital bilateral routine CC and MLO mammographic views of both breasts were obtained with 3-D
tomosynthesis. Additional 90 degree lateral view right breast and spot compression CC, 90 degree lateral and
MLO views retroareolar right breast.
COMPARISON: Bilateral diagnostic breast ultrasound of the same day
FINDINGS:
There is no dominant mass, suspicious microcalcification cluster or secondary sign of malignancy.
IMPRESSION:
No mammographic abnormality is appreciated in the background dense parenchyma. There is however focal
asymmetry appreciated by ultrasound in the area of palpable clinical concern in the lower outer quadrant
right breast.
Please see the separately dictated ultrasound report and recommendations for follow-up guidance. MRI breast
imaging is advised, consideration for targeted biopsy of the palpable clinical concern and consultation with
breast recommended.
iCAD second look technology was utilized for this examination.
HISTORY: Palpable abnormality in the right breast. Abnormal diagnostic mammogram/ultrasound. Follow-up
TECHNIQUE: The patient was placed prone in bilateral dedicated 8 channel breast coil and images were
obtained on a GE 1.5 Tesla. Bilateral simultaneous acquisitions were obtained axially utilizing 1.5 mm T2
fat sat and FSE precontrast, as well as 1.5 mm slice T1THRIVE, T1THRIVE fat-sat and post axial T1THRIVE with
fat sat. Post contrast images were obtained and evaluated utilizing bilateral 3-D reconstructions (maximum
intensity projections), subtraction images in sagittal and coronal 2-D reformatted images. Computer aided in
evaluation (Dina CAD was performed to evaluate for temporal enhancement and enhancement kinetics.
Contrast: 6 cc of Gadavist gadolinium
COMPARISON: Diagnostic mammogram and ultrasound 12/21/2021
FINDINGS:
RIGHT BREAST:
Heterogeneously dense parenchyma. Breast decreased in overall size compared to the contralateral left
Asymmetric enhancement laterally, centered in the lower outer quadrant, extending from approximately 6:00 to
9:00, centered 3.5 cm directly posterior to the nipple, series 10,703 image 43; series 8 image 110.
LEFT BREAST:
Heterogeneously dense parenchyma. No suspicious ductal or masslike enhancement. Fibrocystic changes, with
representative 7 mm cyst at 5:00, approximately 6-7 cm from the nipple
OTHER:
No enlarged or hypervascular axillary lymph nodes
IMPRESSION:
Asymmetric enhancement of the lower outer quadrant of the right breast, corresponding to the palpable
abnormality and asymmetry on mammography. Asymmetric breast size, left greater than right. See comments
As this corresponds to the palpable abnormality, directed biopsy at the palpable abnormality recommended.
Area of asymmetric enhancement is fairly diffuse, with minimal focality as described
If biopsy is noncontributory, consider follow-up MRI guided biopsy at the focal area of asymmetric
involvement as detailed above
No abnormal ductal or masslike enhancement involving the left breast
----- Page Break -----
BIRADS:Federal regulations require all breast imaging reports to have an overall final assessment. Based on
the above findings, this examination is classified as: BIRADS 4 - Suspicious.
CAT 4
Comments
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Hi. There is so much jargon to try and understand. It looks like you had the MRI too. To my UN-trained eye nothing screams worry to me. I know it's hard not to, especially when it is a palpable lump. A LOT of Birads 4 scores turn out to be a benign condition. I really hope that is what they will find. I am posting the link to the benign breast conditions section of this forum if you wish to visit there.
Good luck to you on Monday. Let us know what they find.
https://community.breastcancer.org/forum/148
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Hi mc1234,
We are not physicians but can give you a few things to read. Heterogeneously dense indicates that there are some areas of nondense tissue, but that the majority of the breast tissue is dense. They are suggesting a biopsy to better understand what the lump is exactly. Imaging studies such as mammogram and MRI, often along with physical exams of the breast, can lead doctors to suspect that a person has breast cancer. However, the only way to know for sure is to take a sample of tissue from the suspicious area and examine it under a microscope. Please know there are many benign breast conditions.
Here are some links that you may find helpful.
Mammogram Results: Breast Imaging Reporting and Database System (BI-RADS)Dense breasts
We're here for you, and understand that the waiting can be difficult. Please reach out to us with any questions.
The Mods
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Thank you so much for responding!! Also realizing I didn't include any background. I am 36 no history or family history of breast issues. A couple days before Christmas I had severe pain in my right breast which went away but I have continued to have mild pain since then. My armpit is swollen on that side and there is some visual difference in the nipple and breast on that side also. I had a mammogram, ultrasound and then and MRI.
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this website was helpful to me. I had extremely dense breast tissue at my diagnosis (2017)
https://www.areyoudense.org/stories/
My story is one of the many posted on this site. Many many women have dense breast tissue diagnosis's.
My cancer was felt by chance by me. Mammo didn’t see my cancer. But the breast specialist I had appt with knew something was there because she could feel it. Ultrasound caught my cancer. I have chosen with my medical oncologists support to have diagnostics every 6 mo as afollow up plan. I had surgery. But caught it early. Chose no rads and no hormone blocking meds. So far I’m doing ok.
We are here for support. Chat anytime!
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