Please help decipher my MRI report
hello! First time poster. I recently had my screening MRI (report attached) and my MRI guided biopsy is scheduled for 3/1.
Any insight into the highlighted area would be welcomed. The 1.3cm NME section..
This will be my 6th biopsy since August 2021 and so far, so good but I'm feeling down about this one. This was my first MRI and I'm aware that there there is a high false positive rate.
My mom died of TNBC. My maternal aunt died from breast cancer in the 1990's in Ireland and her daughter had low stage at age 38. It's in the family but no one had the BRCA 1/2 gene mutation.
I really want to prepare myself if this is something but I don't want to contact down the Dr Google rabbithole
thanks
***couldn’t attach the report so this is a copy and paste***
Status post ultrasound guided core needle biopsy of a mass at the 1:00 axis of the right breast with benign results (X shaped marking clip).
Comparison: All prior breast imaging studies.
Multisequence, multiplanar MR imaging of the breasts was performed using dedicated surface coils, both prior to and following administration of IV gadolinium. Following gadolinium administration, dynamic 3D gradient echo sequences were obtained. The pre- and post-contrast images were transferred to a workstation and subtraction images were performed.
The breast parenchyma is composed of scattered fibroglandular elements.
Following gadolinium administration there is mild to moderate background parenchymal enhancement identified bilaterally.
Signal voids due to clip artifact are noted at the 7:00 axis of the left breast, the 10:00 axis of the left breast and the 1:00 axis of the right breast status post prior benign core needle biopsies in these locations. There is no suspicious MR enhancement identified in any of these locations.
A 1.3 C.M. focus of clumped nonmass enhancement is identified at the 3:00 axis of the left breast, mid depth (series #600, image #156 and series #606, image #28). Findings are amenable to MRI guided core needle biopsy.
An 8 mm cluster of enhancing nodules at the 9:00 axis of the left breast corresponds with stable mammographicnodularity in this location and is benign.
There is no suspicious M enhancement identified on the right.
There is no evidence of axillary lymphadenopathy.
IMPRESSION: Suspicious findings.
Printed
on 02/17/2022 at 9:51 am from Welcome to the NEW patient portal Patien
Portal
Comments
-
Hi Sara: I am so sorry you are having to go through all this stress. I too, have/had relatives with breast cancer. My maternal gma had it twice and died of mets. My maternal aunt had lobular dx two weeks before my dx of ductal in 2017. No BRCA genes in my family that I know of either. I was neg.
I know there are others here on the forum who might be able to help with the reading of your mri report. I am not one of those people though. I am here for support though. Just wanted to say hi. The waiting is the worst part. Please keep us posted on your biopsy ok?
0 -
thank you so much for your kind response. I will definitely update after the bx and results
0 -
Hi Sara,
I'm sorry that you have to deal with all the scans and tests. I hope that the MRI finding is benign.
You can see from your experience that MRI is very sensitive, and finds literally everything. My experience is the same. I had lobular breast cancer in the right breast, and MRI showed "same nonmass pattern" in the left. My biopsy from the left side was normal, but surgeon still didn't believe it. I had bilateral mastectomy, and pathology found some atypical cells on the left side, but not cancerous or even precancerous. My surgeon and radiologist were really surprised, and both of them have decades of experience. So, please don't rely on the report readings and just wait for the biopsy results.
0 -
Hi Sara, and welcome to BC.org, although we're sorry you have to be here and worried about those MRI findings. If it helps ease your mind while you wait for your biopsy to be done, this is an article from our main site that describes some of the benign results that can come from testing: What Mammograms Show: Calcifications, Cysts, Fibroadenomas.
Anyway, only a biopsy can make a diagnosis, so that's the next step, but remember that because they order a biopsy does not necessarily mean it is cancer. Please post again to let us know how it goes.
Wishing you the best,
The Mods
0 -
Thank you everyone. I think I mentioned that since August 2021 I’ve had 5 biopsies. This will be the 6th. Two fine needle aspirations that turned into two core needle ultrasound guide biopsies. One stereoctic on some calcifications. all benign so far. Before 6 months ago, there was no activity at all on my left side. Now it’s extremely busy
I’ve been getting mammos for the past 10 years due to my family history. I’ll be 45 soon. My mom was brca negative so we were told that that automatically it made my sister and I negative.
We’re going away for a week starting tomorrow and I kind of wish that I scheduled the bx for before I left but I didn’t because I didn’t want potential bad news while on vacation. Now I’m looking at 2 weeks of stress!!
0 -
I’m sorry your going through all this.
I too had a trip planned when I got the news I needed a biopsy. I didn't want to know on my trip. And we had a wonderful trip. Yes I had some worry. But that's a trip that will always be special. Just keep yourself busy with making memories. Nothing can take away all stress. But have as good of a vacation that you can. That's what I did and the trip was a lot of fun.
As I recall I was told when I was genetic tested that my daughter should be tested. That's what I remember. Supposedly she could test different than I did.
Keep us posted on how your biopsy goes. We are here to support you. Have a wonderful vacation!
0 -
I’m so confused by my report. It could be nothing but maybe not. It could be something but maybe not. Oh yeah there’s something in your lymph nodes but the tech couldn’t really find in ultrasound and said well here is some pics. Maybe that will be good enough to me. Wth
HISTORY: See Diagnosis Abnormal mammogram, 47 years-old Female patient
presenting for 2nd look ultrasound of suspicious MRI mass at 3:00 as
well as for prominent left axillary lymph nodes. At the time of
diagnostic right breast imaging dated 1/19/2022, the patient was
presenting for follow-up from a right breast ultrasound-guided biopsy
with pathology results compatible with "Right breast mass, 1:00
retroareolar, core needle biopsy:
Pseudoangiomatous stromal hyperplasia.
Electronically Signed Out By
Michael Weiner, M.D. ", the patient has also reportedly had 2
previous benign right breast biopsies in addition to this and 2
previous benign left breast biopsies as well, personal history of
right breast cystosarcoma phyllodes status post lumpectomy in 2001,
reported a persistent lump of the right breast at the site of the
biopsy since her biopsy. MRI of the breasts performed at RAPA on
2/18/2022 reports the following: "Small irregular mass in the left
breast at the 3:00 position approximately 5.8 cm from the nipple...
Measuring 11 x 8 mm. This demonstrates rapid wash-in and washout
enhancement characteristics, which is considered suspicious" as well
as "a borderline enlarged lymph node is seen in the left axilla near
the 1 to 2:00 position approximately 15 cm from the nipple measuring
2.7 cm in greatest length with some eccentric cortical thickening of
approximately 8 mm". Left breast ultrasound is being performed
currently as a 2nd look, in an attempt to identify the sonographic
correlate for the left breast mass at 3:00, and also for further
evaluation of the portal and enlarged lymph node in the left axilla
COMPARISONS: MRI breasts from RAPA dated 2/18/2022; mammograms
1/19/2022, 7/21/2021, 7/15/2021 and multiple priors dating back to
7/31/2013; right breast ultrasound 1/19/2022, 7/15/2021, right breast
ultrasound-guided biopsy 7/21/2021
TECHNIQUE: Focused ultrasound of the left breast at 3:00 was
performed, as well as of the left axilla.
FINDINGS:
Right:
1. 1:00, retroareolar: This was the mass which had previously
undergone biopsy, with pathology results as above. At the time of
diagnostic imaging dated 1/19/2022, the sonographic appearance was
felt to be discordant to the benign pathologic results and surgical
excisional biopsy was recommended. It is possible that the appearance
on the ultrasound of 1/19/2022 could merely be related to scar tissue
from the previous biopsy, especially given that interval MRI failed to
show any suspicious findings at this location, and high sensitivity of
MRI. Therefore, the findings are probably benign. Six-month follow-up
mammogram and ultrasound are recommended to reevaluate.
2. 2:30, 12 cm: This was where the patient reported a lump. A 1.5 cm
mass appeared to be present at this location on ultrasound. There is
no MRI abnormality in this location. On review of the ultrasound
images of 1/19/2022, the mass appears less suspicious in the radial
plane, appearing to blend with an adjacent lobule. There was no
suspicious mammographic finding at this location. This may only
represent a prominent fat lobule. Six-month follow-up mammogram and
ultrasound are recommended to reevaluate.
3. 2:00, 8 cm from the nipple: This was site of a suspected evolving
contusion or focus of fat necrosis on the previous ultrasound.
Six-month follow-up ultrasound is recommended, as before.
Left:
On today's ultrasound, at 3:00, 5 cm and 7 cm the nipple, there are
dense patches of breast tissue without a discrete mass identified.
There is no obvious sonographic correlate for the MRI mass. The MRI
masses suspicious. MRI guided core biopsy is therefore recommended.
In the left axilla, only one normal-appearing lymph nodes are seen.
One of these, more anteriorly located, measures up to 2.8 cm. Another,
more deeply located, measures up to 1.2 cm. There is no left axillary
lymphadenopathy or suspicious left axillary mass. The lymph nodes seen
on MRI may only be reactive. This may be reevaluated with MRI
examination in one year.
ASSESSMENT:
BI-RADS 4 - Suspicious.
RECOMMENDATIONS:
Left MRI-guided breast biopsy for the suspicious mass at 3:00, 5.8 cm
from the nipple. There is no clear sonographic correlate for this
mass.
Right Follow-up diagnostic mammogram in 6 months
1. This is to reevaluate the 1:00, retroareolar region, at the site
of the previous biopsy. There were no concerning mammographic features
at time of diagnostic imaging dated 1/19/2022, but this is to ensure
that there is no interval development of suspicious mammographic
findings, given underlying ultrasound findings to be described below.
2. This is also to reevaluate 2:30, where the patient reported a
lump. There were no concerning mammographic features at time of
diagnostic imaging dated 1/19/2022, but this is to ensure that there
is no interval development of suspicious mammographic findings, given
underlying ultrasound findings to be described below.
Right Follow-up diagnostic breast ultrasound in 6 months
1. Targeted to 1:00, retroareolar. There are findings that may only
relate to scar tissue, given absence of suspicious MRI correlate.
2. Targeted to 2:30, 12 cm from the nipple, where the patient
reported a lump. This may only represent a prominent fat lobule, given
absence of suspicious MRI correlate.
3. Targeted to 2:00, 8 cm from the nipple, suspected to relate to an
evolving contusion or focus of fat necrosis.
Right Follow up with your physician for clinical correlation for the
lump at 2:30, 12 cm from the nipple. There may be a prominent fat
lobule in this location on ultrasound. There were no concerning
findings either mammographically or on MRI. Note that probably benign
imaging findings in this location should not preclude more aggressive
management, including biopsy, of clinically suspicious lesions.
Bilateral Follow-up diagnostic breast MRI in 1 year.
1. This is to reevaluate the left axilla, due to some eccentric
cortical thickening of a left axillary lymph node up to 8 mm. However,
on today's ultrasound of the left axilla, there is no left axillary
lymphadenopathy. The findings may have resolved between the MRI and
the current ultrasound examination. The left axillary lymph node may
therefore have been reactive.
2. Additionally, due to the complex nature of the patient's breasts,
annual diagnostic breast MRI is recommended in addition to
mammography, with the examinations offset by 6 months.
0 -
Momof2: this is Sara's thread about what she's going through right now. Have you started your own thread?? It sounds like they want you to schedule a mri biopsy for your left breast. From what I read, I would go have that done definitely. We are here to support you too.
Starting a new thread about what your going through would be a good idea so people can give you support and feedback on your thread. ❤️💐
We are here for you too.
0 -
Sara we are still here for you! Your biopsy is next week right? I hope your having a wonderful vacation with family!
0 -
Thank you for thinking of me. My vacation was great and I had the biopsy on Tuesday. My path came in today and it's DCIS which I guess is the best case scenario for a bad situation. Here is the entire path report. Once again, I had to C&P, couldn't attach a pdf of the results.
Clinical Diagnosis
Left Breast 3:00, 1.3 cm Clumped NME, Buckle Marker
Source of Specimen
Left Breast 3:00, 9g MRI VAB
_________________________________________________________________________________________________
Diagnosis
3:00 1.3 CM NME, LEFT BREAST, CORE BIOPSY: DUCTAL CARCINOMA IN SITU WITH INTERMEDIATE
NUCLEAR GRADE AND CRIBRIFORM PATTERN, INVOLVING MULTIPLE CORES AND ASSOCIATED WITH
FOCAL MICROCALCIFICATION.FIBROADENOMATOID NODULES ALSO PRESENT.SEE NOTE.
Note:Breast carcinoma marker studies (ER,PR) will be performed on block A6 at the Valley Hospital Lab
and reported separately.
CPT: 88305, 88360×2
__________________________________________________________________________________________________
Page 1 of 2
Department of Pathology
Phone 201-447-8242
Fax 447-8657
Surgical Pathology Report Continued
Name
Macroscopic Examination
The specimen is labeled with the patient's name, surgical number, and as "9G MRI biopsy vacuum
assisted left breast 3:00 1.3 cm,CNME, MRI VAB 9-gauge, buckle marker" on the requisition slip and "left
breast 3:00" on container label.Received in formalin are yellowish tan gray cores of fibrofatty tissue
aggregating 3.8 x 3.4 cm.The specimen is entirely submitted in eight cassettes A1-A8
Time to fixation: 10 minutes
Formalin fixation for: 27.5 hours
AR
Dictated: 3/2/2022 12:28:13 PM
DISCLAIMER
ANALYTE SPECIFIC REAGENT DISCLAIMER: Based on the antibody that was ordered,
immunohistochemical evaluation was performed using iVIEW DAB, Ultraview Universal DAB, and/or
Optiview DAB detection kits on formalin-fixed paraffin-embedded tissue. Positive and negative controls
(including internal controls) reviewed and deemed appropriate, all controls show appropriate reactivity.
This immunohistochemistry test was developed and its performance characteristics determined by the
Pathology Department at The Valley Hospital. FDA clearance is not required for clinical use.0 -
I’m sorry for a late response it’s been a crazy week…ugh cow totaled my car
Wow I’m so sorry to hear about your dx! 😢💐We are here if you want to chat. I hope surgery and treatment goes well. Please keep us updated when you have time. So sorry your going through this.
0 -
hey i'm so sorry if i came down on you too harshly. i didn't see all of this and grossly misinterpreted what you were saying, which sucks. that's the last thing you need. and it sounds like you're handling this like a boss, all things considered. i get it. the waiting is hell. the incomprehensible med-speak is hell. i'm still in it and blowing up at people which is what i do when i feel scared and out of control. i'm glad to hear that you're getting answers and that they amount to the lucky draw re: te breast cancer cards. i'm not supposed to say "you'll be fine" probably on this forum but you'll get through this, you have my best wishes and i'm so sorry i was a sanctimonious bully. scared. as you said, lost.
0
