New here and need advice on my mammo report
Hi all! I'm new to this site and I have asked this question elsewhere and keep being told that everything will be ok and my recent mammogram report is probably nothing. I am 55 years old and go yearly for mammograms and sonograms. My sister had DCIS in both breasts at the age of 40 (8 years ago) and had a double mastectomy. There is no other cancer in the family. I had my latest mammo and sono 4 days ago and I got this report on my medical portal asking me to come back. The soonest appointment they had is for the 24th so I made it then. This is what it says and was wondering if anyone has gotten anything similar or understands the lingo. "Left breast tubular focal asymmetry with associated calcifications. There is a tubular asymmetry with associated calcifications in the posterior central aspect of the left breast, more conspicuous compared to prior studies and with increased calcifications. Further evaluation with spot compression imaging, magnification imaging and targeted ultrasound is recommended."
I understand it may be nothing as I've been told numerous times but naturally I'm a little worried as this is my first callback for something like this.
Any input would be so appreciated. Thanks!❤️
Comments
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Worry is natural, anyone saying you shouldn't worry may be right but here you are going back in for more imagining. I get it.
Bright side is there wasn't enough seen on this report to warrant a biopsy. Try to keep that in mind.
IF the asymmetry doesn't resolve on the spot compression (meaning they should be able to see thru it-or not), and IF the 3D images and ultrasound show something concerning then they will let you know right there if you will need a biopsy. That is worse case, or it could be scored as follow up in 6 months. Best case would be a year.
I have had trouble with my surgical site. Fat necrosis looks funny on imaging so last mammogram they took a few more pictures which I read to be spot compression (they really smush your boob in there) and it was fine.
Best of luck! I know it's hard to not worry until you have to. Let us know how you make out.
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The soonest appointment on the 24th isn't soon enough for your peace of mind, but it is soon enough for your health. No bad thing will happen between now and then, from that standpoint. What I read is that they don't have good information, so they want more imaging so they know what they're looking at. That in and of itself really isn't something to worry about.
Try to find fun/distracting/interesting things to do over the next couple of weeks. Don't spend time on google trying to diagnose yourself. It doesn't work that way.
And if you get caught up in anxiety and are really having a hard time, be sure to talk to your doctor to see if there is some prescription help for you. Good luck.
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Hi, thank you for the replies! In 12 more days, if I get an all clear and do not need a biopsy, then I can let out a huge sigh of relief. What bothers me the most about the report is the additional calcifications. My sister had DCIS in both breasts at the age of 40 when she went for her first mammo ever. They discovered it from seeing calcifications in both breasts. What a shock that was. So I know that could be a sign of DCIS or even an invasive cancer. That much I know but my report is very vague, does not describe the calcifications at all so who knows what and where they really are. Just too vague for me. But anyway, I am here to talk it out and thank you both for listening and responding! I appreciate it a lot!
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I had my follow up mammogram and sonogram yesterday. The area they spotted was deemed suspicious and I am getting my biopsy done in two weeks.
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sorry that you are back to the waiting game. The hard part of course that even though having a biopsy doesn’t automatically mean there is an issue and it could still be one of those it’s nothing major, it’s still one of those you don’t know until you know. The thing I tried to remember in any of the waiting stages is I can’t undo what’s already done and I can’t change what’s happened in my body, so try to just go about living life and moving forward and not jump to worse case scenarios. We seem to spend a lot of time in the hurry up and wait stage. Hopefully you can find things to do so you don’t spend time dwelling on the wait and whatever the outcome you get the answers you need to make informed decisions. Sendings hugs and prayers and positive vibes your way which ever you need to get through the next two weeks.
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I was able to copy and paste the report below. Not sure what any of this means. I know the biopsy will be the answer. The biopsy is on Feb 9th. But I cannot find anything anywhere including all the breast cancer forums that uses the description found in the mammogram report (Associated indeterminate calcifications are noted tracking along the ductal system). What is a ductal system? One duct, a few? Totally clueless with this one!
Impression
Suspicious calcifications in the left lower central breast associated
with a dilated ductal system. Stereotactic core needle biopsy is
recommended.
Recommendation: Stereotactic Biopsy
These findings and recommendations, including the importance of image
guided biopsy (and to reach out to the ordering physician if not
contacted), were discussed with the patient at the time of the exam
and the patient expressed understanding. Additionally, a message was
sent to Dr. Lisa Chang in the electronic medical record messaging
system at 1:21 PM on 1/25/2023.
BIRADS: 4-Suspicious
A letter has been sent to the patient with the above recommendations.
Approximately 10% of breast carcinomas are not radiographically
detectable. A negative report should not delay biopsy if a clinically
suspicious mass is present. Dense breasts may obscure an underlying
neoplasm.
BIRADS 0 = Incomplete. Needs additional Imaging Evaluation and/or
Prior Mammograms for comparison
BIRADS 1 = Negative
BIRADS 2 = Benign Findings
BIRADS 3 = Probably Benign Findings - Initial Short Interval Follow-up
Suggested
BIRADS 4 = Suspicious for Malignancy - Biopsy is Recommended
BIRADS 5 = Highly Suggestive of Malignancy
BIRADS 6 = Known Biopsy Proven Malignancy
Richard A Marshall, MD
Workstation: QUMA01AN129474Narrative
LEFT DIAGNOSTIC MAMMOGRAM AND LEFT BREAST ULTRASOUND
Indication: 55 years old; Female. Asymmetry and calcifications on
screening mammogram.
Comparison is made to prior mammographic studies dating back to:
9/14/2012
Technique: Digital diagnostic views of the Bilateral breast(s)
utilizing 2-D technique with magnification. Images were processed by
the R2 CAD system. Additional magnification and spot compression 3-D
views were performed
Density: Heterogeneously dense (may obscure small masses)
FINDINGS:
MAMMOGRAPHY:
Additional magnification and spot compression 3-D views demonstrate a
tubular focal asymmetry in the lower central breast extending from
middle to far posterior depth with morphology most suggestive of a
prominent ductal system. Associated indeterminate calcifications are
noted tracking along the ductal system, which are indeterminate.
Stereotactic core needle biopsy is recommended.
ULTRASOUND:
Targeted left breast ultrasound was also performed. The study was
initially performed by the sonographer, and subsequently by myself
personally.
Comparison is made to prior studies dating back to: 5/15/2019
Left breast:
Targeted ultrasound to the lower central left breast demonstrates a
prominent dilated ductal system corresponding to the mammographic
asymmetry and associated area of calcifications.0 -
Hi wafa510. The ductal system is referring to the chain of milk ducts in the breasts. Since we have several milk ducts in our breasts he may be referring to it as the ductal system. So these calcification are running along side of the milk duct. Depending on how calcifications are layered, clustered and size helps the radiologist determine if they need further investigation. Many calcifications are benign but better to have a biopsy to be certain. Hope this helped ,best wishes for a benign biopsy.
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Thank you so much for your reply!! I am just trying to understand the report. I saw the mammogram image and he said that the duct is too big for his liking and there are more calcifications from prior years but nothing was ever mentioned about this focal asymmetry and calcifications until now so it must have formed in the last 12 months? Most of this seems benign in my eyes and they are being cautious, probably because my sister had DCIS in both breasts at the age of 40 and had a double mastectomy so there is a slightly higher chance I could develop it too. I would assume calcifications would be gathering inside the duct, not alongside it to be DCIS from what I have seen. So I am a bit confused. Ugh!
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Just a quick update. Went for biopsy last week. Results came in today with Atypical/High Risk Intraductal Papilloma and additional microcalifications seen at target site after the biopsy was done that they want biopsied again. Ugh. Appointment with breast surgeon is this coming Friday and will hopefully know next steps then. I got very lucky in getting an appointment this week for a consult. This journey started on January 7th and I am still not closer to really have any conclusive diagnoses.
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wafa,
We all feel for you as waiting is never easy. One very, very important thing to bear in mind is that breast cancer is not an emergency. Yes, I know, the word cancer scares the heck out of us but nothing bad is likely to happen despite what seems like endless waiting. Breast cancer tends to be very slow growing and most research suggests that if one doeshave bc, it has been growing for years before it even reaches a detectable level. While this might seem like little consolation while waiting, it’s important to remember that the wait is quite unlikely to jeopardize your health in any way. Family history, particularly known genetic mutations, actually only account for about 15-20% of bc cases. With what is currently known, most breast cancers arise simply because we have breast tissue. Take good care.
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wafa, It looks like your needle biopsy found precancerous cells but the sample size was not large enough to ensure that nothing else is there. Your breast surgeon will probably schedule an excisional biopsy which will remove more tissue to get an accurate diagnosis and take out all of the intraductal papilloma. If nothing but precancerous cells are found that procedure will eliminate them and you will be done with treatment.
Exbrnxgrl gave you good advice about the pace of diagnosis (and treatment if it comes to that.) My first suspicious mammogram to my eventual surgery spanned two and a half years. While that is atypical I'm still here to tell the tale. I hope things work out well for you.
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Thank you for your reply. I understand what you are saying. At this point, it is beyond having cancer, I think I have come to terms with that in case it is. It is the endless waiting in between appointments and tests just to get more inconclusive results. That is to me the most annoying part. What is really strange is that I am weirdly calm and just in an annoyed state now. I was more a wreck a few weeks ago. Maybe just a coping mechanism. Who knows!
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