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Bi-Rad 0 and confused

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I am 35 years old with no family history of breast cancer, and currently have a 3-4cm palpable mass in my right breast. I noticed it a few months ago, and last week at my annual OBGYN appointment, my provider noticed it as well.

Today I had a mammogram and ultrasound, but did not really get any clarity. The radiologist indicated that a referral to a breast surgeon is appropriate so that a biopsy can be discussed.

I am confused by the imaging report. Does this mean that the palpable lump, which the radiologist also felt, was not able to be seen on the ultrasound or mammogram? Any insight at all would be helpful.

Here is the report from the mammogram and ultrasound:

BILATERAL DIGITAL MAMMOGRAM:

3-D digital CC and MLO mammographic images of both breasts were obtained, and reconstructed 2-D CC and MLO mammographic images of both breasts were generated.

In some portions, the breasts are extremely dense, which lowers the sensitivity of mammography.

There are no suspicious masses, suspicious clusters of calcifications, suspicious areas of architectural distortion, suspicious asymmetries or suspicious skin or nipple changes.

Benign-type breast calcifications are present bilaterally.

RIGHT BREAST SONOGRAM:

Targeted sonographic interrogation was then performed over the upper outer quadrant of the right breast from the 10 o'clock through 12 o'clock radians to assess the small mobile readily palpable periareolar right breast lump.

The background breast parenchymal echotexture is mildly heterogeneous.

There is no suspicious mass, abnormal cystic element or focal sonographic abnormality that can be resolved from surrounding mildly heterogeneous fibroglandular breast tissue to account for the small readily palpable right breast lump.

Impression:

No imaging evidence of malignancy involving either breast at this time.

BI-RADS® ATLAS category (overall): 0 -Incomplete: Needs Additional Evaluation

RECOMMENDATIONS:

In spite of the benign results of these diagnostic breast imaging studies, due to the the fact that the small upper outer quadrant right breast lump is readily palpable, further evaluation with a baseline consultation with a breast surgeon is recommended to obtain a surgeon's input on this case.

Comments

  • moderators
    moderators Posts: 8,081
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    Hi @ennazus, and welcome. We're so sorry you find yourself here and worrying, but we know you'll get great support.

    It sounds like there's just some more information needed before the doctors can make any determinations about what's going on. Please know there are lots of benign breast conditions that can cause worrisome symptoms — that turn out to be non-malignant.

    Check out this thread on BI-RADS Explained for some helpful info.

    Please keep us posted with what you find out. We're thinking of you!

    —The Mods

  • obsolete
    obsolete Member Posts: 333
    edited October 2023
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    Hi, sorry your worrisome situation still needs clarity. A baseline consult would be considered standard. Your report mentioned no typically bad characteristics, which would generally stand out. A good characteristic is that your lump is mobile. As the mod's link pointed out, it could possibly be an unusual complex abscess or a benign papilloma or a benign fibroadenoma, etc. See links below.

    When you meet with your breast surgeon, you are entitled to ask the BS if a Wide Margin Excisional Biopsy is an option for you. Please let us know how things go and best wishes.

    https://radiopaedia.org/articles/intraductal-papilloma-of-breast

    https://radiopaedia.org/articles/fibroadenoma-breast