Hypoechoic mass on initial ultrasound, not concerning on subsequent ultrasound
My Mammogram came back normal, I'm 43 years old with no cancer history in the family. This is the first year I've asked for an ultrasound as I have dense breast tissue. The results were as follows: "Ultrasound was performed by the technologist. Representative images of all 4 quadrants and subareolar breasts were obtained. There is a hypoechoic mass in the left breast 3:00 location 1 cm from the nipple which is indistinct in appearance. Scattered cysts are demonstrated with a benign appearance in the left breast. No other finding is demonstrated in the breast."
They had me come back for another ultrasound about 2 weeks later and were having trouble seeing it, however it was also a different technician. Seems like they were able to find it but it wasn't too concerning the technician. I'm really not sure that they were looking in the same place as the first technician seemed to be focused on an area slightly more to the center and they were looking more to the outside and into my lymph nodes. The radiologist reviewed and told me to come back the next day for a biopsy. The notes from that visit say: "There is a persistent area of hypoechogenicity in the left breast 3:00 location 1 cm from the nipple measuring 4 x 3 x 2 mm." The next day, they wanted to do one more ultrasound to make sure it was still there before taking a biopsy. The radiologist looked herself with the ultrasound and decided that they really couldn't see it / it wasn't concerning and sent me home. They'd like to do a re-check in 6 months. They also commented that my tissue was very whispy. From what I can read online, the different times of your menstrual cycle and various hormone fluctuations can change the tissue. Not sure if the two things are related and could be the cause for having trouble seeing the mass or not.
Should I be concerned that the second technician and radiologist couldn't really see it that well (and maybe weren't looking at the exact right spot) or just wait another 6 months? I'm fine waiting if that's the right thing to do but also want to make sure I'm advocating for myself and understanding everything.
Comments
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@jschroe So here is a very helpful article regarding what provides the best imaging for dense breast tissue. It's great news that there were no findings on your MRI which is a very efficient way to examine dense breasts. Yes your breast tissue does change during different times of your menstrual cycle. I totally understand your concern with all of the changes in decision on your ultrasound. Was this ultrasound done in conjunction with a mammo or after the MRI you had? As you may already know typically Ultrasound is used along with another type of imaging .The radiologist would be in the wrong to biopsy an area that they can't see. Why don't you discuss your concerns with your doctor and go from there. If you feel uncomfortable maybe your doctor will agree with a 3 month follow-up instead. Keep on advocating.
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From what you’ve shared, it sounds like they didn’t see anything too worrying on the second look, which is a good sign. Breast tissue can really change depending on your cycle, so that could explain the difference too. If the radiologist felt okay sending you home and just rechecking in 6 months, that usually means they’re not too concerned.
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