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Dec 3, 2020 03:54PM
I am booked for ultrasound guided core needle biopsy on Dec 23, 8 days after the wide excision for ADH. Continuing my run of spacing all the procedures out :(
Here's the report from Nov 18 ultrasound. If anyone has observations on the report, I'm interested. I've never read an ultrasound report before. But I basically still feel like it's not super comforting, but it's not any more alarming that what I already know.
Is it normal to refer to the patient as "anxious"? I am nonplussed about that.
X-RAY DATE: 2020-Nov-18
BILATERAL BREAST SONOGRAPHY
Ms. XXX is a 50-year-old woman who recently had a two-site stereotactic core biopsy of
calcifications in the right upper outer quadrant, the more peripheral cluster in the 10 o'clock position 6 cmfn demonstrated features of DIN1B and she is due to have surgery. The more medial cluster in the 11 o'clock position 4 cmfn demonstrated stromal fibrosis, considered to be concordant.
The patient presents for assessment of the right axilla because of pain. She also mentioned that she could feel a lump in the 3 o'clock position of the left breast. This could be palpated by the technologist today. She has BI-RADS d dense breasts and is anxious; she has a family history of breast cancer, her mother having breast cancer at age 69.
Right breast: The entire right breast and axilla was examined sonographically.
In the 9:30 o'clock position 6 cmfn in the middle-posterior third of the breast is a somewhat heterogeneous hypoechoic mass within the echogenic fibroglandular tissue. In the transverse plane, on the initial images, this appeared quite irregular, though the central aspect had an
almost anechoic linear tract extending through it. There was a suggestion that this was extending towards the skin. I was unable to re-create this appearance. The entire area measures 11 x 7x13 mm. When assess this region myself, I confirm that it is lying directly medial to the more medial of the two stereotactic core biopsy scars. I suspect that this
represents the needle tract and post-biopsy changes from the benign biopsy.
In contrast no abnormality is noted medial to the more lateral of the two biopsy scars, where ADH was noted.
On the right, there is a 5mm simple cyst in the 3 o'clock position and a 6 mm cyst in the 12 o'clock position near the nipple.
In the right axilla is a single lymph node measuring at least 11 mm in longest dimension with a very thin cortex and a large fatty hilum, There is a small hypoechoic area centrally within the fatty hilum, of uncertain significance.
Left breast: A number of simple cysts are noted, in the 12 o'clock position measuring 5 mm and in the 2:30 and 3:30 o'clock positions measuring 7 and 3 mm in diameter. The one in the 2:30 o'clock position corresponded with the palpable mass according to the technologist.
1. An irregular hypoechoic area is noted in the right 9:30 o'clock position. Given its location I suspect it represents post-biopsy changes from the benign stereotactic core biopsy. A six-month follow-up ultrasound examination of this area could be performed to re-evaluate it though this may be technically challenging as this area may be included when the patient has upcoming surgery.
2. There is a lymph node in the right axilla. It does contain a central hypoechoic focus which could be concerning but given the fact that the cortex is completely normal, is of uncertain significance. If the patient is to have a sentinel lymph node biopsy, hopefully this will be addressed at that time.
3. There is a simple cyst in the region of the palpable finding.
BI-RADS 3 - Probably benign findings - short term follow-up
ADH, surgical excision 2020-12-15