Topic: Interpreting Your Report

Forum: Not Diagnosed But Worried — For those who are experiencing symptoms or received concerning test results, but haven't been diagnosed with breast cancer.

Posted on: Aug 25, 2017 04:30PM - edited Mar 22, 2018 01:57PM by djmammo

Posted on: Aug 25, 2017 04:30PM - edited Mar 22, 2018 01:57PM by djmammo

djmammo wrote:

Mammogram and ultrasound reports contain (should contain) a fairly specific vocabulary as recommended by the Birads Lexicon. They have very specific meanings so if used correctly other docs can picture in their mind what the abnormality looks like without seeing the actual images.

I have divided the more common terms into 2 groups Favorable and Less Favorable, favorable meaning it leans toward the benign side, and less favorable if leaning toward the malignant side (as no finding is 100%). This in combination with the Birads score should give you a good idea about what the rad is considering if in fact they did not speak directly to you about your results. Below that is a link for a downloadable guide which is more complete.

Favorable: Oval; parallel; circumscribed; anechoic; hyperechoic; isoechoic; posterior enhancement or good through-transmission; avascular; macrocalcifications include pop corn, large rod like, rim, milk-of-calcium.

Less Favorable: Irregular; non-parallel (can also be written as "taller-than-wide"); not-circumscribed margins includes indistinct, angular, microlobulated, and spiculated; hypoechoic; posterior shadowing; architectural distortion; internal vascularity; microcalcifications including amorphous, coarse heterogeneous, branching, fine pleomorphic.

Downloadable Quick Reference Guide PDF which also includes MRI terminology

Board Certified Diagnostic Radiologist specializing in Breast Imaging. Contact me at
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Sep 8, 2017 12:47AM - edited Sep 8, 2017 04:24AM by djmammo


“Density" is not an approved term especially without an adjective before it but we all have done it from time to time. I assume the actual report says a “new" or “asymmetric" density there would otherwise be no reason to call you back. Most turn out to be nothing but this kind of follow up is necessary to make sure.

Board Certified Diagnostic Radiologist specializing in Breast Imaging. Contact me at
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Sep 8, 2017 12:57AM dressmaker wrote:

Thank you, I figured there was a word missing! Hopefully will turn out to be fine! It is great to see someone with knowledge here. Wish you had been here 14 years ago!

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Sep 8, 2017 05:30AM Dark13 wrote:

I need help to understand what this means how bad it really is


I did a needle biopsy and got the result: The biopsy has been embedded toto and examined at multiple deeper levels showing cores of a moderately differentiated mucinous adenocarcinoma demonstrating cyto-arcbitectural features consisten with a Nottingham Histologic Score of 7 (T ubule formation=3, Nuclear Pleomorphism=2 Mitotic Inde=2) The lesion is disposed predominantly as nests and cords of malignant epithelial cells with areas of mucinous differentation evident. There is no evidence lymph- vascular permeation and no micro-calcification are seen.

Conclusion: Truecut biopsy at 11oclock left breast. - Mucinous adenocarcinoma, moderately differentiated.

immunohistochemistry for homone receptor status and Her2/Neu over-expression is recomended. Pls advise.

Dx 8/21/2017, IDC, Left, 3cm, 1/19 nodes Surgery 9/28/2017 Mastectomy: Left Chemotherapy 12/12/2017 Adriamycin (doxorubicin), Taxol (paclitaxel)
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Sep 8, 2017 03:15PM djmammo wrote:


See my response under PM's

Board Certified Diagnostic Radiologist specializing in Breast Imaging. Contact me at
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Nov 4, 2017 04:21AM Harms1975 wrote:

Hi djmammo,

Can you please help me understand all of this? I just had my repeat today and there were 8 spots total they looked at.. all were black in color, except one. I wasn’t sure what that meant, so I referred back to my original results that I found in my online health chart. (Hadn’t seen the report, until today)... Below is the only part I really couldn’t understand.

I’ve read from your posts that Hypoechoic is/could be bad, but what is bilobed? What does no vascularity mean?

At the 6 to 7 o'clock location left breast 1-2 cm from the nipple is a bilobed area that is Hypoechoic. One area measures 0.5 x 0.4 x 0.4 cm and the contiguous area 0.4 x 0.3 x0.3 cm. This may be due to a complex cyst or two complex cysts. No vascularity. Followup recommended in 6 months to reevaluate

Recommend ultrasound examination of 6 to 7 o'clock location 1-2 cm from nipple left breast at site of suspected complex cyst or cysts -cannot completely exclude solid lesions but no definite vascularity

Thank you!!!

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Nov 4, 2017 12:38PM djmammo wrote:



The radiology report is the doctor to doctor communication of what is basically a medical consultation. It is not written for the patient, it is for your doctor and other radiologists. This is why a law was passed to send patients a lay letter in the mail with your findings. If your doctors did not explain the findings of your study to you, shame on them. Also unless you have had training in imaging there is no point in looking at the screen unless someone is pointing explaining to you what is on there and what all 512 shades of grey mean.

No vascularity means there are no blood vessels feeding it, thats a good sign.

Bilobed means it looks like an 8 on its side. The circles may or may not be attached. Neither good not bad sign.

They used the word "complex" which can be bad but some readers confuse it with "complicated" which is usually good. I assume thats what they meant since they did not suggest a biopsy but I cant be sure. Either way it is very small. On a practical note, no rad would recommend a 6 month follow up if they thought it was a cancer.

So that is an explanation of the portion of the report you shared above. Is there a report of the new study? Were the results explained to you before you left the imaging center? If not I would find another imaging center.

Board Certified Diagnostic Radiologist specializing in Breast Imaging. Contact me at
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Nov 5, 2017 04:52AM Harms1975 wrote:


Hi djmammo,

I had a Bi-Rad of 3.... which lead me to the second mammogram and ultrasound that I had this past Friday, Nov 3rd. Nothing was explained to me. I was only told that the radiologist would go over it 'with a fine tooth comb and compare both mammograms and ultrasounds side by side', and was sent on my way. I told my husband over and over again that I thought someone should have come to talk to me to let me know what was going on?

I haven't gotten the last study yet, but will definitely share when I do. (I was only watching the screen as they have a big tv up on the wall that you see while you're laying there....)

Thank you so much for your quick response! I really appreciate it

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Nov 5, 2017 05:10AM - edited Nov 5, 2017 05:15AM by Ozarkgirl

Hello djmammo! This was from my ultrasound -- I'm scheduled for biopsy on November 7 -- are there reasons to worry? Thanks in advance!

ULTRASOUND FINDINGS: Targeted ultrasound of the right breast was performed. At the 5:30-3 position there is a parallel hypoechoic mass measuring 8.2 x 4.7 x 6.4 mm. It has some angular margins and internal vascularity. The mass has no posterior acoustic features. It corresponds in size and location to the mammographic mass. At the 6:30-7position and intramammary lymph node is identified which has been mammographically stable for many years.No suspicious lymph nodes are identified in the right axilla.


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Nov 5, 2017 06:27AM na_na wrote:

I'm on 6 month follow up schedule and already did 2 of those six month follow up MRIs. There is smth. that they refer to as fibroadenoma in each report, 5×7 mm. at the margin of outer quadrant of the right breast. This lesion is not growing as they say, so they don't want to biopsy it, and it is not visible on ultrasound. I have two enlarged lymphnodes in my right armpit, and the biggest was biopsied (trucut biopsy with ultrasound control). The right breast feels heavier and became bigger than the left one.

Should I seek an imaging centre where MRI biopsy is performed?

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Nov 5, 2017 10:01AM djmammo wrote:


I wouldn't worry yet. Since a prior study was mentioned in the report I assume this finding is new. They didn't use any descriptive terms that sound specifically malignant which is encouraging. It does need to be biopsied though.

The other good news is it is very small and the nodes under your arm on that side are OK so if it does turn out to be something bad it is very small and more treatable than if had been caught later. Let us know the path report when you hear. Good luck.

Board Certified Diagnostic Radiologist specializing in Breast Imaging. Contact me at

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