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 11:30AM - edited Mar 22, 2018 09:57AM by djmammo

Posted on: Aug 25, 2017 11:30AM - edited Mar 22, 2018 09:57AM 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 DJMammo@gmail.com
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Mar 18, 2020 11:35AM djmammo wrote:

JL80

See my reply to your PM

Board Certified Diagnostic Radiologist specializing in Breast Imaging. Contact me at DJMammo@gmail.com
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Mar 19, 2020 08:30AM Sampson2013 wrote:

I have had multiple biopsies on both breast. Last June they completed a left breast biopsy with needle localization that indicated proliferative fibrocystic changes consisting of moderate intraductal hyperplasia, intraductal paillomas and a 2mm radial scar. I have gone for follow-up mammograms every 6 months. Last week during my follow-up they found amorphous calcifications in the upper, outter quadrant of the left breast and recommended a stereotactic biopsy. I had the biopsy on Tuesday and received a call yesterday stating that my results show non-proliferative fibrocystic changes consisting of mild ductal hyperplasia, fibroadenomatoid changes, apocrine metaplasia and numerous microcalcifications. Can proliferative breast changes turn into non-proliferative? Also, what is the difference between intraductal and ductal?

Thanks!

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Mar 19, 2020 12:18PM djmammo wrote:

Sampson2013

I would direct non-imaging questions like these to your doctor or the pathologist that handled your case.

Board Certified Diagnostic Radiologist specializing in Breast Imaging. Contact me at DJMammo@gmail.com
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Mar 19, 2020 12:20PM edj3 wrote:

djmammo, not sure if you're in a hospital setting these days but take care during this pandemic. You're a real help to all of us.

Tried the tamoxifen, no thanks. Dx 4/9/2019, IDC, Left, <1cm, Stage IA, Grade 2, 0/1 nodes, ER+/PR+, HER2-, Dx 5/6/2019, LCIS, Left, <1cm, 0/1 nodes Surgery 5/6/2019 Lumpectomy; Lymph node removal: Sentinel Radiation Therapy 6/3/2019 Whole breast: Breast Hormonal Therapy 9/23/2019 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone)
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Mar 20, 2020 11:53AM djmammo wrote:

edj3

ThumbsUp

Board Certified Diagnostic Radiologist specializing in Breast Imaging. Contact me at DJMammo@gmail.com
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Mar 23, 2020 07:13PM - edited Mar 23, 2020 07:15PM by Pct27

To JL80 Was there any response to your post regarding your first mammo? I am in similar situation.

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Mar 24, 2020 07:52AM moderators wrote:

Pct27, welcome to Breastcancer.org, although we're sorry you are here and worried. Just in case JL80 doesn't see your post, we suggest sending her a private message. To do that, click on her username, and under the information at the top, you'll see the option to send a private message. Sometimes is easier to connect with another member this way!

Hope this helps! Please let us know if we can be of any assistance.

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Apr 3, 2020 07:24PM CalicoKitty2000 wrote:

I have had nipple discharge from my right breast. Went in for a mammogram and ultrasound. I had an existing fibroidenoma that was diagnosed in the surgeons office via needle biopsy about 15 years ago. Since the hospital didn’t have those results, they really honed in on the fibroidenoma. I feel like they didn’t even get to what was causing the nipple discharge. I tried to tell her that was already diagnosed and I think the discharge is coming from either behind the nipple or slightly above. It is unilateral, single duct. Was clearish yellow and I made it bleed messing with it. Now it’s back to straw colored. It happened spontaneously on my period last month with much more cyclical pain. But it is less discharge (Has to be expressed not spontaneous) and pain overall than last month.

Mammogram

CLINICAL INDICATION: discharge from the right nipple

Digital mammography was performed on the GE Essential Digital Mammography Unit. Images were processed with and without iCAD. iCAD markers, if present, were reviewed.

Bilateral digital diagnostic mammograms were performed. Additional lateral view of the right breast was obtained to evaluate the asymmetry seen in the right subareolar region. The examination shows a sharply defined, 2.1 x 1.7 cm density in the right breast at about the 5 to 6 o'clock position in the

subareolar region. No other similar lesions can be seen in the rest of the breasts. There is the presence of scattered fibroglandular tissue in both breasts.


Ultrasound

CLINICAL INDICATION: Asymmetry seen on mammograms

Real-time targeted ultrasound examination of the right breast was performed at the 6 o'clock position, 3 cm from the nipple. The examination shows a sharply defined 2.0 x 1.4 cm hyperechoic lesion with horizontal disposition and some through transmission. This is most likely a fibroadenoma.

IMPRESSION: Asymmetry in the right breast appears very likely to bea fibroadenoma as described. Follow-up ultrasound examination in six months is recommended to confirm its benign nature.

(BI-RADS CATEGORY 3: PROBABLY BENIGN FINDING - Short term follow up needed)

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Apr 3, 2020 08:48PM - edited Apr 4, 2020 03:33PM by okangansummer

I posted on another thread too and I so appreciate any of your help. I'm distraught, as I'm sure otherS are. Needle biopsy is Wed. This was my first mammogram. I just never thought all of this would happen. I'm 42. I have been reading so much and going crazy. Could the one in question maybe just be wrong and, why do I have cysts only on the right upper breast? Is it common to have a mix of simple cysts and then a malignant one? Or is it more in my favour that the one is not malignant. Could past mastitis cause any of this? I breastfed for 8 years, and had mastitis once in there, but I can’t remember which breast. Also, the architecture distortion seems to worry me the most, is that always reported? Can it happen with regular cysts? Is it sometime just described as distortion?I'm sorry for all the questions and that'sthis was also posted on another part of the forum.


The breast tissue is heterogeneously dense which may obscure small abnormalities.

FINDINGS:

Diagnostic right breast mammography:

Compressive and MLO and a lateral view demonstrate persistent architectural distortion within the posterior upper right breast. CC view localizes subtle architectural distortion to the axillary tail. The area of concern is approximately at the 10 o'clock position. It is approximately 6 centimeters lateral to the nipple.

The small oval mass within the slightly lower outer right breast localizes to the 8 to 9 o'clock position at an anterior depth, within 2.5 centimeters of the nipple.

Targeted right breast ultrasound:

There are multiple simple cysts within the outer right breast from the 8 to 12 o'clock position. 1 at 9 o'clock, closer to the nipple measuring 8 millimeters corresponds to the smaller oval mass seen mammographically.

In the area of concern in the posterior upper outer right breast axillary tail, there is an irregular taller than wide 6 x 7 x 6 millimeter hypoechoic mass with no internal flow on Doppler interrogation. It does demonstrate posterior acoustic enhancement. It could be cystic or solid.

A few other oval masses with posterior acoustic enhancement and internal hypoechogenicity are seen but there wider than tall and oval, at the 8 o'clock and 10 o'clock position.

IMPRESSION:

Taller than wide 7 millimeter hypoechoic mass at 10 o'clock within the posterior right breast corresponds to the area of architectural distortion. Recommend urgent ultrasound-guided fine-needle aspiration/biopsy. It could be solid or cystic. A requisition must be submitted to general hospital.

Other scattered oval hypoechoic masses are wider than tall and appear more benign. These could represent complicated cysts with internal debris. These could be assessed at the time of the biopsy, and further aspiration or biopsy recommended if felt suspicious by the radiologist.

Background of other simple benign cysts in the outer upper right breast.

RECOMMENDATIONS: As above.

BIRADS:

Right breast: BI-RADS 4 Suspicious Abnormality RESULTCODE: BR-4


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Apr 3, 2020 09:16PM cdc1682 wrote:

Ugh. BiRads5. I think mine is bad bad but I'm here for your take on it. This is the mammo and US report.

Two very large tumors, one in right breast with a satellite friend, the other in right armpit in node.

Biopsy scheduled for Tuesday. Pretty freaked out right now.

Findings:
This procedure was performed using tomosynthesis. Computer-aided detection
was utilized in the interpretation of this examination.
The breasts have scattered areas of fibroglandular density.

Mammo Digital Diagnostic Bilat w/ Tomo
Right
Mass: There is a 71 mm oval mass with indistinct margins seen in the outer
central region of the right breast in the middle depth. The mass
correlates with the palpable mass reported by the patient. Associated
features include nipple retraction and skin thickening. Ill-defined focal
asymmetry extends from the anterior margins of the mass to the subareolar
region, concerning for possible infiltration. There is a satellite lesion
measuring approximately 15 mm along the inferolateral margins of the mass.



US Breast Right Limited
Right
Mass: There is a 78 mm x 61 mm x 68 mm irregularly shaped, non-parallel,
hypoechoic mass with microlobulated margins seen in the right breast at 9
o'clock. The mass tracks to the retroareolar region. There is a similar
appearing satellite lesion measuring 14 x 10 x 17 mm at 08:00 o'clock, 9
cm from the nipple which measures approximately 7 mm from the margins of
the primary mass which is favored to represent the same process.

Lymph Node: There is a 64 mm x 53 mm x 53 mm lymph node with
microlobulated margins seen in the right axilla.

Left
There is no evidence of suspicious masses, calcifications, or other
abnormal findings in the left breast.

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