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 DJMammo@gmail.com
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Apr 5, 2020 03:03PM djmammo wrote:

okangansummer

What about the other descriptors?

In general.....

No internal flow on doppler interrogation- good

Demonstrate posterior enhancement - good

Does taller than wider mean the shape? Or position? - shape

The other thing I note is that the architectural distortion

Isn't in the ultrasound report - does that mean it was not observed with the ultrasound? It just states at the end in the findings that it corresponds?- the taller than wide mass = the area of arch distortion. this is the combination of findings we look for

Is there anything about the position that would be another cause for concern or not concern?

Axillary tail - that you will need to ask your surgeon

Board Certified Diagnostic Radiologist specializing in Breast Imaging. Contact me at DJMammo@gmail.com
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Apr 5, 2020 05:32PM - edited Apr 5, 2020 05:33PM by okangansummer

djmammo

Thank you for all of that addition info, it is so appreciated.

I have been doing the most exhaustive reading on architectural distortion and does it not occur with cysts because they are liquid? Is there ever cases where it is in connection to complicated cysts? I read lots about scelorising lesion as well and know this could be a reason for another benign option versus a malignant optio.

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Apr 5, 2020 09:32PM minustwo wrote:

Okanagan - What WindingShores said on the other thread you started is right on. You need to be trying to distract yourself with long walks & movie binges. Too much research when you don't have all your testing done & your diagnosis confirmed is very stressful. We know, it's hard to wait.

2/15/11 BMX-DCIS 2SNB clear-TEs; 9/15/11-410gummies; 3/20/13 recurrance-5.5cm,mets to lymphs, Stage IIIB IDC ER/PRneg,HER2+; TCH/Perjeta/Neulasta x6; ALND 9/24/13 1/18 nodes 4.5cm; AC chemo 10/30/13 x3; herceptin again; Rads Feb2014
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Apr 6, 2020 11:39AM djmammo wrote:

okangansummer

"...does it not occur with cysts because they are liquid?"

Its because cysts have a sharp well defined borders.

Is there ever cases where it is in connection to complicated cysts?

AD is usually, cancer, radial scar (complex sclerosing lesion), surgical scars, and occasionally incomplete compression during mammography.

Board Certified Diagnostic Radiologist specializing in Breast Imaging. Contact me at DJMammo@gmail.com
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Apr 10, 2020 01:19AM Nelsonfam05 wrote:

hi I’m new here! I had a mammogram and ultrasound on Tuesday and a biopsy on wed. I am awaiting results. Can I post my mammogram and ultrasound report her for your opinion?


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Apr 10, 2020 01:30AM - edited Apr 10, 2020 01:40AM by Nelsonfam05

Here is the report from my ultrasound and mammogram. I'm pretty worried and mentally preparing to hear the words you have cancer. I'm not really sure what to ask. I've looked up bits and pieces of this report online. Anyway any insight you have would be helpful in my processing of this report

Report HISTORY: Palpable right breast lump 2D MAMMOGRAM COMPARISON: None. Baseline mammogram.
TECHNIQUE: Composite 2D (C-view) full field mediolateral oblique (MLO) and craniocaudal (CC) views of both breasts with computer-aided detection (CAD). Composite full field mediolateral, spot compression MLO and spot compression CC views were also obtained.

BREAST COMPOSITION: There are scattered areas of fibroglandular density.

FINDINGS: There is a suspicious, spiculated mass in the inferior right breast measuring about 3.5 x 3.0 cm. On the MLO composite view, the patient also appears to have a second lesion about 5 cm superior to the dominant lesion, superior to the plane of the nipple. This secondary right breast lesion measures less than 1 cm. Additional note is made of a relatively prominent right axillary lymph node, measuring about 1 cm. 3D

MAMMOGRAM COMPARISON: 2D Mammogram TECHNIQUE: Bilateral 3D digital breast tomosynthesis (DBT) images were obtained with compression. FINDINGS: There is a suspicious, spiculated mass in the inferior right breast measuring about 3.5 x 3.0 cm. Tomograms also demonstrate an adjacent 1.4 x 1.3 x 1.1 cm radiodense lobule. On the MLO composite view, the patient also appears to have a second lesion about 5 cm superior to the dominant lesion, superior to the plane of the nipple, and localizing laterally on the tomograms. This secondary right breast lesion measures less than 1 cm. Additional note is made of a relatively prominent right axillary lymph node, measuring about 1 cm.

LIMITED RIGHT BREAST ULTRASOUND TECHNIQUE: Ultrasound imaging of the inferior and lateral right breast was performed, as well as the right axilla. FINDINGS: There is an irregular hypoechoic mass at the 7:00 position, corresponding to the dominant mammographic mass, measuring approximately 2.4 x 2.0 x 1.4 cm. This mass is highly suspicious for malignancy. At the 9:00 position, there is a superficial, hypoechoic oval lesion measuring 8 x 6 x 4 mm. This lesion is 2 echogenic to characterize as a simple cyst, but it appears avascular on Doppler imaging. A secondary site of malignancy is possible. A right axillary node measures approximately 2.5 x 2.3 x 1.4 cm, and has a partially effaced fatty hilum. This node may be a site of metastatic disease.

IMPRESSION: 1. Suspicious inferior right breast mass, corresponding to the clinically palpable lump. 2. Indeterminate superficial lesion in the lateral right breast, possibly a complex cyst, although a secondary site of malignancy is possible. 3. Indeterminate right axillary lymph node also characterized, possibly a site of metastatic nodal disease.

BI-RADS CATEGORY: 5, highly suggestive of malignancy RECOMMENDATION: Ultrasound-guided biopsy of the dominant, inferior right breast mass. ***** Final *****

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Apr 10, 2020 03:01PM djmammo wrote:

Nelsonfam05

After reading the description I agree with their conclusion. I suspect the path may come back IDC. They may want to biopsy that node too. An MRI will likely follow.

Board Certified Diagnostic Radiologist specializing in Breast Imaging. Contact me at DJMammo@gmail.com
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Apr 10, 2020 04:18PM Nelsonfam05 wrote:

what does IDC mean

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Apr 10, 2020 04:30PM Nelsonfam05 wrote:

I figured it out.

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Apr 10, 2020 07:53PM Nelsonfam05 wrote:

why would the mass be larger on mammogram vs ultrasound

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