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May 24, 2020 05:46PM
UPDATE: GOT MY US AND MAMMO REPORTS TODAY!
My documents unlocked today on the hospital portal and I was able to download, and read them for myself. Based on what I'm reading... NO MENTION of TNBC, so I'm not sure WHY that was mentioned by the surgeon!? I'm a little angry about this!!! I've decided a needle biopsy to get a dx is what I need. I'm also going to get a second opinion from MD Anderson...I have great insurance, so why not!? All of your responses have provided me a WEALTH of information and information is power! Below are my mammo and US results from Thursday. Thanks again, EVERYONE! I hope this helps someone in the future not make the mistake that I almost made!
Bilateral digital diagnostic mammogram with 3-D tomosynthesis evaluation
Clinical indication: The patient is a 50-year-old female being further evaluated for area of right breast palpable concern. The left breast was also subjected to mammography as the patient was due for her annual screening mammogram.
Technique: CC, MLO and ML views of the bilateral breasts were acquired using digital technique. The study was interpreted with the benefit of CAD technology.
Three-dimensional tomosynthesis was applied to all views.
Comparison: Bilateral digital screening mammogram, October 11, 2018.
Findings: The breasts are composed of heterogeneously dense fibroglandular tissue, which may obscure small breast masses. The included axillary regions are benign. There is a palpable marker at the 12:00 position of the right breast, 6.5 cm from the nipple, denoting site of right breast palpable concern. There is a 1.8 cm sized isodense round mass with indistinct margins (margins confirmed on three-dimensional tomosynthesis evaluation) at the 12:00 position of the right breast, 7 cm from the nipple, that accounts for the area right breast palpable concern. A targeted ultrasound examination of the right breast and axillary nodal basin is recommended for further evaluation.
There is no suspicious calcification in the right breast. There is a postbiopsy marker clip at the 12:00 position of the right breast, 6 cm from the nipple, denoting site of previous benign right breast biopsy. There are is no dominant mass, architectural distortion or suspicious calcification in the left breast to suggest malignancy. There is no pathologic skin or nipple alteration.
1. There is no mammographic evidence of malignancy in the left breast.
2. Right breast mammographic abnormality as detailed above with above recommendations.
ACR BI-RADS Category 0: Incomplete examination.
Management: Need additional imaging evaluation.
Targeted ultrasound examination of the right breast and axillary nodal basin Clinical
indication: The patient is a 50-year-old female being further evaluated for right breast mammographic abnormality.
Technique: An additional MLO view of the right breast was acquired using digital technique. MLO.
Comparison: Bilateral digital diagnostic mammogram obtained the same day. Findings: Further evaluation was performed on the 1.8 cm sized isodense round mass with indistinct margins at the 12:00 position of the right breast, 7 cm from the nipple, seen on bilateral digital diagnostic mammogram obtained the same day. This correlates with a wider than tall angularly marginated hypoechoic mass at the 12:00 position of the right breast, 5 cm from the nipple, measuring 2.5 x 1.3 x 1.6 cm in size. This mass demonstrates internal vascularity to mild hyperemia on color Doppler analysis. This mass also demonstrates increased through-transmission. This mass is located 0.2 cm deep to the dermis. There is no pathologic skin thickening. This mass is located at least 1.5 cm superficial to the right pectoralis major muscle. The remaining evaluated right breast demonstrates normal heterogeneously dense fibroglandular tissue. No pathologically enlarged right axillary lymph nodes are identified.
IMPRESSION: 1. Suspicious right breast masses detailed above. An ultrasound guided core needle biopsy is recommended. Recommendation for ultrasound-guided core needle biopsy was discussed with the patient.
ACR BI-RADS Category 4C: Suspicious abnormality.
Management: Tissue diagnosis.
Dx at 50: <10% ER+, KI-67 80%, Oncotype 57, treating as TN
5/27/2020, DCIS/IDC, Right, 2cm, Stage IA, Grade 3, 0/5 nodes, ER+/PR-, HER2- (IHC)
6/4/2020 Lumpectomy: Right; Lymph node removal: Sentinel
7/17/2020 AC + T (Taxol)