Concerned About Mammogram Report

SelenaRG

I have background of atypical ductal hyperplasia with many biopsies. My doctor and I found a small nodule that also showed up on my annual MRI as a 3mm spot found to be suspicious by the radiologist. I was set up to have an MRI guided biopsy. I got a call back that I needed an ultrasound and mammogram prior to the biopsy. I went in for the ultrasound and the radiologist did a mammogram instead which showed suspicious changes and he recommended I have the biopsy then, which I did. He kept telling us that he could not be certain that this biopsy was of the exact area shown on the MRI. I received the results today which showed fatty tissue, which is wonderful. But our concern is first what the mammogram said: "increasing focal asymmetry...with associated linear and fine pleomorphic fine micro-calcifications" in conjunction with my ADH history and the fact that the radiologist could not be exact of the area biopsied. Should the biopsied tissue not have reflected some of these changes? I have a follow-up with my oncologist this week and wonder if I should push for the MRI guided biopsy or even an excisional biopsy to make certain all is well.

ziggypop

I had an MRI guided biopsy - the reason that they do them that way (from what I understand) is because the area that they want a sample of is very small and also because some things show up on MRIs that don't show up on ultrasounds or mammograms. If it were me, I would go ahead and get the MRI guided biopsy although your onc may have a reason to say otherwise.

SelenaRG

Thanks ziggypop for the response.

Went to the onc yesterday.  The report given to doctor said fatty tissue with necrosis, He said he was told by the radiologist that he captured all of the calcifications and there was no need for MRI guided biopsy right after the procedure,  however the MRI folks called to confirm my appointment and said it had not been cancelled. So we assume the onc is thinking the radiologist that performed the mammogram guided biopsy and the MRI radiologist were one in the same? (one is in the Breast Center and one is in the main hospital). 

My husband and I both have the question...If an MRI doesn't pick up calcifications... what was the MRI showing if all the mammogram showed was calcifications? We pushed for extra testing to make certain. We are completely confused at this point!!!  Thanks for any insight.

ziggypop

MRIs, ultrasounds and mammograms are all good tools, but none of them are perfect & they 'visualize' things in different ways. I had a 9cm tumor that did not show up on a mammogram even though the lump that I had was obvious - so they knew that they were looking for something. It did show up on the ultrasound along with some nodes that were suspicious (and turned out to be positive for IDC). On the other hand some calcifications showed up on the mammogram of the non-cancerous breast that led to the mri guided biopsy (turned out negative).



I'm not sure which are better at showing what things - and it may differ just based on what our breasts are 'like' - mine are exceptionally dense which is why the solid mass didn't show up on a mammogram. One thing I have learned since my diagnosis is that women have a lot of things that can go on in their breasts (cysts, etc.) that most often turn out to be benign. Being cautious is a good thing, and it sounds as if that's what your onc is doing. The only thing that I can think is that you had two things that 'showed up' - one on the MRI and one on the mammogram. The thing on the mammogram has already been biopsied, but it sounds like the thing on the MRI has not.