Inconclusive imaging, nipple discharge, waiting for MRI

agritty

Hi

I am 45 and recently saw my OB for a spontaneous clear discharge from my right nipple. I thought it would be a "this is normal go home" appointment, but it turned out to be a "can you go to the radiologist today?" appointment. The diagnostic mammogram and the US showed a nodule, the report describes it, gives dimensions, BiRADS 4 - suspicious and FNA biopsy recommended. I went in again for the biopsy and the technician could not find the spot. The radiologist said it must be my "tortuous" milk ducts and I should have an MRI. My OB was not happy about the confusing results and didn't buy the curvy milk duct explanation, so she referred me to a BS, who I saw yesterday. Her research fellow examined me and located the spot immediately. The doctor got a sample of the discharge and it was positive for blood, which was a surprise to me because it looks clear. Now I am waiting for the insurance referral to have the MRI and feeling a bit nervous. The BS said she had already informed the MRI radiologist of my case, which made me more nervous. I do have breast cancer in my family (non-invasive, grandmother and maternal aunt). I am curious if anyone has had a similar experience with a phantom area of concern, or similar symptoms. I guess I never imagined it would be so difficult to determine what is going on, and with an 8 year old daughter I am starting to get a bit anxious. Thanks in advance for any advice or comments!

Meadow

Agritty, sounds like you are getting good care, that is a blessing. I did not have a discharge, but others have and I hope some of them will respond soon. The waiting is hard. Hoping you get good news, and keep us posted. Hugs to you

Fakeboobs123

I had a nodule, birads 4 and a fine needle biopsy, it came back benign, normal breast tissue. I also recently read about someone here having discharge who had benign results. I think the communication between radiologist snd Breast surgeon is what good doctors do and in the Breast clinic I was at it was standard to see the Breast surgeon right after imaging and get your results. I had an MRI, be prepare you have to lie on your front with your head in the donut hole like a massage table, make yourself comfortable in that donut hole because once that machine starts you can't move an inch, I walked out of there with an impression of the donut hole on my face haha! They will attach a saline IV to your arm and about five mins before the end of the scan they will inject the substance that provides contrast through the IV. The whole process takes about 25 minutes. Of course you're having the MRI guided biopsy which is great because they will hit the spot. I have a young son, I know the thoughts that go through your mind are torturous, force yourself to think good thoughts and check out these boards not Google, so much info and good vibes from women in varying situations, it's very encouraging. Let us know how you're doing during this difficult period

agritty

Thank you so much for your kind response!

I had the MRI, which came back with BiRADS 4 - lobulated mass of 5x5x4 and medium initial enhancement with plateau. I am going for another attempt at a biopsy tomorrow. I am not really sure what the MRI results suggest. Is a lobulated mass a good or bad thing? If anyone has experience interpreting results like this I would be most grateful. I am scheduled to speak with my breast surgeon next week.

PistolMama

agritty, how did your biopsy go?

agritty

Thank you so much for asking, PistolMama. I had the ultrasound guided biopsy yesterday. In the course of the process they located two more spots they needed to biopsy, so I ended up with three instead of one, which is a bit unnerving. Not sure how long the pathology results take - hoping I don't have to wait much longer. I see the breast surgeon on Wednesday, so I should know something by then, I hope!

Just curious if anyone else has also gone in for one biopsy and ended up with more? This was post-MRI...

agritty

So I received the pathology results, which indicate a papilloma, but also a number of other conditions as well. I am so happy at seems to be benign, and I am having it removed in two weeks. The results said it was a benign papillary lesion with florid sclerosing adenosis - reviewed by two pathologists. The other biopsies were stromal fibrosis and benign sclerosing adenosis.

It seems from reading a bit about these conditions that they each seem to put me at higher risk for BC in the future. I am curious if anyone has had a similar situation, and if so did you monitor the sites or have them out?

Many thanks for any ideas!

MelissaDallas

I was told that the sclerosing adenosis is a minimal, if any, risk factor and I am treated at an NCI cancer center

PistolMama

My breast surgeon said it doubles the lifetime risk and here's a link from this website that talks about it ( http://www.breastcancer.org/risk/factors/breast_ch... ). Do they have a high risk program available? Glad everything points to b9 for now!

Edited to add that the risk that is doubled is base risk. Most doctors aren't concerned if this is the only risk factor. It becomes important if there are other factors in play.

Ddw79

I too had the sclerosing adenosis and I've received confusing info about these . The Surgeon said no increased risk and the MO said significant increased risk. Who to believe

agritty

Thanks so much for all the responses. I will ask my surgeon about it when I meet with her and report back. It does seem to be an area around which there is a lot of conflicting information.

agritty

I just received the pathology from my excisional biopsy - very happy to say it is all benign, but there is a lot going on and I have read conflicting things about some of these conditions being worrisome in the long run. I would be very grateful for any expertise from this learned group! Seeing BS next week to discuss.

- Mild usual ductal hyperplasia, columnar cell change, sclerosing adenosis, cysts, and

fibrosis.

- Pseudoangiomatous stromal hyperplasia.

"ADDITIONAL LATERAL MARGIN":

- Sclerosing intraductal papilloma, completely excised.

- Sclerosing adenosis and stromal fibrosis.

C) "ADDITIONAL SUPERIOR MARGIN":

- Sclerosing adenosis, focal apocrine metaplasia, and stromal fibrosis.