Understanding MRI Results (long)

IrishEyes39

Got my MRI results, but am not sure what they mean.

I spoke to the radiologist and he said he doesn't "understand" my right breast LOL. As for the left, does that fact that all three "non-masslike enhancements" sound exactly the same mean they are likely to be other areas of DCIS? So confused. Waiting to hear from MO or BS today, as both were sent copies of report.

I researched "Clumped non-masslike enhancement - rapid initial and plateau delayed phase" and it looks to nearly always be malignant. Since MO, RO, and PS all say double mastectomy anyway, I guess I'm just confused as to why it matters what those other things are in my breasts.

_______________________________________________

FINDINGS:

RIGHT: Breast tissue pattern is heterogeneously dense. There is extensive background parenchymal enhancement which limits evaluation. Three biopsy markers are identified on nonfat suppressed images.

A focus of clumped masslike enhancement measuring 0.8 cm in the 9:00 position, 2.0 cm posterior to the base of the nipple. See dynamic image 46. Delayed phase kinetics are progressive.

A second smaller focus of clumped masslike enhancement measuring 0.5 cm is present in the 9:00 position, 1.0 cm posterior to the base of the nipple. Delayed phase kinetics are progressive.

It is not clear which, if either, corresponds to the 9:00 position mass seen recently as larger on the July 31, 2015 ultrasound and biopsied on 08/11/2015 (pathEfibroadenoma) nor if either corresponds to one of the prior 2012 biopsysites.

No other suspicious findings in the right breast. Scattered benign cysts noted. The nipple and skin of the right breast are normal. There is no right chest wall mass, right internal mammary adenopathy, or right axillary adenopathy.

LEFT: Breast tissue pattern is heterogeneously dense. Extensive background parenchymal enhancement which limits evaluation.

Clumped non-masslike enhancement - rapid initial and plateau delayed phase - within the upper outer quadrant left breast, anterior third measuring 1.1 cm, see dynamic image 39-41. This is positioned anterior to the expected location of the palpable sonographic mass on exam of 7/31/2015 at 1:00, 1 cm from nipple (biopsy 8/11/15 path E intraductal papilloma with focal hyperplasia without atypia) and anterior to the expected location of the sonographic finding at 1:00 position, 3 cm from nipple (biopsy 8/11/15 path E ductal carcinoma in situ with lobular carcinoma in situ). Due to the extensive adjacent parenchymal enhancement the exact extent measurement of the process is not possible to determine. A definite biopsy marker is not seen by MR within the left breast.

Posteriorly positioned and possible corresponding to the resent sites of biopsy is a 1.2 cm focus of clumped non-masslike rapid initial and washout delayed phase enhancement just lateral to the posterior nipple line centered 4 cm posterior to the base of the nipple and 1 cm anterior to the pectoral fascia, see dynamic image 36.

Thereis a smaller adjacent similar area of clumped enhancement in the posterior nipple line at the same distance from the nipple on image 39 measuring 0.6 cm.

The nipple and skin of the left breast are normal. There is no left chest wall mass, pathologic enhancement of the left pectoral muscle, internal mammary adenopathy or left axillary adenopathy.

IMPRESSION:

1. The true extent of disease following biopsy proven ductal carcinoma in situ at 1:00 position, 3 cm from nipple is difficult to ascertain in this case due to extensive parenchymal enhancement..

2. Indeterminate findings right breast. Extensive background enhancement in the right breast also limits evaluation

_____________________________________________________

Radiologist recommends ultrasounds of both breasts (already had, but he wants to do himself) and biopsies (already had three, and REALLY don't want more). I am still bruised and sore and it has been weeks, and I still have a (shrinking) hematoma in the right breast.

Sorry this is so long. Overwhelmed and I just keep ending up with more and more questions and things progress.