Birads 4! Enhacements that demostrates plateau kinetics. Help?

RNstrong

I've been here since September. Found a lump on left breast, did Mammo and US but it turned out to be a fluid filled cysts. I was sent to MRI for evaluation of a focal asymmetry on the right breast. I got my results today. The focal asymmetry has no MRI correlate. But the found 2 enhancements on the same breast. One circumscribed mass at the right breast upper inner quadrant 2 o'clock measuring 5 mm with non enhancing septa. A breast US is recommended, possible biopsy. And then the other on right 3 o'clock 6mm non mass enhancement, biopsy is recommended. If they don't find it on US they might do an MRI guided biopsy. It also says both enhancements demonstrates plateau kinetics. What do you mean by that? My BS says a plateau is less concerning than a washout? I am so scared right now. Most that I've read states plateau kinetics is concerning for malignancy. Any thoughts? I would greatly appreciate it thanks!

dbRN

I received my MRI results today as well, one area (where the segmental microcalcs are that was biopsied and came back benign) with mixed progressive/plateau kinetics, 2 new masses with progressive kinetics one intensely bright the other intermediately bright, and my palpable irregular mass (its 3cm x 1.5cm) with a "concerning" enhancement pattern and enhancing tail? My Surg/Onc called today and only wants to u/s the two new masses to evaluate further though the rad suggested u/s bx or MRI bx, or repeat MRI in 6 mo. Initially she thought the palpable mass was biopsied during my steriotactics which came back benign/fibrocystic disease but after comparing the MRI and clip placement the palpable mass was not biopsied so now I have to do that next week! I also read that plateau was concerning for malignancy but shows with benign as well - similar to bi-rads 4 score I suppose - lots of maybe's! I'm sorry you did not get some concrete answers, waiting sucks! I asked my surg/onc if she was less concerned, more concerned, or the same after seeing the MRI and she said the same - so still giving me a 25% chance of ca....and more testing before surgery. Good luck you are in my thoughts.

~D

RNstrong

I've read, progressive kinetics are mostly benign. I am still hopeful for benign results. My BS says she is not too concerned with the 5mm mass, it might be a fibroadenoma. Im kinda worried about the non mass enhancement.