Ultrasound results clarification, waiting on biopsy

Ashleyne84

Hi everyone,

I am new here and was looking for some clarifications on my ultrasound report. I don't understand all the terminology and when I google the info I feel like I am just stressing myself out. I had an ultrasound then the doctor immediately ordered a mammogram then back for another ultrasound. She wanted to do an immediate biopsy, but it was too late in the day for the lab to pick up the specimen. Now, my biopsy is tomorrow, but I am just concerned over the ultrasound findings. They read:

Focused sonography of the 3 o'clock position right breast 2 cm from the nipple in the palpable region of concern demonstrates a superficial oval hypoechoic mass with lobular margins, measuring 0.4 x 0.4 x 0.5 cm. There is no surrounding architectural
distortion or posterior shadowing. Mild surrounding associated vascularity is noted. Focused sonography at 6 o'clock position right breast demonstrates no abnormality.

Does anyone have any insight on what this means?

Thanks,

Ashley

Tpralph

I am a nurse practitioner so will try to decipher it to the best of my knowledge for you.

Focused sonography (this means the ultrasound)  of the 3 o'clock position right breast (your area of concern and its location which is )- 2 cm from the nipple in the palpable region of concern  (means you can feel it) demonstrates a superficial oval hypoechoic mass with lobular margins, measuring 0.4 x 0.4 x 0.5 cm. ( so very small solid mass)  There is no surrounding architectural
distortion or posterior shadowing. (not quite sure what this is, perhaps someone else would but tells me that again it is small and not irregular in shape- another good indication)

 Mild surrounding associated vascularity is noted.  (cancers make their own blood supply so the fact  yours is mild tells me IF it is cancer it is early) Focused sonography at 6 o'clock position right breast demonstrates no abnormality  (hooray good news! nothing there at the bottom of your breast).

so overall if it is cancer probably very early lobular cancer as is very small - half of a cm , doesn't look like it is speculated - which means invasive but still too early to tell probably.  The fact that it is small and superficial is good.

could be scar tissue or fat necrosis, what was your BIRADS score?

GOOD LUCK TOMORROW, let us know your results when you get them ok?

MTwoman

Ashleyne84, I know from reading responses from a radiologist who frequents these boards that posterior shadowing is a characteristic more likely seen in malignancy, so NO posterior shadowing would also be a good sign! At this point, what you know is that you have a mass that has a few concerning features, and your medical provider is being appropriately cautious and ordering a biopsy to be sure. The vast majority of biopsies come back benign, so try to stay as calm about this as possible, don't go too far down the 'what if' road and don't go on google (too much outdated or just plain wrong info). Good luck tomorrow for B9 findings!

Ashleyne84

Thanks so much for your responses! My BIRADS was 4. I am especially concerned about the "lobular margins" because I can't seem to find any information about that.

AnotherMichelle

My surgeon showed me my mammogram as I was being diagnosed, and the "architecture of the breast" really does look like architecture. Because I had a tumor, the architecture--straight lines connected throughout the breast like a toothpick house or building a kid might build--was pulled out of shape. I could see that the structure was lopsided, and part of it was pulled over to the side like a house on a bad foundation, leaning. So, if yours is unchanged, that's good. Keep us posted!

Mooshi

Ashleyne84, here is a website that shows lobular margins are more suspicious than well-defined margins, but less suspicious than ill-defined or spiculated (spiky)margins:

http://breast-cancer.ca/mass-chars/

I hope it all works out well for you. I get my biopsy results first thing in the morning with a BI-RADS 5 rating, so I can only imagine how you feel. Please keep us posted.

Ashleyne84

so I just came from the breast cancer center atthe hospital where the biopsy was scheduled and they ended up not doing it?? The doctor came in to do another ultrasound before the biospy and said she didn't see anything. Then another doctor came in and said the same thing. Both doctors and the ultrasound tech clearly felt the lump. They saw the images from my last ultrasound and mammogram two weeks ago and all agreed something is there, but they couldn't see it on ultrasound today. So, I was sent home and told to keep an eye on the lump and report any changes! I do not feel comfortable with this at all! I'm not sure what to do.

Tiger98

I wouldn't be ok with that at all!! Have you seen a breast surgeon?

LisbethS

Well it is good news that they couldn't find it and that they didn't seem worried about it. If they can't find it, there is no way for them to biopsy it. I would think if they were worried about it they would have ordered a breast MRI. Sometimes doctor's hands are tied by insurance and I know MRIs are expensive so insurance can have strict criteria for when they will cover them.

But I know it is still worrisome because everyone wants a definitive answer, not "keep an eye on the lump". It is very small so I could see that they might have trouble finding it again. Were you able to feel the lump, and can you still feel it? You can get a biopsy done by the radiologist or by a breast surgeon. At this point, if you are uncomfortable with the wait and see approach, I would call your gynecologist and ask for referrals to another radiation place and a list of breast surgeon's she recommends and maybe ask her/his opinion on what you should do. I would probably recommend calling a breast surgeon to see what they say but I am a worry wart. Or you could make an appt with a different radiation place. Just make sure your insurance will cover it.

It could be a fibroadenoma. After my mammo & U/S, they said it could be a fibroadenoma but I was old for one; they are more common in younger women. I am 52. Fibroadenoma's often show up oval on U/S. I think they still biopsy fibroadenoma's since they can't tell for sure from U/S or mammo if it's fibroadenoma or BC.

Remember most lumps are benign.

Keep us updated. Sending positive thoughts your way that this will all turn out to be nothing.