Had US and Diag Mammo - now waiting for biopsy

Nikki444

Hello everyone! I went to the dr because I noticed a dimple/indent on my lower right breast when putting on deodorant. My Dr. sent me for a diagnostic mammogram and ultrasound. The findings of the ultrasound are below followed by the results of the mammo. My biopsy is scheduled for 2.12.1 - I'm just hating the waiting and worrying. Does speculated usually mean malignant? I'd love to hear feedback.

Exam: Bilateral mammogram targeted bilateral breast ultrasound, 1/25/2018.

Clinical History: Area of skin dimpling along the lower inner quadrant of the right breast. Focal pain felt by the patient within the inferior and subareolar left breast. The patient had a prior history of benign right breast needle biopsy.

Comparison: Comparison was made with prior outside mammograms and ultrasounds dating back to 2014

Density: The mammary tissue is heterogeneously dense, which may lower the sensitivity of mammography.

Technique: Low-dose tomosynthesis 3D views were obtained in combination with 2D images. 3-D spot compression image was performed of the right breast as well as a full lateral view.

Findings:
Within the inferior right breast at or slightly 5-6 o'clock there is an area of architectural distortion. Additional CC spot compression images suggest that there are 2 spiculated masses within the distortion measuring approximately 2 cm. The oval
circumscribed mass within the 7:00 position of the right breast was previously biopsied and found to be benign is smaller on today's mammogram. Stable benign-appearing calcifications are noted bilaterally.
No abnormality suspicious for malignancy within the left breast.

Diagnostic ultrasound:
A targeted ultrasound was performed of the patient's right and left breast.

A left breast ultrasound was performed in the area of focal pain. At 5-6 o'clock, 4 cm from the nipple in the area of focal pain and thickening there is a hypoechoic mass with indistinct margins measuring 0.6 x 0.3 x 0.4 cm. Ultrasound-guided core biopsy
is recommended. There is no mammographic correlate.
Interrogation of the left axilla demonstrates normal lymph nodes.

Within the area of dimpling involving the right breast at 6:00 4 cm from the nipple there are 2 adjacent irregular hypoechoic masses, one within the near field and the second within the far field measuring 1.6 cm in totality. The mass within the near
field measures 0.4 x 0.7 x 0.8 cm. And the mass within the far field measures 0.7 x 0.6 x 0.8 cm. Both findings appear to be part of the same pathologic process and correlate with the area of distortion on mammography. Other scattered cysts and clusters
of cysts are noted within the adjacent tissue. The patient has a very complex breast pattern.
Interrogation of the right axilla demonstrates normal lymph nodes.

Study Result

Impression

Impression:
2 adjacent suspicious masses within the right breast at 6:00. Ultrasound-guided core biopsy is recommended of the larger mass.

Mass within the left breast at approximately 5-6 o'clock 4 cm from the nipple with no mammographic correlate. Ultrasound biopsy is recommended.

Recommendations:
Ultrasound-guided core biopsy of the right and left breast
If pathology yields a malignant entity, breast MRI is recommended due to the complex breast pattern.

This mammogram was interpreted following analysis with Computer-Aided Detection technology.

The patient has been notified of the results.

BI-RADS: (4): Suspicious

Narrative

Exam: Bilateral mammogram targeted bilateral breast ultrasound, 1/25/2020.

Clinical History: Area of skin dimpling along the lower inner quadrant of the right breast. Focal pain felt by the patient within the inferior and subareolar left breast. The patient had a prior history of benign right breast needle biopsy.

Comparison: Comparison was made with prior outside mammograms and ultrasounds dating back to 2014

Density: The mammary tissue is heterogeneously dense, which may lower the sensitivity of mammography.

Technique: Low-dose tomosynthesis 3D views were obtained in combination with 2D images. 3-D spot compression image was performed of the right breast as well as a full lateral view.

Findings:
Within the inferior right breast at or slightly 5-6 o'clock there is an area of architectural distortion. Additional CC spot compression images suggest that there are 2 spiculated masses within the distortion measuring approximately 2 cm. The oval
circumscribed mass within the 7:00 position of the right breast was previously biopsied and found to be benign is smaller on today's mammogram. Stable benign-appearing calcifications are noted bilaterally.
No abnormality suspicious for malignancy within the left breast.

Diagnostic ultrasound:
A targeted ultrasound was performed of the patient's right and left breast.

A left breast ultrasound was performed in the area of focal pain. At 5-6 o'clock, 4 cm from the nipple in the area of focal pain and thickening there is a hypoechoic mass with indistinct margins measuring 0.6 x 0.3 x 0.4 cm. Ultrasound-guided core biopsy
is recommended. There is no mammographic correlate.
Interrogation of the left axilla demonstrates normal lymph nodes.

Within the area of dimpling involving the right breast at 6:00 4 cm from the nipple there are 2 adjacent irregular hypoechoic masses, one within the near field and the second within the far field measuring 1.6 cm in totality. The mass within the near
field measures 0.4 x 0.7 x 0.8 cm. And the mass within the far field measures 0.7 x 0.6 x 0.8 cm. Both findings appear to be part of the same pathologic process and correlate with the area of distortion on mammography. Other scattered cysts and clusters
of cysts are noted within the adjacent tissue. The patient has a very complex breast pattern.
Interrogation of the right axilla demonstrates normal lymph nodes.