Needing additional imaging, extremely worried

Anamaris

A little background, my mother was diagnosed with BC at 49, LT side, then RT side at 51. She had lumpectomies followed by radiation.

I am a RN and I work at an Oncology practice.

I am currently perimenopausal with frequent light periods (around 21 days apart).

I had a 3D mammo on Monday and findings are as follows:

Extremely dense breast tissue

Right breast; On CC tomographic images there is a questionable asymmetry just lateral to the nipple axis at mid posterior depth. On The MLO view there are calcifications seen above the nipple axis at posterior depth. Based on tomographic images, there is asymmetry at the nipple at posterior depth.

Left breast: On the CC tomographic images, there is asymmetry at the nipple axis at posterior depth.

Impressions RT breast Asymmetry. Microcalcifications. Recommend additional imaging.

LT breast : Asymmetry. Recommend additional imaging.

ACR BI-RADS category 0

Radiologist did not specify if additional imaging should be done via diagnostic mammo w/US or go straight to MRI. I work in an oncology practice and one of the physicians ordered MRI while the other one thought diagnostic mammo with US is better.

I am not sure how helpful another mammo would be as that particular radiologist classified tissue as extremely dense.

I just feel like the mammo report is bare bones. I am not sure what she means by " questionable asymmetry" . Is she questioning the presence of asymmetry, comparison to previous mammo or questionable as in being potential mass. Also, on the issue of microcalcificates, she did not mention any specifics such as size, density or distribution.

I am having a terrible anxiety over this, I know I should not worry about it right now, but my brain is relentless. I wish that report was a bit more detalied so I'd at least have a bit better idea of what to start preparing myself for.

Thank you in advance

Recap

Some places still do 2D and others do 3D mammo for initial digital screening, and I think the next level up-diagnostic mammo-is always 3D, but with extra computer enhancement?? (I was never fully clear on that but there is definitely a big difference in the images produced between screening and diagnostic.)

http://densebreast-info.org/breast-mammography-tomosynthesis.aspx

Microcalcifications and their patterns-clusters, lines, scattershot, etc are seen more clearly on the diagnostic mammo, so it is a natural escalation up from the digital screening.

Ultrasound always follows diagnostic mammo where I am presumably because the mammo images give ultrasound a starting point/location.

If a lump was detected prior to any imaging, they skip the digital screening and go straight to the diagnostic mammo and ultrasound.

You want that ultrasound. You want the tech/dr to really scan you comprehensively-all 4 quadrants of your breast and up into that triangle of tissue towards your armpit.

After you have that ultrasound report is the time to make a decision about the MRI. If you want the MRI still, get it done before a biopsy.

They might want to biopsy you while still there after the ultrasound-you should discuss that with someone beforehand so you are not caught between a rock and a hard place deciding whether to wait for mri first.

Recap

I finally read all the way thru the link above and found this interesting:

OTHER BREAST IMAGING IN DEVELOPMENT: Contrast-Enhanced Digital Mammography (CEDM).

Says it detects better than ordinary mammogram OR ultrasound, and the same as mri w/contrast.

Given the simplicity of mammogram machines, the expense and complexity of mri machines (and my breasts didn't seem to be susceptible to the magnet), and in my case my sense that the ultrasound exam was operator-inadequate, I would love to have this done on the next go-round.

Higher radiation than regular mammogram but from screening mammo to diagnostic mammo to mammo-guided biopsy and post-biopsy mammo, I had more than my fair share of radiation on this go-round. Contrast for me was not an issue. Ultrasound gets to those areas that don't fit into the mammogram field, but since my ultrasound technician did not go to those areas that is a moot point.

So apparently a cancer absorbs contrast which then lights up better in the images.

Wonder it they can't attach some chemical weapon to the contrast to kill the cancer-maybe something where targeted radiation turns it into a killer once it reaches it's location so it only kills the target not the host. Are they able to remove a "live" cancer and keep it growing in a petri dish? Is there a living organism out there that likes to eat cancer and could be introduced and removed from the body? Enquiring minds want to know. Nothing worse than feeling totally in the dark.

Michele327

I was told today as well that I need additional imaging because I have fine pleomorphic calcifications with grouped distribution. My sister had cancer at the age of 45. I am 41. I picked up my CD to see the images and I don't see what they are talking about. They said at 9 o'clock and i don't see any little white dots. Its plain as day online. Im feeling scared. I have a right magnification mammo on Wednesday