Scheduled for an MRI - bloody discharge

TryingNotToStress

First, I want to say thank you to the many of you who posted about nipple discharge. It is because of you that I made my appointment when I say blood coming from a single pore.

I had my diagnostic mammogram today. They then decided upon an ultrasound as well. Now they are sending me for an MRI. There is something that isn't quite presenting itself as a cyst. It's only 5mm, that's a good sign, right? Doc mentioned that a biopsy may be called for upon MRI findings. Doc said ductagram or MRI, but he thinks it should be MRI.

At this point, I am not sure what to expect nor what to feel. The ductagram is highly recommend for this type of issue, why would the doc prefer an MRI? Does this mean there is something abnormal and now they are figuring out what, or is that still even yet to be seen?

mustlovepoodles

Mammogram, ultrasound, and MRI are different modes of imaging. They each have their pros and cons. They are all very accurate, although they can have false positives occasionally. Still, I think I'd rather have a false positive report than a false negative report!

djmammo

TryingNotToStress

A ductogram is pretty much the gold standard for demonstrating an intraductal mass but not everyone performs them these days and it might be hard to find someone who does enough of them often enough to be really good at it. It is a little tedious and a bit time consuming so everyone seems to prefer to order/recommend an MRI to find a papiilloma as it does not require a radiologist's presence to be performed.

There are some MRI sequences that look like a ductogram and are excellent for demonstrating papillomas but if I remember correctly not every one uses it as this sequence is actually patented and owned by the radiologist that developed it and the company that makes a particular brand of MRI machine.

Now this is my personal opinion: At 5mm it would be very well demonstrated on a ductogram but thats a little small to resolve on an MRI. The MRI's value is that it affords excellent contrast resolution, that is it can tell the difference between two different types of adjacent tissue but it is lower than a CT for instance in spatial resolution which refers to how well you can see the size and shape of little things on an image.

The bottom line is, where was the 5mm mass they found? Inside or outside the duct? If it was outside the duct then the MRI is definitely the way to go.

TryingNotToStress

Thank you for the responses. I didn't catch all of what the radiologist said but he said it was just behind my nipple. While watching the US, I don't recall seeing it inside a duct. I just remember seeing a black spot. I don't think he specified where.

Also, how long does it typically take to actually schedule an MRI?...if typical even exists. I am surprised I haven't received a call yet.

Thank you again, I really appreciate your input.

djmammo

TryingNotToStress

If you know where they want you to have the MRI, call them and tell them you want to schedule a breast MRI ordered by your doctor at that center. No reason to wait for them to call. Doesn't happen often, but every now and then an appointment falls through the cracks and no one calls you. Quicker if you do it.

TryingNotToStress

I just learned that they are looking at a complicated cyst. Tomorrow, they will schedule the MRI (for more information). I am feeling much better about this. Thank you for taking the time to reply.

TryingNotToStress

MRI (it was breast MRI, thank you!) looked good.

Ultrasound findings:

I think my report looks pretty good but I'm not sure due to the term "Hypoechoic.". Can you help me identify if this is pretty typical & not much too worry over? Also, if there is a possible cause of concern that I may not be aware of would be appreciated.

on dedicated ultrasound examination of the left breast a dilated duct is present in the retroareolar region with some low-level internal echoes without any vascularity. a 5 mm hypoechoic lesion with some internal echoes and with mildly increased through transmission is present at 1:00 position which could represent a complicated cyst. A 5 mm anechoic lesion with septations is present at 12:00 position for centimeters from nipple which could represent a complicated cyst or a cluster of micro cysts. a 5 mm cyst is present at 11:00 position. A 9 mm cyst is present at 11 to 12 position. A 7 mm anechoic lesion with low-level internal echoes is present at 3:00 position likely a complicated cyst. A 6 mm anechoic lesion within crease through transmission and low-level internal echoes is present in the retroareolar region which could represent a complicated cyst.

..... follow up in 6 mos...which will be around February

I thought the bloody discharge was gone & tried to forget about it until my 6 mos us came up. But I checked this morning and it remains. Going to specialist as doctor advised initially. Should there be concern? Does this look pretty typical w/ b9 outcomes?