Bi-Rads 0, but findings scream Bi-Rads5, waiting on MRI

Tmh0921

I had my 6 month mammogram Monday. Went in expecting some level of drama as my mammograms are never normal (usually end up with some kind of biopsy). Anyway, started the process with a 3D mammogram, and of course radiologist wanted extra views (expected this, not worried yet). Then they wanted to do an ultrasound of an area in my left breast (again, expected this, not worried yet). In the room where the US is done, they have an image from my mammogram up on the screen and I get a look at the area they are investigating. Now I start to worry as it is clearly a spiculated mass. US tech performs US on area of concern, then also does an US of my axillary nodes. This is cause for concern, as they've never done and US of this area in my history of imaging. I just kind of laughed and told the tech good luck finding nodes, they removed 14 of them back in 1999.

After all of this, radiologist still isn't happy (she's very thorough, I trust her explicitly). So she now has given me an order for a breast MRI with specific instructions to schedule it for 10 days after the start of my next menstrual cycle.

Oncologist called with my mammogram report yesterday:

Indication: Multiple prior surgical procedures bilaterally including lumpectomy in 1999 and recent excisional biopsy on the left.

Comparison: 9/5/18, 8/14/18, 7/23/18, 6/15/16

Findings: The study is reviewed by CAD. Tomosynthesis images are obtained in two projections.

There is heterogeneously dense tissue bilaterally, limiting sensitivity. Biopsy marker is present adjacent to several stable calcifications in the upper outer right breast middle depth. Surgical clips and distortion are seen in the left breast posteriorly. There appears to be a new spiculated density in the posterior upper outer left breast. Compared to prior studies however, the patient has undergone interim excisional biopsy which may have been more anterior.

Ultrasound of left breast demonstrates an irregular hypoechoic attenuating lesion at 2:00, 5cm from the nipple, measuring 1x1.1x0.9cm. No definite vascularity is seen within the area. Scanning of the axilla demonstrates 2 deep nodes that do not appear to contain a fatty hilum.

Impression: Spiculated mass upper outer left breast, scarring versus suspicious finding. There are also deep nodes that appear indeterminate. Breast MRI is recommended to further assess. If MRI cannot be obtained, then biopsy of the upper outer quadrant mass in the left breast under ultrasound guidance is recommended.

Result code (0) incomplete: Need additional imaging evaluation

Follow Up (0) needs additional imaging.

Unfortunately, the whole spiculated appearance of the mass (seriously looks like a well defined starfish), and the lack of fatty hilum in the nodes doesn't bode well. There is some hope the mass could be scar tissue (I have had 2 core biopsies and 2 excisional biopsies in that area in the last 3 years), but it does feel like the proverbial other shoe is about to drop.

Spoonie77

Oh how stressful! I will be keeping you in my thoughts.

How long until the 10 days after your next cycle? Hope you don't have to wait a whole month!

If you would like some other eyes on this, you could post here "Interpreting Your Report". Even though you know a whole ton about reports and meanings from your expereiences. But, maybe DJammo could give you his thoughts as a Radiologist.

https://community.breastcancer.org/forum/83/topics/858196?page=44#idx_1313

I have no idea on what this could all mean, but somehow hope you can stay distracted and in the moment until the MRI.

Hang in there.

Hugs.

Tmh0921

Based on my calculations, I should be able to have the MRI around 5/17 (assuming the stress doesn't delay my cycle

I'll post on the other forum as well - I should have avoided google, I know better.

Spoonie77

Oh I'm glad you won't have to wait weeks and weeks in that case. Just checked the other thread and am glad DJammo was able to explain a few things that helped you out. My fingers will be crossed for you that indeed this is just scar tissue. Please keep us posted.

Also -- thank you for posting! Because of your post and DJammo's reply, I now know to time my first follow-up MRI for about 10 days after my own cycle. I too have very dense breasts and will do whatever it takes to get a clearer image! If that means timing it (which NO one had mentioned to me as of yet) I'm glad to do so.

Tmh0921

When they told me to wait for 10 days after the start of my next cycle I was a little irritated, i wanted the test ASAP. We all know the waiting is the worse part of all this. But with djmammo's explanation it makes sense and I understand the need to wait.

Thank you for your replies today, I'll definitely post my results so others can benefit from the info

Spoonie77

Right?! I'd have been irritated too. It's not like it's common knowledge to most people of why the delay is necessary. If they would just give us an explanation up front it would help us tremendously in the interim knowing that waiting will ensure a more accurate image. So glad DJMammo was able to fill you in on the secret! Now we know. Thanks again.

Rah2464

Tmh I am really glad you are in such careful hands. And thanks for sharing these little gems of information that help others receive the best care possible. I hope things go well for you with the MRI.

Tmh0921

Thanks Rah2464

I’ve been lucky to have a great medical team for the last 19+ years. My oncologist is retiring, which scares me... it’s good to be around long enough for doctors to retire though

Tmh0921

I had the dreaded MRI today, which wasn’t bad at all with 2mg of Klonopin helping out

Now we wait for results. I really hope the results are available before the long holiday weekend.