BI-RADS 4 - finding the right surgeon

CrowLuv

Greetings, all.

I posted in the "not diagnosed but worried" forum recently - it was way too long and rambling, probably even incoherent so I deleted it lol!

Recently found a palpable mass directly underneath my nipple - was referred to a breast clinic and had diagnostic mammo (BI-RADS 0) then targeted ultrasound which came back BI-RADS 4. Due to the location which is mostly in the base of my nipple they were unable to perform a fine needle biopsy and I need a surgical consult for excisional biopsy.

While the bold type IMPRESSION: SUSPICIOUS OF MALIGNANCY did kind of leave me shaken, I'm really glad I've been lurking here for awhile because now I know that BI-RADS 4 is something like 80% benign.

The radiologist who performed the ultrasound told me it's "possible" it could be a papillary lesion, she also said she wasn't sure. I have had NO nipple discharge, by the way.

I'm in Houston so I'm hoping to go to MD Anderson for my surgical consult because I want to feel confident in how we proceed. Will be checking insurance today and on the hunt for an experienced breast surgeon.

At the moment, I feel no "terror" but I'm definitely "concerned." Not particularly about cancer, but about the fact that I have found sooooo many conflicting reports and info about this kind of mass and it's odd location.

Looking for some extra support right now - and for anyone who has had this kind of mass in the retroareolar region of the breast - there's not much out there about it and strong disagreement between breast cancer doctors on how aggressively to approach these things.

Any advice for BI-RADS 4 peeps? Thanks in advance for any insight or shared experiences!

Moderators

Hi CrowLuv,

We're so very sorry you're here and worrying, but we're really glad you've found us. You're sure to find our Community a very informative, helpful, and supportive space. We're all here for you while you wait!

Please keep us posted with your biopsy results -- we'll be sending good thoughts your way!

--The Mods

obsolete

Hi Crow,

So sorry about all the anxiety this has caused you. 5-6 years ago I had several lesions in that same area, had the biopsies, surgeries and treatment, and I'm perfectly fine now. I never had any nipple leakage, but I did have intermittent 24-hr pain in the affected breast.

Please just take baby steps, one by one. It's a long process, but you'll get thru it. Yeah, I know, easier said than done.

It's good that your team suggested an excisional biopsy only and NOT a core needle biopsy because lesions in the papillary family can tend to be cystic and contain some fluid. It's also quite possible it's benign or a only "pre-cancer" issue. Papillomas are benign and common.

Please let us know how you make out and remember to just take baby steps, day by day. We're here for you.

CrowLuv

Thanks, Mods! What a wonderful forum this is, I'm so grateful for it.

CrowLuv

Hi, Obsolete! Thanks so much for your response, not that I'm glad that you experienced this, but grateful to find someone else who had breast "issues" in this odd region. So much confusing/conflicting info but mostly seems positive overall.

Happy to hear that you made it through all of that and are doing well now, thanks again for the support!