Extremely dense breasts and multiple cysts

schurchill

Last year I experienced bloody nipple discharge from my right nipple. I went through lots of tests (mammogram, ultrasound, ductogram and MRI) to try and determine the cause. Although the reason for the blood was never discovered (it has since stopped) the results showed that the breast parenchyma was extremely dense. And I had multiple cysts throughout my breasts. Fine, I though nothing of it and wasn't really bothered and had never really felt any cysts myself. Last night I was doing a self exam and felt a hard lump in my left breast. I am assuming (hoping) it is one of the cysts on the MRI. I did a little research about dense breasts and was a bit nervous to read that my cancer probability was higher because of it. I don't want to overreact to a situation that has already been looked at but now am questioning if I should go back to the doctor to check this lump...

Any insight about this?

MR BREAST DENSITY: The breast parenchyma is extremely dense. There is moderate
 background parenchymal enhancement.

 MR FINDINGS: No suspicious extramammary findings.

 LEFT BREAST: There are multiple cysts throughout the breast parenchyma,
 measuring up to 11 mm in the upper outer quadrant. In the lower outer quadrant
 of the breast seen on series 7 image 97, there is a kidney bean shaped 5 mm
 well-defined nodule with some plateau enhancement kinetics and high T2
 precontrast signal intensity. This lesion is consistent with an intra-articular
 parenchymal lymph node. This is BI-RADS Category 2. There are no suspicious
 lesions.

 RIGHT BREAST: Numerous cysts are seen scattered throughout the right breast
 parenchyma, the largest at the 9:00 position measuring 18 mm. The nipple is
 unremarkable. No suspicious periareolar or enhancing lesions are seen. The
 remainder of the breast parenchyma is also unremarkable.

 IMPRESSION: No findings suspicious for malignancy. No cause for bloody nipple
 discharge is seen. Numerous cysts scattered throughout both breasts. Clinical
 follow-up for the nipple discharge suggested.

djmammo

schurchill

Aside from the typo (the word articular should be deleted) its a very straightforward negative report.

Bloody discharge is most often from a small papilloma in a duct. The vast majority are benign and they are all removed as a precaution. It is sometimes too small to see on MRI, and usually hidden on mammogram. A good US tech can sometimes find them . The gold standard for finding them is a ductogram (a.k.a. galactogram).

See this article: https://www.radiologyinfo.org/en/info.cfm?pg=galactogram