BIRADS 4 - Looking for help, just received ultrasound results

okangansummer

Hello I know many can probably relate, I just feel scared and I keep googling but unsure and hope maybe there is someone that has had a similar situation and maybe ease my mind. I just received results today and will have to go for a biopsy, is there anyone that can shed some light. I'm so grateful and thank you

BREAST DENSITY:

The breast tissue is heterogeneously dense which may obscure small abnormalities.

FINDINGS:

Diagnostic right breast mammography:

Compressive and MLO and a lateral view demonstrate persistent architectural distortion within the posterior upper right breast. CC view localizes subtle architectural distortion to the axillary tail. The area of concern is approximately at the 10 o'clock position. It is approximately 6 centimeters lateral to the nipple.

The small oval mass within the slightly lower outer right breast localizes to the 8 to 9 o'clock position at an anterior depth, within 2.5 centimeters of the nipple.

Targeted right breast ultrasound:

There are multiple simple cysts within the outer right breast from the 8 to 12 o'clock position. 1 at 9 o'clock, closer to the nipple measuring 8 millimeters corresponds to the smaller oval mass seen mammographically.

In the area of concern in the posterior upper outer right breast axillary tail, there is an irregular taller than wide 6 x 7 x 6 millimeter hypoechoic mass with no internal flow on Doppler interrogation. It does demonstrate posterior acoustic enhancement. It could be cystic or solid.

A few other oval masses with posterior acoustic enhancement and internal hypoechogenicity are seen but there wider than tall and oval, at the 8 o'clock and 10 o'clock position.

IMPRESSION:

Taller than wide 7 millimeter hypoechoic mass at 10 o'clock within the posterior right breast corresponds to the area of architectural distortion. Recommend urgent ultrasound-guided fine-needle aspiration/biopsy. It could be solid or cystic. A requisition must be submitted to general hospital.

Other scattered oval hypoechoic masses are wider than tall and appear more benign. These could represent complicated cysts with internal debris. These could be assessed at the time of the biopsy, and further aspiration or biopsy recommended if felt suspicious by the radiologist.

Background of other simple benign cysts in the outer upper right breast.

RECOMMENDATIONS: As above.

BIRADS:

Right breast: BI-RADS 4 Suspicious Abnormality RESULTCODE: BR-4

Georgia1

Hi there. DJ Mammo is super helpful, and some time ago he posted this list of terms, dividing them into "good" and "bad" for simplicity. It seems like your results were not conclusive and the biopsy is to be safe. As someone who has been through the whole ordeal, I can only tell you that no matter what, you will be ok. For now, my advice would be to stay optimistic and keep yourself busy. We're here for you.

GOOD: Oval; parallel; circumscribed; anechoic; hyperechoic; isoechoic; posterior enhancement or good through-transmission; avascular; macrocalcifications include pop corn, large rod like, rim, milk-of-calcium.

BAD: Irregular; non-parallel (can also be written as "taller-than-wide"); not-circumscribed margins includes indistinct, angular, microlobulated, and spiculated; hypoechoic; posterior shadowing; architectural distortion; internal vascularity; microcalcifications including amorphous, coarse heterogeneous, branching, fine pleomorphic.

okangansummer

Thank you so much, that is helpful. I'm trying hard not to worry. I just don't understand why I would have all these cysts. This was my first mammogram, which was in Feb, I'm 42 (I breastfed for 8 years in total)

I actually was in my dr office the next week and mentioned the results said they needed a repeat mammogram and she said my physical exam was good (also had in Feb) from her. She said it is because of the first mammogram likely and dense breasts.

Then before I knew it I’m getting an ultrasound and a needle biopsy on Wed (coming up

There seems to be one that was of concern and it has that taller than wide description.

Georgia1

I don't think anyone knows what causes cysts. I have ovarian cysts, thyroid cysts, cysts on my fallopian tubes and the good lord only knows what else! It's a lot of monitoring but so far they're all benign.

Beesie

You have these cysts because you are a woman, with estrogen and breasts.

About 60% of women have fibrocystic breasts. Some have only a few symptoms, others have many symptoms. Cysts are very common and some of us are just prone to develop them, particularly once we hit the peri-menopause years. I had more cysts than I can remember. It's annoying but not unusual and it does not increase breast cancer risk.

Fibrocystic Breast Condition (Changes, Lumps, Cysts, Fibrosis) https://www.medicinenet.com/fibrocystic_breast_con...

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Breast Cysts. https://www.mayoclinic.org/diseases-conditions/breast-cysts/symptoms-causes/syc-20370284

Simple and complicated cysts are normally monitored, but in addition to the cysts, you have the one other very small mass that might be solid or cystic and has some questionable characteristics. That's the reason for the biopsy. Good luck! Hopefully this small mass turns out to be benign.

windingshores

okangansummer, many of us have learned that too much research before we know what we are dealing with can cause undue stress.

When I was in your shoes I took walks, watched Netflix and asked my doctor for a few Ativan.

I did buy the Mayo Clinic's book on breast cancer for a very general understanding but there was no point in reading about different kinds and treatments until I had my post-surgical pathology back. Then I did crazy research!

Right now, try to preserve your energy. Your testing is on Wed. right? And don't be embarrassed to ask your doc for some meds.

Ginger1234

Hi. I had a fine needle aspiration biopsy plus a core needle all in the same day due to being graded a b rad 4 on ultrasound. This all took place tue. I was told I have alot of cystic lesions in my right breast but one measures 3.2 by 1.9 cm at the 1 o clock of my right breast the other cystic lysions are described as multiple scattered echo free. No evidence of solid lesions nor evidence of lymph node enlargement. But on my mam it states a I'll defined circumscribed nodular density. Also it stats No speculated masses, malignant calcification or focal architectural distortion seen in either breast waiting for the results are the worst😔 the b rad 4 part has me all upset. The fine needle asperation did bring fluid which shrank the cystic area & the color was a tea color from what the surgeon told me. But he took some tissue samples also.. my question really is has anyone been graded a rad4 & everything turn out to be o.k. ? I'm driving myself crazy. I'm 34..

Beesie

Ginger, in most cases, BIRADs4 means that a biopsy is being done in order to rule out cancer, not because a diagnosis if cancer is expected.

Approx. 75% to 80% of BIRADs4 biopsies turn out to be benign.

MelissaDallas

Ginger, most Birads4 biopsies are benign-overall about 80% of them. Anything that looks to have even a 3% chance of being cancer is recommended for biopsy. Try not to worry too much.

Ginger1234

Thank you guys so much❤️ I have made myself so sick worrying 😔

MelissaDallas

Ginger, what were your biopsy results