Help understanding ultrasound results while waiting for biopsy

Tdiiulio

wondering if anyone can help me understand the ultrasound findings and the BiRad 4C score.

Study Result

Impression

MAMMOGRAM IMPRESSION: INCOMPLETE NEED ADDITIONAL IMAGING EVALUATION

The 1.3 cm oval mass in the left breast at 11 o'clock posterior depth is indeterminate. An

ultrasound is recommended.

The 0.5 cm x 0.3 cm oval mass in the left breast at 3 o'clock middle depth is indeterminate. An

ultrasound is recommended.

BREAST DENSITY AND RISK STATEMENT:

The patient has heterogeneouly or extremely dense breast tissue and and elevated lifetime risk of

breast cancer secondary to the Tyrer-Cuzick risk assessement model. Consider genetic screening

if applicable and adjunct screening whole breast ultrasound and/or screening breast MRI as

clinically indciated.

LIMITED ULTRASOUND OF LEFT BREAST AND AXILLA: 4/2/2020

COMPARISON:

Comparison is made to exams dated: 5/9/2014 mammogram and 6/17/2011 mammogram.

FINDINGS:

Color flow and real-time ultrasound of the left breast 2-4 o'clock, 11 o'clock, and axilla

regions were performed. All representative images including gray scale of the real time

examination were reviewed.

Accession #

MA-20-0040063

MA-20-0040066

There is a 1.4 cm x 1.4 cm x 0.7 cm oval mass with a lobulated and circumscribed margin in the

left breast at 11 o'clock 6 cm from the nipple with the long axis parallel to the skin. This

correlates as palpated and with mammography findings. Color flow imaging demonstrates that

there is vascularity present and an adjacent vascularity.

There also is a 0.4 cm x 0.4 cm x 0.2 cm oval mass with a circumscribed margin in the left breast

at 3 o'clock middle depth 7 cm from the nipple. This oval mass is hypoechoic. This correlates

with mammography findings. Color flow imaging demonstrates that there is no vascularity

present.

There is no sonographic correlate for the palpable concern in the left breast 11 o'clock 8 cm

from the nipple.

A left axillary lymph node is visualized, normal in size and appearance, fatty hila maintained.

ULTRASOUND IMPRESSION: SUSPICIOUS ABNORMALITY - MODERATE CONCERN BUT NOT CLASSIC FOR MALIGNANCY

No sonographic or mammographic correlate a reported prior palpable concern in the left breast 11

o'clock 8 cm from the nipple. Negative imaging results should not deter further evaluation or

biopsy of a clinically suspicious findng.

The 1.4 cm x 1.4 cm x 0.7 cm oval mass in the left breast at 11 o'clock is consistent with

a solid mass and is at a high suspicion for malignancy. An ultrasound guided biopsy is

recommended.

The 0.4 cm x 0.4 cm x 0.2 cm oval mass in the left breast at 3 o'clock middle depth is probably

benign. Follow-up left mammogram and ultrasound in 6 months are recommended to demonstrate

stabilty.

Results were given to the patient at the completion of the studies.

Results were faxed to the referring clinician, Dr. Alka Kale.

OVERALL STUDY BIRADS: 4c High suspicion of malignancy

Georgia1

Hi Tdilulio. DJ Mammo is the expert on this site, so you can ask him about this on his "Interpreting Your Report" thread. But it looks like you have one spot they're not worried about, and one that does give them concern so they need a biopsy to be sure. Best wishes to you, and in the short term, here is DJ Mammo's list of "good" and "bad" words in an ultrasound or mammogram report:

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.

Tdiiulio

thank you for your input. I did post in the thread you recommended so hoping for a response. We are on a stay at home order due to the Covid 19 and of course with nothing normal to help keep me busy my mind is wandering. Thank you again.

Ingerp

I can’t add much other than you should probably prepare yourself going forward. BIRADS 4c has a 79% probability of malignancy. They’re recommending a biopsy on that side.

Tdiiulio

thank you. I am preparing as much as I can, I saw so many positive things like circumscribed and oval and the lymph nodes looked good so I was really surprised to have a BiRad of 4C. I am glad that if it is malignant it’s early. My mom is 10yrs since her surgery and doing well, hers was caught early too.