Need biopsy can you help explain what this means for cancer?

momanddaughter

Says: Screening detected right breast focal asymmetry with associated distortion the 12 o'clock posterior right breast persists on additional Mammographic imaging and appears to be a cyst with mild distortion on additional views obtained today.

Affirm tomosynthesis stereotactic guided vacuum assisted core needle right breast biopsy.

ctmbsikia

Look at the bottom of your report for your Birads score which I have listed here below that should help you understand the chances of cancer.

Good luck on the biopsy, let us know how it goes. Most of them do come back benign, and from what little you have said, it is hopefully just a cyst.

ctmbsikia

Hang on, having trouble editing that.

ctmbsikia

Category

Definition

What it means

0

Incomplete - Additional imaging evaluation and/or comparison to prior mammograms is needed.

This means the radiologist may have seen a possible abnormality, but it was not clear and you will need more tests, such as another mammogram with the use of spot compression (applying compression to a smaller area when doing the mammogram), magnified views, special mammogram views, or ultrasound. This may also suggest that the radiologist wants to compare your new mammogram with older ones to see if there have been changes in the area over time.

1

Negative

There's no significant abnormality to report. Your breasts look the same (they are symmetrical) with no masses (lumps), distorted structures, or suspicious calcifications. In this case, negative means nothing bad was found.

2

Benign (non-cancerous) finding

This is also a negative mammogram result (there's no sign of cancer), but the radiologist chooses to describe a finding known to be benign, such as benign calcifications, lymph nodes in the breast, or calcified fibroadenomas. This ensures that others who look at the mammogram will not misinterpret the benign finding as suspicious. This finding is recorded in your mammogram report to help when comparing to future mammograms.

3

Probably benign finding – Follow-up in a short time frame is suggested

The findings in this category have a very high chance (greater than 98%) of being benign (not cancer). The findings are not expected to change over time. But since it's not proven to be benign, it's helpful to see if the area in question does change over time.

You will likely need follow-up with repeat imaging in 6 months and regularly after that until the finding is known to be stable (usually at least 2 years). This approach helps avoid unnecessary biopsies, but if the area does change over time, it still allows for early diagnosis.

4

Suspicious abnormality – Biopsy should be considered

Findings do not definitely look like cancer but could be cancer. The radiologist is concerned enough to recommend a biopsy. The findings in this category can have a wide range of suspicion levels. For this reason, this category is often divided further:

4A: Finding with a low likelihood of being cancer (more than 2% but no more than 10%)

4B: Finding with an moderate likelihood of being cancer (more than 10% but no more than 50%)

4C: Finding with a high likelihood of being cancer (more than 50% but less than 95%), but not as high as Category 5

5

Highly suggestive of malignancy – Appropriate action should be taken

The findings look like cancer and have a high chance (at least 95%) of being cancer. Biopsy is very strongly recommended.

6

Known biopsy-proven malignancy – Appropriate action should be taken

This category is only used for findings on a mammogram that have already been shown to be cancer by a previous biopsy. Mammograms may be used in this way to see how well the cancer is responding to treatment.

momanddaughter

Birads sore is a 4 with no additional detail - says suspicious for malignancy.

MinusTwo

mom - the best person to ask for clarification is your doctor. Call the doc that ordered the test (maybe your PCP or maybe your OB/Gyn?) and discuss this with them.

momanddaughter

I did and just had a vacuum biopsy yesterday. awaiting results and wanting to know if anyone else has experience with focal asymmetries like this.

Beesie

Lots of people come here because of callbacks or biopsies for asymmetry. I've responded to probably a 1/2 dozen posts on this topic over the past few weeks. Asymmetry on breast imaging can indicate the presence of cancer, but asymmetry can also be caused by a whole bunch of things that are benign. Most often, the people who come here with asymmetry turn out to have not have cancer. But as per the BIRADs evaluation system (see ctmbsikia's post), a biopsy will be recommended for anything seen on imaging that presents even just a >2% risk of being cancer.

The fact that the Radiologist indicated that the focal asymmetry may be caused by a cyst is a good sign since cysts generally are benign and harmless.

Hope your results are benign. Let us know.

momanddaughter

Thank you for your response - but my assymetry was developing, meaning the it wasn't on past mammograms. doesn't that make it much more likely to be malignant?

Beesie

But that's always the case.... something is not on a mammogram one year and it shows up on a mammogram the next year. That's why you had the biopsy - because it's new and the Radiologist can't say for sure what's caused the asymmetry. But it still could be any number of benign things. Approx. 75% of BIRADs 4 biopsies turn out to be benign. So no guarantees, but hopefully it is benign.