Birads 2 benign?

Anonymous

Birads 2 benign?

Butterfly9012

Hello,

I just received the radiology report for my mammogram and ultrasound. The radiologist noted that my breasts are almost entirely fatty, there were no significant or malignant findings and no cysts or masses were seen in the areas that I have palpable lumps. I have nipple discharge from one breasts with a raw scabby nipple skin underneath the crusty discharge.

When I look up birads 2 it seems as though that category is for benign findings so I don't understand why I am in that category if nothing was seen on the images.

I requested an MRI or to see a breast specialist for a biopsy to determine what is going on with my nipple. I am 37 and breast fed two children without ever experiencing this kind of discharge and I want to get to the bottom of it.

Is anyone familiar with Birad categories, can category 2 be assigned with nothing shows up on images?

I don't understand how my lumps didn't show up at all but I'm glad no malignancies were seen. The sonographer took measurements of something by placing a ruler on my breast. Whatever she saw wasn't noted on the report

Thank you.

Beesie

If the tech was measuring something and you have a BIRADs2, it would suggest that something was seen that is clearly benign. I suppose it's also possible that the Radiologist rated the imaging as a BIRADs2 because of your complaint about nipple discharge, but with nothing seen on the imaging, that would be unusual (I think).

What does the report actually say?

Butterfly9012

Hi,

This is the report:

MAMMO DX BILAT SEQUENTIAL W OR WO COMPUTER AIDED DETECTION ANALYSIS BILATERAL DIGITAL DIAGNOSTIC MAMMOGRAM SEQUENTIAL:

CLINICAL: Reason: Right Medial Breast Mass Radiologist: Follow Sequential Breast Imaging Orders Policy And Procedures. FIRST EVER MAMMOGRAM.

No prior exams were available for comparison. Both breasts are almost entirely fatty.

There is no suspicious mammographic abnormality in the areas of interest of both breasts.

No significant masses, calcifications, or other findings are seen in either breast.

IMPRESSION: BENIGN

Patient reports palpable lumps. Recommend further evaluation with ultrasound.

There is no mammographic evidence of malignancy.

SUMMARY:

A right breast ultrasound is ordered. A left breast ultrasound is ordered. Perform right breast ultrasound per sequential order. Perform

left breast ultrasound per sequential order.

Mammogram BI-RADS: 2 Benign

US BREAST DIAGNOSTIC BILATERAL SEQUENTIAL

ULTRASOUND OF BOTH BREASTS- SEQUENTIAL:

CLINICAL: Reason:Rt Breast Mass Medial Breast Radiologist: Follow Sequential Breast Imaging Orders Policy And Procedures.

No prior exams were available for comparison. Real-time ultrasound of both breasts was performed.

Targeted ultrasound over the area of palpable findings identified by patient in the right breast at 5:00 and 9:00, and in the left breast at

3:00, failed to identify any solid or cystic mass.

There are normal appearing lymph nodes in the bilateral axilla. There is no abnormality in the right retroareolar region.

IMPRESSION: BENIGN

No sonographic correlate for palpable findings indicated by patient. There is no sonographic evidence of malignancy.

letter sent: Clinical Follow-up

Ultrasound BI-RADS: 2 Benign

Beesie

The BIRADs2 is because the Radiologist remarked on the clinical finding, "No sonographic correlate for palpable findings indicated by patient.".

https://radiopaedia.org/articles/breast-imaging-reporting-and-data-system-bi-rads-assessment-category-2

"Reporting recommendations

Although BI-RADS 1 and BI-RADS 2 both denote an essentially zero chance of malignancy, BI-RADS 1 is used in situations where the breast is completely unremarkable, and BI-RADS 2 is used when the radiologist wants to remark on a benign finding."

Butterfly9012

That makes sense. Thank you