MRI Radiologist Report

Anonymous

MRI Radiologist Report

NotYourEverydaySuperHero

Hello..

Recently diagnosed DCIS right breast. Had Bilat MRI last Friday. Results on right confirmed DCIS on right as did biopsy two weeks prior, but the original ultrasound/mammogram said it was a 5mm area. MRI report says 8mm? Could this be due to the higher rate of sensitivity of the MRI.

Also on left, found an "Between the 2 and 4:00 position in the left breast there is a 1cm area of enhancement with ill-defined margins. Washout curve shows progressive enhancement."

I tried looking up the terminology, but didn't get many answers. Help?

Monday I'll have an MRI Guided Biopsy on the left because when I went in for the Ultrasound, the Radiologist and tech couldn't see anything.

I'm inwardly freaking out I could have DCIS on both sides.

Thanks in advance ❤️

LivinLife

Hi NotYouEveryDay! The addidtional 3 mm is really a small increase so try not to worry about that. Could be due to greater accuracy of MRI. I had a diagnostic mammogram showing a near 3 cm area of DCIS. A subsequent MRI showed a 5 cm total area including non-mass enhancement for some of that. Final pathology after my BMX showed 1.2 or 1.5 cm of DCIS and the rest was benign and precancerous conditions and many of those conditions - so that 3.5 cm extra area was what the non-mass enhancement actually consisted of. I hope the findings in your case are the same! Please let us know, ok?

ctmbsikia

Is this your 1st MRI ? Can you tell us the Birads score for the left?

When I was diagnosed via biopsy of my left, the MRI right after showed focal asymmetry on the outer right breast, however looking back the Birads score was normal. As was mammo and US for the right side. The BS put it in for "1st tissue biopsy" The day I was scheduled for that, another radiologist reading that same MRI called BS with a 2nd area of concern and I had 2 biopsy's that day. One was fibroadenoma, the 2nd LCIS. I also had most of this area excised at surgery. Also LCIS. Tumor in my left was of mixed type. Since this was my 1st go around and they had absolutely nothing to compare to, I feel I got the whole work up. Hopefully, this is similar to your situation? They are just being extra sure, which will be a good thing when it's all over and benign. Let us know. Good luck!

NotYourEverydaySuperHero

It was my first, yes. Left doesn't have a BIRADS I think because that's where the area of concern is? The right has DCIS. The bottom of the MRI report did say BIRADS 6 for right. I thought it only went up to five.

It's all so confusing and mix that with anxiety and the ability to Google, well... #2020.

ctmbsikia

I believe the 6 means you have a confirmed diagnosis (for the DCIS). I think they see something else, but really think the report would say more if it is truly suspicious. My other side was not scored either, so I hope all goes well.

peggysmom

1. BiRads 6 is assigned for biopsy-proven malignancy. So the right side, where you have known DCIS is a Bi-Rads 6.

2. As for the terminology in your biopsy report, it translates into:

Location: left outer breast.

Finding:(they did not use Bi-Rads terms, i.e. mass, non-mass enhancement, or focus) but basically something is enhancing. I'm assuming it's a mass since they described margins.

Kinetics: This describes how the tissue breast tissue takes up and holds on to contrast. Washout is bad and is highly suggestive of malignancy. Plateau is neither bad nor good, kind of in-between but is still concerning for malignancy. And Persistent (aka progressive) is typically benign. HOWEVER, caveat- there are malignancies that demonstrate persistent kinetics especially low-grade malignancies. So usually the morphology (the shape or appearance) trumps kinetics.

All that being said about kinetics. When it comes to DCIS, which appears as "non-mass enhancement" all that goes out the window. DCIS is notorious for having variable kinetics. But since they described margins, it's probably not DCIS. Go back and take another look at the report. Did they describe "mass" or "non-mass enhancement". Did they talk about a correlate on mammogram or ultrasound?

3. Given that they described findings in the right breast, there should have been a separately reported Bi-Rads for that breast, especially if there is an "actionable" finding that needs a biopsy.