Need HELP on my Pathology results

Monkeyes

Can't get a word or a call back from my NP. On what to do next but here's my results

Large heterogeneous mass at 6:00 with smaller mass nearby.
There is associated extension into the skin, which is thickened. It is
not clear whether this is due to infection or neoplasm.
Ultrasound-guided aspiration/biopsy is recommended, the patient is in
the process of scheduling this procedure Breast density: Heterogeneously dense BI-RADS Category 4-suspicious finding Results were discussed with the patient at the time of the exam. The patient's information will be entered into a reminder system with a target due date for the next mammogram when the workup is complete andthe target due date has been determined. Approved By: Linda Huff MD 3/29/2021 5:24 PM NBCRR01R

Narrative

Bilateral diagnostic digital mammography with tomosynthesis and CAD and
Limited left breast ultrasound
Clinical Indication: Palpable lump left breast, chronic but worsening
left nipple retraction, baseline mammogram
Digital CC and MLO views of each breast were obtained without and with
tomosynthesis, and 90 degrees lateral and spot compression views were
also obtained on the left without and with tomosynthesis. Reconstructed
C views are provided. Images were evaluated with CAD technology. The
breasts are heterogeneously dense, which decreases the sensitivity of
the exam. Left breast sonogram of 1/11/2018 was reviewed, although there
are no prior mammograms.

Triangular marker was placed on the left breast at about 12:00
periareolar at the site of reported lump. There is some architectural
distortion in the breast, but this appears closer to the 6:00 position.
The left nipple is retracted, and there is periareolar skin thickening.
No masses or areas of architectural distortion are evident in the right
breast. There are no calcifications suspicious for malignancy in either
breast. No abnormal lymph nodes are viewed.

Sonography of the left breast was performed in the retroareolar and
periareolar area. There is a heterogeneous hypoechoic irregular mass
subareolar and at 6:00 that reportedly corresponds to the palpable lump.
This measures approximately 4.6 x 2.5 x 4.2 cm and extends into the
overlying skin. There is internal blood flow by color Doppler. A similar
but slightly smaller area was observed in the left breast in 2018, but
the patient did not follow-up with her physician. There is overlying
skin thickening. There is a similar lesion at 6:00 6 cm from the nipple
measuring about 1.5 x 1.1 x 1.4 cm. This is separated from the other
mass by about 1.4 cm. The left axilla was scanned, and no abnormal lymph
nodes are viewed.

Component ResultsPathology results indicate benign breast tissue with abscess cavity andassociated fibrohistocytic inflammatory response; no atypia ormalignancy identified. Results are concordant with imaging. The patientmay need surgical consultation. Follow-up ultrasound is recommended in 6months or perhaps at a different interval if determined by the patient'sphysician. Results and recommendations were discussed with the patient

With no Insurance ! I'm Lost in Confusion because I've not yet been told what to do PLEASE CAN SOMEONE HELP ME!

Moderators

Hi, We completely understand how difficult it is to interpret the reports, and are sorry that you're not getting a call back!

It looks like what they may be recommending a biopsy, or did you already receive the biopsy and these are your results?

To better understand your pathology report, you may find this helpful on our site: Pathology Report Booklet (PDF)

Also, to better understand what Bi-Rads 4 means, you can read here: Mammogram Results: Breast Imaging Reporting and Database System (BI-RADS).

We see that you have no insurance. Did your hospital/doctor cover the ultrasound?

Although you haven't been diagnosed with breast cancer, you may want to look at this page to get advice on paying for tests, etc: Help for people without health insurance.

We're here for you!

ctmbsikia

Did you have a biopsy yet? If so, I am assuming this last paragraph are the results, whereas what you posted previously are the results of the mammogram and ultra sound.

""Component ResultsPathology results indicate benign breast tissue with abscess cavity andassociated fibrohistocytic inflammatory response; no atypia ormalignancy identified. Results are concordant with imaging. The patientmay need surgical consultation. Follow-up ultrasound is recommended in 6months or perhaps at a different interval if determined by the patient'sphysician. Results and recommendations were discussed with the patient.""

If this says pathology on it, and you've already had the biopsy then you are not being diagnosed with cancer, so yeah I am confused what you're asking.

Beesie

So it sounds as though you had BI-RADs4 imaging and then had a biopsy.

The biopsy findings are benign - it's a bit unclear from what you posted but it sounds like what was found was an abscess and inflammation, with the very good news being no malignancy (i.e. no cancer) and no atypia (i.e. no high risk condition). The results are concordant, which means that what was found in the pathology adequately explains what was seen on the imaging. A 6 month follow-up ultrasound is suggested; this is standard after a benign biopsy.

That's all great news. The only confusion I have is why any mention has been made of a surgical consult. It says that the results and recommendations were discussed with the patient. Was any mention made of a surgical consult, and the reason why?

Monkeyes

Thanks so much.!

First let me slow down and take a breath'

I have been having a problem with my left breast with it hurting and turning hard around the nipple and the nipple goes in and a rash appears. I go to the emergence room at Piedmont for a torn muscle from lifting a heavy object cause now I'm in so much pain I ignore my breast. Seeing this now 4 years later, every year my breast would flair up, and I would ignore it till now. I had gone to MedAfford clinic, and they said it was Mastitis and gave me a shot and an antibiotic that didn't help, then another antibiotic that helped, but I ran out and that I needed a mammogram. Where they wanted to send me they wanted too much money, so I got and an appointment with Piedmont and a grant that paid. So Blessed Got the results that Friday 15 minutes later MedAfford called, and I told her the results, and she said she'll get with me when she sees them. And it's been how long now. But the top part I guess is a measure of 4 years ago and now. I found this when I made a MyChart. I'm just worried I don't it to turn into cancer. And do I need surgery or antibiotics Oh, Thank you so much for answering! Sincerely, Susan

Monkeyes

Not sure if I read it from the results from Piedmont, or they told me. I was so overwhelmed that this was my first mammogram and on top of it biopsy, they just said they would call me first with results. Thank you so much for answering Sincerely Susan

BrooklynWoodpecker

I have a similar size mass as the original poster right now; mine is a little larger. Mine is a fibroadenoma according to the biopsy. I had to do a surgical consult because it's usual to take anything out over 3 cm because of potential malignancy that wasn't picked up by biopsy, potential for further growth, and anything large and benign can start to harm the tissue around it. I am scheduled to get it out 2 weeks from now. I stopped nursing my preschooler a couple of days ago, and they think that might decrease the size, but probably not much, so I will probably still have it out rather than waiting to see whether stopping nursing will be enough. My last fibroadenoma went down from 3 cm to 2 cm in a year, and then to 1 cm in another year and then to undetectable after 8 more years.