Changing BiRads

Marigold1330

Hello and Happy Mothers Day to us all! I'm new here and glad to have found this site. I'm 67 and no history in my family. I've been tracked since 2018 for asymmetry in left breast. Several reports defined it as a BiRads 3 likely benign. Nov 11 2019 that changed back to BiRad 1 stating that the density now appear similar dating back to 2015. And now this latest US which has taken me to a BiRads 4 suspicious for malignancy. Im concerned that possibly I should have had a biopsy back in Nov 2019. Input or thoughts on these current results much appreciated.

PROCEDURE: Diagnostic left mammogram and targeted left breast ultrasound performed. CAD was utilized.
COMPARISON: 4/26/2021 and 11/11/2019 mammograms
FINDINGS:

Left breast tissues contain nodular scattered fibroglandular densities. Screening mammographic finding of upper quadrant 9 mm lobulated mass persisted upon diagnostic spot compression imaging, without associated microcalcifications. Diagnostic targeted sonographic evaluation of the left breast mid upper inner quadrant revealed corresponding 12Q00 position (4 cm from the nipple) 0.7 x 0.8 x 0.7 cm irregular hypoechoic solid mass with partial posterior shadowing. Doppler evaluation demonstrated no abnormal vascular flow.

Diagnostic targeted sonographic evaluation of the left axilla revealed no enlarged lymph nodes.
IMPRESSION:
Left breast: BI-RADS Category 4: Suspicious finding of 12Q00 position 0.7 x 0.8 x 0.7 cm mass.

Ultrasound guidance needle core biopsy is recommended for evaluation of suspected underlying malignancy.

Marigold1330

Here's the report taking it down to a 1 back in November -

DATE OF EXAM: 11/11/2019 9:00 AM
PROCEDURE: MAMMO BILAT DX 2 VIEWS EA BREAST W OR WO COMPUTER AIDED DETECTION, ALL VIEWS

HISTORY: Left breast asymmetric glandular density.
COMPARISON: Mammography May 14, 2019, November 14, 2018, November 1, 2018, and August 4, 2015. TECHNIQUE: Bilateral CC and MLO views. CAD was utilized in the interpretation of this exam.
FINDINGS:
RIGHT BREAST:
Right breast demonstrates average fibroglandular density without concerning microcalcification or mammographic mass. LEFT BREAST:

Left breast demonstrates average fibroglandular density without concerning microcalcification or mammographic mass. Previously described left breast posterior depth asymmetric density along the posterior nipple line on CC and MLO projections demonstrate significantly decreased conspicuity on today's study. Glandular density in this region now appear similar dating back to 2015. This was the source of the patient being within BI-RADS Category 3 designation.

IMPRESSION:
BI-RADS Category 1-negative. Recommend follow-up bilateral screening mammography in one year. Findings and recommendations were discussed directly with the patient.
THIS IS NO LONGER A YELLOW DOT CASE.
OVERALL ASSESSMENT: BI-RADS 1 - Negative
OVERALL RECOMMENDATION: Screening in 1 Year

OVERALL DENSITY CODE: b - Scattered fibroglandular density

Beesie

Marigold,

Did you ask if the current area of suspicion is in the same location of the breast as the previous area that had been watched? The location descriptions are different. By my (admittedly amateur) interpretation, the earlier area sounds to be behind the nipple, whereas the new area sounds to be higher in the breast (12Q00), on the inner side.

Current - "left breast mid upper inner quadrant revealed corresponding 12Q00 position"

Previous - "left breast posterior depth asymmetric density along the posterior nipple line"

Based on that, it's possible that this is an entirely new finding.

Good luck with the biopsy.

Marigold1330

Well ugh! Thank you Beesie I was trying to figure that out also. Thanks so much for replying. I'll share back my results when I get them. Thanks so much.