Scared - Focal Asymmetry with New Architectural Distortion

Fyrecatt

Hi, new here and scared/anxious I had my routine screening mammo (3D) on 5/5. This is only my 2nd one. My very first one in 2019 was normal.

I got a message on 5/7 saying it was a callback and I needed to have more images. I figured it was because they couldn't see something clearly because I have very large breasts. Scheduled for the 18th due to work issues, even though they offered an appt on the 12th, bc I really wasn't worried.

I found my report last night and it says there is "focal asymmetry with new architectural distortion within the upper outer quadrant of the RIGHT breast, 10:00 position, 11 to 12 cm from the nipple (CC slice 37, MLO slice 22). Bi-RADS Category 0.

The architectural distortion is what's scaring me the most, especially with the focal asymmetry. It just seems to often be an indication of malignancy from what I've read. I haven't had and injury, surgery or biopsy on my breasts, so no obvious reasons that it might be scarring.

I'm 43, no history of breast cancer in my family. However, I went into menopause at 29 and I've been on HRT for 14 yrs. There's studies done on HRT /cancer risk in women's over 50, but nothing about young women in my situation.

I guess I'm just looking to see if anyone else here had similar findings and what did it end up being. The waiting for the next week is going to so hard.

Thanks in advance for any suggestions, help, words of wisdom.

Moderators

Hi Fyrecatt, and welcome to our community,

We all understand how scary it can be to have a call back. It looks like they need more testing to understand what they are seeing. From our page here (BI-RADS) a BI-RADS 0 means "need additional imaging evaluation: more studies are necessary to gather more information".

Have you discussed the HRT with your doctor, taking it longterm? Here's some articles we have on Using HRT (Hormone Replacement Therapy) and Hormone Replacement Therapy.

We're here for you, and please keep us posted.

Warmly,

The Mods

Salamandra

Your initial reaction not to worry was the correct one. The vast majority of callbacks go no further. But doctors are cautious. Birads 0 does not mean they found something concerning, it means they want a clearer/different view.

Beesie

As Salamandra said, a BI-RADS 0 simply means that more imaging is necessary. Most often, the additional imaging clears up any concerns. And if not, a biopsy might be recommended. Approximately 70%-75% of breast biopsies turn out to be benign. So it is definitely too soon to worry.

One possibility, with the combination of focal asymmetry and architectural distortion, is that you have a mass hiding in your breast tissue. That sounds scary but many breast masses are benign. The diagnostic screening, which likely will include a diagnostic mammogram (different views, possibly magnified views) and an ultrasound, will hopefully find a mass, if one is in there. And this mass could be something as harmless as a simple cyst - in which case no follow-up would be necessary, or possibly just a repeat screening in 6 months. I'm not saying that this is what will happen in your case, but I can say that I've seen exactly this result in others who've presented with similar screening mammogram results.

Good luck with the wait - that's never easy - and good luck with the diagnostic imaging. Hopefully the results are good and this turns out to be a false alarm or nothing serious. Let us know how it goes.

LivinLife

Welcome FyrreCatt! As the others said callbacks are typically benign. I've had several on my right breast with two stereotactic biopsies - one was a fibroadenoma and I'm not sure the other was anything really.... The left breast was a different deal unfortunately though still was luckier than many since it ended up being DCIS plus even less worrisome things....

Fyrecatt

Thank you all for the replies. I'm planning on talking to my Dr about getting off the HRT. I've been on it since I was so young when my ovaries failed (29), I'd have osteoporosis by now if I wasn't on it. Plus the brain fog was so bad I had to stop driving.

I think since I'm closer to standard menopause age now, that getting off the HRT is a good idea.

I'm trying not to stress too much, but I feel like there's a chance of a biopsy in my future at the very least, since the distortion is showing up in both planes on the 3d mammo. Still, no way to know for sure till Tuesday.