Worried but Hopeful

FMPA

I am posting this on behalf of spouse she is late 40s in age... BIRADS 4 with a bioppsy scheduled tomorrow. A 4-5mm spot was found on left breast. MRI and ultrasound already done. She is a high risk patient , as her sister had breast cancer and her mother has had at least 3 cysts removed over the years. As such, its routine for her to get mammogram and ultrasound, occasional MRI.

Here is what I think is good news: the MRI already done showed no adenopathy. Right breast is clear, no other suspicious activity. Her OB GYN, ultrasound technician and radiologist all told her that this was " probably nothing", That this was being ordered because this was new, that it was not there last year. Radiologist also stated that the spot was symmetrical. I am also interpreting this as good news. The words suspected malignancy also did not appear on the reports.

All this being said, I am just afraid, stressed and worried. Please let me know if anyone else sees what I have presented here as favorable.

exbrnxgrl

FMPA,

I am sorry that your wife is going through this but she is lucky to have a supportive spouse. Although I believe that your worry is normal please understand that none of us are your wife's doctor and very few of us are doctors at all! However I do know that the vast majority of Birads 4s are not malignant. Regardless of the outcome, which is likely good, don't get ahead of what you know. Stress and worry about the maybes and what if's benefits no one and none of us have crystal balls.

Because we are actual bc patients, many of us have not had the experience of being a spouse or caregiver to someone with bc. Here is a link to our forum where you can gettips from folks who have been in your shoes: https://community.breastcancer.org/forum/16

Moderators

FMPA, welcome to BC.org! As you can already see, this great community is here to help you with information and support. We hope this will turn out to be just a benign incident. Please come back to let us know how you both are doing.

Best wishes,

From the Mods

wondering44

Can a radiologist see breast cancer? I have a biopsy scheduled today. Radiologist said when she sees this much suspicious activity on two tests it turns out to be cancer. she said it has not gone to my lymph nodes which is good. Could it be fat necrosis?

mammogram 04/2019 and 08/2020 - negative results

saline breast implants - no fat transfer 11/2020

lump found 06/2021

3d mammogram and ultrasound 06/2021

Result:
US Breast Right Limited
Mammo Digital Diagnostic Bilat with Tomo

History:
Patient is 44 y.o. and is seen for diagnostic imaging. Patient presents
with a palpable abnormality in the right breast for about 1 week with
associated skin dimpling when she is sitting upright. The patient did
have saline implants placed in November 2020 (since her last mammogram).

Films Compared:
Prior images (if available) were compared.

Findings:

Bilateral diagnostic mammogram:
The breasts are heterogeneously dense, which may obscure small masses.
There has been interval placement of bilateral retropectoral saline
implants.

There is a 2.2 cm irregular equal density mass with spiculated margins in
the outer right breast at middle depth which corresponds to the palpable
area of concern designated by two BB markers on the skin surface. There
are fine pleomorphic calcifications associated with the mass and extending
anteriorly towards to the nipple with a total inclusive distance of at
least 3.6 cm.

There is no evidence of suspicious masses, calcifications, or other
abnormal findings in the left breast.

Right breast ultrasound:
There is a 2.2 x 1.4 x 0.9 cm irregular hypoechoic mass with spiculated
margins in the right breast at the 9:00 position, 4 cm from the nipple
which corresponds to the mass in the outer right breast on mammogram and
the palpable area of concern. There is suggestion of associated ductal
extension towards the nipple.

Targeted ultrasound of the right axilla does not demonstrate any
morphologically abnormal lymph nodes.

FMPA

From my very limited knowledge and experience, I dont think the radiologist can diagnose cancer, only the biopsy can. All they can do is provide educated opinions I am guessing? I am glad that you are having your biopsy today and I am hoping very much for a favorable result for you! Good luck and I will be keeping you in my thoughts.

kathabus

The way I kind of see it is this….radiologists suspect cancer. They know what characteristics to look for. They might have an opinion as to whether it is a low, medium or high probability. But at the end of the day….unless you look at it under a microscope…:you just don’t know for sure. Even with a Birads 5…even though you should probably be prepared for a diagnosis…some of those come back benign. So there is always hope that it is benign. Many many biopsies come back benign.

eviec1

Radiologists know how cancer typically presents on imaging and, when they see that presentation, they order a biopsy. They do not diagnose cancer - only the biopsy can do that. But they make biopsy referrals when a mass or calcifications show some of the typical features found with malignancy. However, keep in mind that they also tend to err on the side of caution and make referrals for a biopsy even when the suspicion is fairly low or moderate - there's a statistic I don't exactly recall, but it's something like 80% of biopsies come back benign. It might be exactly 80%, but it is a large majority.

wondering44

Thanks. I am waiting on the biopsy results.Patience is a virtue I guess. Ugh. I find it odd that I could have negative mammograms and a lump not long after.

exbrnxgrl

wondering,

Not as odd as you think! There is simply a point when bc grows enough to be detectable and until it reaches that point, it can’t be detected. The vast majority of breast cancers have been growing, many for years, for some time before they reach the point of being detectable. Take care.

wondering44

Received the biopsy results. Let my husband know first and family afterward. diagnosed with invasive carcinoma and ductal carcinoma in situ. probably going to have to wrap my head around it for a bit before it sinks in.

tntnsd

hi Wondering44,

Yes, mammogram and other detect methods have their own flaw, not always detect BC 100% of the time. My screening mammogram did not detect any abnormal a month before I was diagnosed even though I could feel the lump at that time. Only after my doctor and I requested diagnostic mammogram, following ultrasound, they were able to find it.

Anyhow, I wish your biopsy result is benign. Waiting is super hard. Hang in there.