increased patchy background parenchymal enhancement

trace621

Hello,

Back in August I had a mammogram done and they found micro-calcifications on my right breast. Sept I had a hysterectomy (leaving 1 ovary only due to adenomyosis). I just had my 6-month routine MRI and the staff is out this week but hoping anyone would have insight here. I tried googling BPE and getting a few different things. I also had a transvaginal ultrasound and they found a mass on my right side. I am concerned I am "right side heavy" and they are missing something and I keep getting dismissed and "come back in 6 months"

I have had tumors on both breasts plus surgery for removal. Both sides of family BC history. My cousin had a "cyst", doctors kept insinuating that it was a cyst and it was actually stage 4

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Impression

Increased background parenchymal enhancement bilaterally. No suspicious enhancement within either breast. No suspicious enhancement is seen underlying the skin marker at the upper outer anterior right breast. There are numerous bilateral cysts.

RECOMMENDATION:
Annual mammography alternating with screening MRI every 6 months per high risk screening protocol. Of note, the patient is due for a six-month follow-up bilateral mammogram in February of 2022.

RESULT/FOLLOW-UP CODING:
ACR BI-RADS Category 2: Benign

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SmoothOperator78

welcome!

It looks like they are aware of your high risk for bc status and you’re on increased screening schedules recommended for high risk individuals (6 months and alternating with MRIs). The BPE is a benign finding for now and probably hints that things in the tissues are changing (due to aging or reduced hormones or whatever). Hopefully, these changes won’t turn into cancer, but a six month screening schedule will help make certain that IF something changes that’s harmful, there is much greater chance it will be found early.

trace621

thank you for responding! I do have a follow up mammogram in Feb to check the micro-calcifications. Does BPE just develop? I have been having routine exams every 6 months but this is the first time I ever had this show up and increased/clustered microcaclifications.

SmoothOperator78

you might find this summary useful: https://pubmed.ncbi.nlm.nih.gov/31004391/

It says that BPE is benign but indicates greater risk for bc. You already know you’re at high risk. This finding is just reinforcing that you’re at high risk.

Microcalcifications are little grains of calcium that deposit in the breast and can be there because of mostly benign reasons but can also be there in certain patterns associated with cancer. If there was enough concern about the micro-calcifications pattern being concerning, a biopsy would be indicated to see if there was evidence of cancer cells or something benign like cysts or fibrocystic tissue