BI-RAD 4 MRI Results

Cmparker80

Hello,

I am scheduled for a breast biopsy next week following an MRI resulting in BI-RAD 4. Little back ground I have strong family history of breast cancer. Genetic tests on some which includes my mom shows a BRCA variation of unknown significance. That being said I had my routine mammogram in Sept and it showed a 6mm mass, followed up by US revealed there are 4 nodules described as ehcogenic ovoid circumscribed lupper quadrant Bi-rad 3, suspected fibroadenomas. At that time it was wait 6 months if they have doubled in size we will biopsy. I could only feel the one seen on Mammogram but none of the others. Early Dec I could feel 2. My doctor ordered MRI given family history and had my MRI last week and right away my doctor called about it looking suspicious and now I'm scheduled for biopsy next week. Obviously I'm concerned given family history but trying to over worry. Im most conerned because it's stating moderate inhancement and the 6mm mass showing mixed kinetics including washout, the other 3 enhanced showing persistent. Just wondering if anyone has had similar results as mine.

Thank you in advance.

MRI Results:

BREAST FINDINGS:

Amount of fibroglandular tissue: Scattered fibroglandular tissue
Background parenchymal enhancement: Moderate, symmetric

Right breast:
There is a 6 x 5 x 4 mm T2 hyperintense enhancing mass in the right
upper-outer quadrant anteriorly, approximately the 11:00 position, as
seen on axial slice location 81.77 and sagittal slice location 62.88.
This mass demonstrates mixed enhancement kinetics, including washout.
This is felt to correlate with the hypoechoic mass in the 11:00
position at a distance of 7 cm from the nipple seen on ultrasound from
September 16, 2021.

There are 3 additional T2 hyperintense enhancing masses in the right
upper-outer quadrant from the 9:00 to 11:00 positions demonstrating
persistent enhancement kinetics. These are located on axial slice
locations 84.97, 81.77, and 54.57 and likely correlating to the
additional masses seen on ultrasound from September 16, 2021.

There is an indistinct area of enhancement in the right lower outer
quadrant, slightly below the inframammary fold, as seen on axial slice
location -31.82 and sagittal slice location 36.88. This is in the
region of skin outpouching and could possibly be related to artifact
from positioning.

There is no axillary or internal mammary adenopathy.

Left breast:
There are no suspicious enhancing masses or areas of nonmass
enhancement.

There is no axillary or internal mammary adenopathy.
Bilateral subpectoral saline implants are intact.


IMPRESSION:

1. Suspicious enhancing 6 mm mass in the right breast at 11:00, likely
correlating to the hypoechoic mass seen on ultrasound from September
16, 2021 located at 11:00 at a distance of 7 cm from the nipple. An
ultrasound-guided biopsy targeting the 11:00 mass at a distance of 7
cm from the nipple is recommended. Confirmation of clip placement
using a nonfat sat T1 image is recommended to ensure the correct mass
was biopsied. If the clip does not correlate then an MRI guided biopsy
may be attempted which may not be possible in setting of implant.
2. Area of indistinct enhancement in the right lower inner quadrant,
just beneath the inframammary fold. A second look ultrasound is
recommended with clinical evaluation of this area. If no ultrasound or
clinical correlate is seen, then a six-month follow-up breast MRI is
recommended.
3. Additional T2 hyperintense enhancing masses in the right upper
outer quadrant. Follow-up diagnostic mammogram and ultrasound can be
obtained pending pathology results, for which the patient will be due
in March 2022.
4. No MR evidence of malignancy in the left breast.
5. Bilateral subpectoral saline implants are intact.

OVERALL ASSESSMENT CATEGORY: BI-RADS Category 4: Suspicious finding

RECOMMENDATION: Multiple recommendations as above.

Moderators

Hi Cmparker80, We're sorry you have to go through this process, but glad they are able to get you in for a biopsy. We understand the anxiety given the family history, but hope you can take one day at a time. We also hope you keep us posted here to let us know what they say. We're here for you, in any case.

Warmly, The Mods