I am confused....anyone have a similiar situation?

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SarahRose
SarahRose Member Posts: 15
edited April 2015 in Benign Breast Conditions
I am confused....anyone have a similiar situation?
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  • SarahRose
    SarahRose Member Posts: 15
    edited December 2014

    I have had a mammo and three ultrasounds on my right breast starting in December of last year for a mass found. Left breast a year ago was fine with some small simple cysts noted, and right breast had pain, multiple cysts,and a complex hypoechoic structure that was partially cystic ( BIRADS 3). Went in a week ago for my third ultrasound and they checked both breasts. The tech took my images to radiologist and came back twenty minutes later stating concerning area in my right was smaller and I didn't need to come back anymore for ultrasounds. Didn't even mention my left breast. I Was so relieved to be done! Then Dr. office called the next afternoon stating they had found something in my left breast and I needed to come back in six months to have it checked...I thought she was mistaken until I received a letter from imaging center the next day saying the same. Received my report later in the week that said this.........

    FINDINGS:

    Right breast: Oval hypoechoic structure at the 11 o'clock position,
    4 cm from the nipple is noted. This measures 0.5 x 0.1 cm. This
    likely represents a small area of ductal ectasia.

    At the 10-11 o'clock position there is a simple cyst measuring 0.6 x
    0.2 cm.

    At the 10 o'clock position there is an oval-shaped anechoic structure
    measuring 0.4 cm.

    Left breast:

    At the 1 o'clock position a simple cyst is present measuring 0.4 cm.

    At the 1 o'clock position there is an anechoic structure measuring
    0.9 x 0.3 cm. This appears similar to the previous examination.
    This likely represents a focal area ductal ectasia or periductal
    fibrosis. No blood flow is evident. Follow-up ultrasound in this
    abnormality is recommended 6 months.

    The patient will be notified by letter.

    Can a complex cyst turn into ductal ectasia?? And what is that?? My doctor said she can't really explain it except to say it is changes in the tissue of the breast not a cyst, and that doesn't mean cancer but they will want a biopsy if it changes at all. So here I go with more six month waits. I just wish someone could explain it to me, and why did my radiologist say something so different than when I was sitting in the office. Each of my ultrasound reports say something different about the same area....how can that be? Thanks for listening :)

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  • MelissaDallas
    MelissaDallas Member Posts: 7,268
    edited December 2014

    From the Mayo Clinic website:

    Mammary duct ectasia (ek-TAY-zhuh) occurs when a milk duct beneath your nipple becomes wider (dilated), the duct walls thicken and the duct fills with fluid. The milk duct can then become blocked or clogged with a thick, sticky substance. The condition often causes no symptoms, but some women may have nipple discharge, breast tenderness or inflammation of the clogged duct (periductal mastitis).

    Your chance of developing mammary duct ectasia — with or without inflammation — increases with age. Mammary duct ectasia usually improves without treatment. However, if symptoms persist despite self-care measures, you may need antibiotics or possibly surgery to remove the affected milk duct.

    Though it's normal to worry about any changes in your breasts, mammary duct ectasia and periductal mastisis aren't risk factors for breast cancer.

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  • horsedoc
    horsedoc Member Posts: 512
    edited December 2014

    I had a fairly similar issue. I had a unilateral mastectomy almost 5 years ago, and my mammos on my left breast have been clear until a few months ago. Came back with a diagnosis of BiRads 3 also (I had to look that up) which qualifies as "probably benign." For the some reason though the history on the form sent to the pathologist just said "history of breast reduction" that I had done when I had the unilateral mastectomy, it didn't also say "history of cancer" on other side. Just recommended a recheck in 6 months. (that was 3 months ago.) In a way I'm not concerned but I guess I am a little...

    Just prior to that I had a uterine ultrasound as a follow up to one I had 2 years ago from my periods being very abnormal and sporadic (after they had returned to normal 6 months post-chemo.) There is a "lobulated cyst-like lesion" on or next to an ovary. Did a CAT scan and didn't get much more specific results, except it had increased blood flow and small amount of fluid around it. Recommended recheck in 3 months. That was a little over 3 months ago; my doctor's office said I would get a reminder but I didn't and I just realized it's time to schedule that.

    I don't know if anyone will read this or have any input. Thoughts?

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  • SarahRose
    SarahRose Member Posts: 15
    edited December 2014

    The area on my right breast was on the upper outer quadrant, a hypoechoic, complex partially cystic lesion (2nd report) Or a complex cyst with debris (1st report). My other two reports do not say it was near the nipple, and on my mammogram image the spot was up high and they even had to take additional images up towards my armpit . I am confused at how my other two reports say it is a cyst, and it can change to ductal ectasia. Also my radiologist sent me home with a "you are good and no more follow ups" only to completely change his mind. He also states the area on my left breast is "similiar to previous exam", but my first exam of the left breast and nipple are noted that there is nothing around nipple and some small simple cysts...no ectasia or structures that size? wondering if anyone out there has had or has Ductal ectasia, or had a cyst that was changed to this that can give me some insight on this.

    horsedoc....I too have had sporadic and irregular cycles this past year, just had a pap last week and am waiting for the okay on this. I had part of my cervix removed in my twenties (I am 32 now) for what I am assuming was precancer sells. I am thinking with these issues lately I should get my records to see exactly what my results were as I was young and unconcerned at the time. Wish I could give you some input!

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  • horsedoc
    horsedoc Member Posts: 512
    edited December 2014

    Thanks SarahRose, I hope your situation gets sorted out. Yeah, I agree you should see what your cervical issue was years ago.

    I actually had a thickened endometrium in my uterus 2 years ago (found on ultrasound because of irregular cycels) and a uterine biopsy (painful!!!!) which came back normal, and now my endometrium is normal thickness. I have no clue if any of that is related to the mass by my ovary now.

    I don't know a lot about ductal ectasia, but I'm a vet and ultrasound things occassionally, so I might have a little idea why you are getting conflicting names/descriptions of things. Basically a cyst is a fluid-filled area, and if there are white specks in it that would be "debris". A simple cyst is just a round or oval, smooth-edged, black (fluid) structure. On your report at the top it says "likely" ductal ectasia, so that means the radiologist thinks it's consistent with that in the area that it is and it's appearance, with THEIR experience and history of reading ultrasounds. It says it was 0.5 cm X 0.1 cm so that is basically "long" and narrow, more consistent with a duct, than round or oval, which is more consistent with a cyst.

    When they briefly look at them vs. really study them with no interruptions they have more time to measure things and see more things and make conclusions, plus potentially ask another person's opinion, so that's why you might get a slightly different final report vs. why they told you right after you got it. Or when you were in the office and they said you were clear, that had only compared the right one to the old scan and not analyzed the left one yet.

    Hope that helps!


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  • SarahRose
    SarahRose Member Posts: 15
    edited December 2014

    That is a great explanation horsedoc! Makes so much sense. I wish my doctor could be clear like that. I have another ultrasound in June for my follow up. I was supposed to follow up with my breast surgeon again in September, before my ultrasound this month, but never did because I felt I was being overly concerned with my breast lump/ pain. I am thinking of making my follow up now, with this report from my new ultrasound (take in all three ultrasounds images and reports), and have him explain them to me so I won't worry so much. last time he didn't even have all my reports or images. I tend to over think things...so I feel silly making doctor appointments, and only go if I have to.

    My pap came back negative for malignancy, and just inflammatory cells on my cervix so that is good, and I am still waiting to get my records for my LEEP, and cone biopsy that was done previously to see exactly what it was. Are you having any pain in your abdomen? Have you scheduled your follow up yet? I wonder if abnormal or irregular cycles have any connection to breast issues? Mine seem to be happening simultaneously. My doctor said hormone and cycle issues wouldn't be causing my breast issues.

    All week I have been having more breast pain and soreness in my arm/shoulder. Non cyclic.Comes and goes when it pleases as it has been for the last year. thanks for your reply!! I do feel better.

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  • horsedoc
    horsedoc Member Posts: 512
    edited December 2014

    I'm glad that helped! Human doctors can get away with not explaining things well a lot better than vets can for some reason. I think it's a good idea to take all the images and reports. I really think I need to bring my latest mammogram and ultrasound reports to my original surgeon and get his opinion. I need to schedule my uterine/ovary ultrasound. I will try to do that tomorrow. I guess I need to call my PCP and have them refer me to the imaging place or have them make the appointment. It aggravates me that it's not simple to figure out how to do this stuff.

    I don't know if my irregular cycles have anything to do with the breast issues but I don't think so UNLESS they are both related to high circulating Estrogen. (my original cancer was E/P +.) And I don't know why I have (or may have) high estrogen. I wonder if it's related to my diet. When I originally had the thickened endometrium I completely cut out soda, artificial sweeteners, and ate as organic as possible. And the problem resolved. I have a hard time eating that way now mainly due to money issues. Isn't it ridiculous that it's cheaper to eat crappier food??

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  • SarahRose
    SarahRose Member Posts: 15
    edited January 2015

    I agree!! My food budget is through the roof with seven kids when I buy only healthy foods. I'm always trying to rework my budget to find a happy medium! Let me know how your ultrasound turns out. Have you had any other symptoms that are associated with your ovary cyst?

    I have an appointment ( not until February!) to get my issues with the irregularity and spotting I have been having all year. I had some pretty horrible pain right after my cycle ended at the end of December that almost made me got to the ER, and then bloating, pain in my back/low abdomen/thigh, indigestion, breast pain in my right breast sharp and constant, and so tired for the following week. Also spotting after intercourse the last few times. Something is just not right! I have read that Ductal Ectasia happens when you are older and going through menopause or perimenopause.....wonder if it could be connected to my other issues? Also symptoms for Ectasia are nipple tenderness and pain, thick discharge, redness inflammation of the skin around the areola, and nipple rtraction when it is at end stages (fibrosis) and I have none of that! Makes me Wonder if this is even what I have? I ordered all my breast images (ready to pick up today) and records and made my follow up with the Breast Surgeon for the end of the month so he can explain things to me, and figure out if the ductal ectasia/periductal fibrosis is a new finding or a change to the cystic lesion they have been following. Next ultrasound is in May and I am hoping this time I will get a REAL "you are good to go" finding and not have to come back!

    Anyone with ductal ectasia/periductal fibrosis out there have any information/synptoms or are young in there early thirties???

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  • horsedoc
    horsedoc Member Posts: 512
    edited April 2015

    Sorry I didn't reply sooner SarahRose. About the ovary cyst... I did have pain associated with it. And I finally know now that I had cysts in the past. They make my lower back hurt on the side, and it must be around they burst that I will have a TERRIBLE shot of pain when I bend over; so much that I feel like I won't be able to stand up, It eventually resolves. So that's basically what happened with the last one, but it wasn't as bad as ones had been in the past. I also had bloating too.

    I don't think I have ductal ectasia/fibrosis but I had a couple irregular mammograms (6 months apart) that were read out as ok, but I'm taking them to my breast cancer surgeon, and if he says they are ok then I'll feel better.

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