Biopsy tomorrow, looking for greater understanding before app

“Persistent asymmetry" means that no matter how hard your breast was compressed in the mammography machine and no matter how the radiologist tried to manipulate the ultrasound probe, the “asymmetry" (i.e., the thing they noticed from your screening mammo that isn't present in your other breast) won't distort or go away, and is visible from several angles.

“Laterally at 5:00...5 cm from nipple" means it's toward the lower outside of your left breast, about 2-1/2 to 3" from your nipple. 18 mm, or 1.8 cm, is about 3/4 of an inch, or a tad smaller than a thumbnail.

“Margins ill-defined" means that it doesn't have a clear border on imaging but rather looks irregular (and its true shape probably can't be known until it's been removed). It means it's hard to tell just by imaging where it ends and the surrounding breast tissue begins,

“Hypoechoic" means that the ultrasound waves don't bounce back off it very strongly, so the blob looks darker compared to its surroundings (“hyperechoic" is completely solid and looks lighter because the ultrasound waves bounce back very strongly, and “anechoic" looks completely dark because it absorbs the ultrasound waves,"); and “posterior acoustic shadowing" means that it casts a shadow behind it. It's usually characteristic of a malignant mass, but sometimes a benign mass can exhibit it too.

The fact that it's ill-defined, hypoechoic and casts a shadow means that though it bears some hallmarks of a malignancy they can't state with absolute certainty whether it's malignant or benign, nor what size it truly is---it is just as likely that the actual dimensions might include the shadow and be smaller than estimated, as it is that it might be larger.

“Fatty replaced lymph nodes in the axilla" means that tissue in some of the lymph nodes in your armpit seems to have been replaced by fat...which is normal as we age; “noted incidentally" means it wasn't the reason for doing the imaging, nor something they were looking for, but they saw it anyway.

Does the report mention a BIRADS score? (Probably 4)? It means that the anomaly they saw bears some but not all characteristics of a malignant tumor and might in fact be benign--so the only way to tell is by doing a biopsy. The biopsy would show the type of cells (and if cancerous, what type of breast cancer), how fast or slowly they're dividing (if at all) and how hard or easy it is to tell them apart from any normal cells; and if malignant, whether they have hormone receptors and overexpress a protein called HER2-neu. All those would help determine what to do next, and down the line. But its true size can't be determined until it's out.

But don't put the cart before the horse: you should know that 80% of these turn out benign.

Dear Sturbaj1,

Just sending you my support and care remotely. Good luck tomorrow and just remember to breathe. Make some kind of plan for after to sit down with someone you trust and just try to process. (If you can) You may find yourself feeling like you are in a surreal world or in slow motion. You may cry, it's ok. This in my personal opinion is normal. This is a game of one foot in front of the other, get support and extra eyes and ears and let your self process. Hugs! I'll look for you *;).

Dear ChiSandy:

Can you clarify what you wrote about hypoechoic.  Is hypoechoic generally indicative of a malignancy?  You also included other terms so I am not sure which terminology may be malignant.  (I realize that nothing is absolute.)

Dear Sturbaj:

Good luck.  I hope that you find out your results soon and that they are benign.

Dear ChiSandy:

Thanks.  I thought that is what you meant. 

I had a biopsy on Monday for an area that was seen on my ultrasound as being hypoechoic with shadowing.  However, the area is a "non-mass".  This area was seen 6 months ago on my MRI and I chose to wait and watch for 6 months. (It turns out that it would not have been able to be biopsied 6 months ago anyway.)  My doctors feel that this suspicious area is due to my surgery and/or radiation rather than this being a malignancy.  I am confident that it is benign and I am not worried about it.  I will find out the results of my biopsy hopefully, tomorrow.

I appreciate all of your help and input.

Thanks again to everyone here.