intro and awaiting stereotactic biopsy results

Options
gogoamy
gogoamy Member Posts: 7
edited September 2016 in Waiting for Test Results

hi everyone, i'm new here. i'm 34 years old and just had a stereotactic biopsy yesterday. i'm anxiously awaiting results.

i think i'm driving my husband crazy talking about all the what-if's and possible outcomes, so i thought it might be helpful for me to join this site and write out everything here where others can relate.

some background: family history of breast cancer on my dads side. i had my second ever mammogram last week followed by an ultrasound. the mammogram had a new asymmetry finding on the right side (BIRADS 4), from the report --

The breasts are heterogeneously dense, which may obscure small masses.
Multiple diagnostic views of both breasts were performed. New asymmetry in the outer posterior right breast on the craniocaudal view persists with spot compression measuring approximately 12 mm. No definite correlate identified on the mediolateral oblique spot compression or 90 degree lateral views.

Impression/recommendation:
1. New persistent 12 mm asymmetry in the outer posterior right breast
seen only on the craniocaudal view, without sonographic correlate.
Stereotactic biopsy of the right breast recommended for further
evaluation.
2. No mammographic evidence of malignancy in the left breast.
3. Probably benign finding in the left breast at 3:00, 1 cm from the
nipple as described, likely small bowel, located cyst or intramammary
lymph node. Short interval follow-up ultrasound recommended in 6
months, pending pathology from a stereotactic biopsy.

the radiologist wouldn't give me much info, either positive or negative -- the most she would say is that it is not a cyst. there doesn't seem to be much info out there on asymmetry on one view/only on cc view and does not appear on ultrasound. does anyone have any thoughts or experience with this? i've seen a couple things that might point in the direction of ILC. i know nobody out there knows the definite answer but i can't help but speculate while awaiting results :/

thanks for listening!

***UPDATE 9/3/16:

Just wanted to update: I decided to get a second opinion/find a breast specialist I like to follow me. The new dr felt that because I have such dense tissue and a family history, I should do an MRI. A couple days after the MRI, I received a call from the nurse, saying something was found and they want to do an ultrasound to get a better look. I just had a mammo and ultrasound when this all started in July and this new finding was not in the reports from either of those. I am scheduled for an ultrasound early this week, but in the meantime, does anyone have an opinion on the following MRI report? --

BREAST(S): scattered fibroglandular tissue with mild to moderate parenchymal enhancement on the right and minimal parenchymal enhancement
on the left. Right upper inner quadrant 0.7 cm enhancing round mass with possible internal nonenhancing septation and less likely clumped nonmass
enhancement, located in the mid third depth at the 1:00 axis, approximately 3.0 cm from the nipple. Right upper outer quadrant 10:00 axis posterior depth susceptibility artifact represents the biopsy clip with no associated abnormal enhancement.
No suspicious findings are present in the left breast.

IMPRESSION:
Right breast upper inner quadrant enhancement possibly benign (fibroadenoma vs PASH). Targeted ultrasound is recommended to document benignity.

BI-RADS 0: Incomplete; needs additional imaging evaluation.

The finding(s) and mild to moderate perenchymal enhacement on the right + dense breasts + family history makes me nervous (along with BIRADS 0..??) I am also somewhat skeptical on this latest finding coming up on ultrasound when it wasn't there before (and neither was the PASH).

Comments

  • Moderators
    Moderators Member Posts: 25,912
    edited July 2016

    Gogoamy-

    Welcome to BCO! We're glad you've joined us, and hope you find support and information in these boards as you wait for your results. The waiting is truly one of the hardest parts. We're sure other members will be along to shed some light on the findings you posted above, but we just wanted to let you know that we're thinking of you, and we hope the results are benign and you can breathe a big sigh of relief! Please keep us posted!

    The Mods

  • ElaineTherese
    ElaineTherese Member Posts: 3,328
    edited July 2016

    Hi!

    I don't have any answers to your questions; I don't have ILC and wouldn't know the signs of it. I do want to wish you well and let you know that I'm hoping that your biopsy is benign. Yes, waiting is very, very hard. Keep busy!

  • Lotusconnie
    Lotusconnie Member Posts: 101
    edited July 2016

    I hope I know the answer to your question...

    The good part is that there was no ultrasound correlation (so no mass) and no microcalcifications.

    Hope you get a benign result soon

  • gogoamy
    gogoamy Member Posts: 7
    edited July 2016

    Thanks so much for your replies and support!

    i just got a call from the doctor, it is a Pseudo-angiomatous stromal hyperplasia (PASH), which is a rare benign tumor. This is a big relief, however it seems there's differing opinions on whether or not to have it removed. Dr recs waiting six months to do repeat imaging, but everything I've seen online says to remove it especially if there is a family history of BC. Personally I'd like it gone and will be getting a second opinion on this for sure. If anyone has experience with PASH, please let me know.

  • aj77
    aj77 Member Posts: 3
    edited July 2016

    Hi please help
    I had a mammogram that came back with bi rads 4a rating radiology report says a cluster of microcalcifications within the left upper outer quadrant if they are not able to do a stereo static biopsy, surgical biopsy is recommended, these appear slightly more numerous then the previous mammogram done a year earlier and could not be included in the left cc views secondary to their posterior position, these microcalcifications are punctuate and round, slightly heterogenous in size no linear or branching forms are identified, on the lm magnification view there is a possible small macrobolated asymmetry, overall these calcifications span a region measuring 0.4 x 0.3 x 0.3 cm what are the chances this is cancer mammogram also states these breasts are extremely dense. Also how is are these biopsies done and what to expect I have tiny breasts to begin with. I am 36 no cancer in the family other than I am a smoker I am overall healthy, diagnosed with fybrosystic breasts last year.

  • gogoamy
    gogoamy Member Posts: 7
    edited September 2016

    Just wanted to update: I decided to get a second opinion/find a breast specialist I like to follow me. The new dr felt that because I have such dense tissue and a family history, I should do an MRI. A couple days after the MRI, I received a call from the nurse, saying something was found and they want to do an ultrasound to get a better look. I just had a mammo and ultrasound when this all started in July and this new finding was not in the reports from either of those. I am scheduled for an ultrasound early this week, but in the meantime, does anyone have an opinion on the following MRI report? --

    BREAST(S): scattered fibroglandular tissue with mild to moderate parenchymal enhancement on the right and minimal parenchymal enhancement
    on the left. Right upper inner quadrant 0.7 cm enhancing round mass with possible internal nonenhancing septation and less likely clumped nonmass
    enhancement, located in the mid third depth at the 1:00 axis, approximately 3.0 cm from the nipple. Right upper outer quadrant 10:00 axis posterior depth susceptibility artifact represents the biopsy clip with no associated abnormal enhancement.
    No suspicious findings are present in the left breast.

    IMPRESSION:
    Right breast upper inner quadrant enhancement possibly benign (fibroadenoma vs PASH). Targeted ultrasound is recommended to document benignity.

    BI-RADS 0: Incomplete; needs additional imaging evaluation.

    The finding(s) and mild to moderate perenchymal enhacement on the right + dense breasts + family history makes me nervous (along with BIRADS 0..??) I am also somewhat skeptical on this latest finding coming up on ultrasound when it wasn't there before (and neither was the PASH).

  • MelissaDallas
    MelissaDallas Member Posts: 7,268
    edited September 2016

    Birads 0 just means incomplete, as in they suggest an ultrasound which hasn't been done yet.

    Sounds like from the report that there is nothing of much concern going on, subject to ultrasound confirming the benign appearance of the fibroglandular/PASH area

  • marie5890
    marie5890 Member Posts: 3,594
    edited September 2016

    Amy, I just came across your posts.

    I had PASH. Chose not to do anything about it, though normal protocol was to remove it. It went away on it's own. Sometimes it does that. Sometimes it grows.

    My BS said he was comfortable just leaving it. If it grew and it bothered me, he would remove it.

    I have been happy with my decision to just leave it. Not sure if that helps you at all, but that was my experience.

  • gogoamy
    gogoamy Member Posts: 7
    edited September 2016

    Thanks for your replies! Just to clarify, there was a new finding since the initial post in July. The first finding was PASH, not quite sure on this second one. If it is more PASH, it's in a different area in the same breast -- anyone know if that is common? I'll have the ultrasound on Tuesday and we'll take it from there. Either way, my dr has recommended another MRI in six months. I'm just surprised that I could get a BIRADS 0 from an MRI with contrast -- I thought that was supposed to be the best imaging available.

  • gogoamy
    gogoamy Member Posts: 7
    edited September 2016

    had my ultrasound today and they were not able to find the area that was on the mri. radiologist is sending the report to my dr to see what she thinks. if nothing else, the next step is a repeat mri in six months.

    i wonder why these things aren't biopsied when they aren't certain what it is? i know its impossible to do with ultrasound since they can't find it, but what about an mri guided biopsy?

  • aven
    aven Member Posts: 36
    edited September 2016

    I am reading you, because I am a step behind you. The radiologist found PASH via biopsy in June, and I am due for a follow-up mammo in December.

    In the meantime, I'll read a little bit about MRIs because I really didn't understand a word of your report. Didn't even know that "benignity" was a word :)

    Just to follow along, did they find the PASH in the 3 o'clock position in the left breast in July and now they are trying to figure out what's in the 1 o'clock position? (I don't know what the 1:00 axis is)

  • gogoamy
    gogoamy Member Posts: 7
    edited September 2016

    hi aven, i barely understood the mri report, either! i have had my second look ultrasound, and they were not able to find what was on the mri at the 1:00 position. the plan given to me by my dr is 6 month follow up mri for the right side with the already diagnosed pash at 10:00 and mri finding at 1:00. also at 6 months, i'll have a mammo and ultrasound for the left which had the finding at 3:00 in my initial ultrasound earlier in the summer. in the meantime, they are scheduling me with genetics to review family history and test to see if i have the gene. unfortunately that department is very busy and i won't be able to get in for months :/

Categories