Birad 4b and worried
Hello. Ok so I'm 41 with family hx of bc in maternal grandmother. My mom hasn't had mammo in over 10 yrs (shame on her) so as of then she was fine. 6 months ago I had my first screening mammo and was called back for dx mammo with us. They had found several simple and complex cysts in rt breast, and one complex cyst in lt breast. I was birad 3. It was recommended I do 6mo f/u with dx mammo on rt and bilateral us. I went today for this f/u and all the cysts are still there. They found a new mass though. All I know right now is that it's solid, speculated, and has + blood flow. I have to have biopsy. I'm so worried. I have read that spiculations and blood flow are highly suggestive of malignancy. Thoughts???
Thank yo
Comments
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Hi Luv-
When is your biopsy? That will clarify what they're seeing. I did a lot of googling after my biopsy and reading my MRI report too, everyone will tell you not to google but it's so hard. I don't have the knowledge to answer your question, but understand completely your worry. Just know this- I'm very cysty (probably not a word lol)....and have had cysts for years and years without any concern. Obviously things changed for me, but I was clear (with cysts) for 15 years.
This sucks, especially all the waiting....hang in there and please let us know how you're doing....hoping and praying you are done with this forum sooner than later!
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ajbclan
Thanks for your response. I'm not worried about the cysts. I have been cysty too (breasts,ovaries)and this doesn't concern me. It's this new solid spiculated mass that is the concern. I don't know yet when my biopsy is. I expect I'll hear from my doc mon to schedule. It's just that I've read 3 medical studies that said if a birad 4 mass is spiculated it goes up to 80% chance of malignancy. Yikes. Well on a positive note I was there 6 months ago and they didn't see the mass on us, so I'm assuming whatever it is I'm catching early. This time I had 3D mammo. So ladies it's worth the extra cost as it found mass that 2d didn't.
Thanks
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What size?
I'm in a similar position. They just found a new BI RADS 4 mass, .5 x .2 x .4 cm, vascular at the periphery and inelastic (both suggestive of malignancy), oval (suggestive of benign), taller than wide (suggestive of malignancy if I'm reading correctly that the 1st # is the largest dimension parallel to the breast surface, the second is parallel to the breast surface and perpendicular to the first dimension vector, and the third is tallness (the depth into the breast)), non-spiculated (suggestive of benign), but partially indistinct border (suggestive of malignancy). The didn't designate a sub-BI RADS class. It's a coin toss - but at the moment I'm leaning toward malignant.
(FWIW, the 3d mammogram they did 6 months ago didn't catch it; the 2d one they did a week ago did, so my suspicion is that it is as much the radiologist as the technology.)
Biopsy on Monday. Back on the merry-go-round far too soon.
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Ok- I went back to my initial reports, and obviously you can tell my outcome. I've been watched for years- going between Mammo/Ultrasound and MRI's- ideally every 6 mos, but this year the routine MRI was delayed a few months. So this was initially caught on an MRI, with a follow up Mammo and Ultrasound. Mammo report showed BIRAD was a 5 (high suspicion of malignancy)- MRI showed: multiple similar lobulated masses. Biopsy was done immediately after the ultrasound. I had a bad feeling just by what the radiologist and technician weren't saying. I know this doesn't help- and I don't want to speculate- I did exactly what you all are doing while waiting for my results. I just hope things work out more positively for the both of you!
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I don't know size yet or other descriptors. I only know what little info I could get the radiologist to reluctantly tell me which is
1. Birad 4b moderately suspicious for malignancy
2. Solid mass
3. Spiculated
4. + blood supply to mass
I should have my final report by Monday with more info. My understanding is even at a birad 4 if the mass is spiculated the likelihood of malignancy jumps to 80%. Ugh.
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oh and also I agree that skill of radiologist reading mammo and us can make a huge difference. Hopefully this was not there 6 months ago and missed.
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I just wanted to say good luck and I will pray for you.
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It may not have been visible 6 months ago - but it was almost certainly there. Most tumors have been growing for a number of years before they are detected. Doctors estimated mine had been there at least 5 years. In most cases, even a 6 month delay doesn't alter the outcome.
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thank you to all you ladies responding. It is nice to have support from others that understand the feelings, emotions, and thoughts one ha when going through this process. It's awesome that all of you that have had the unfortunate outcome of + biopsy and gone through (going through tx) take the time to offer support to those of us that are afraid and don't even know if we need to be yet.
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Well my preliminary report is in.
Mammo findings: focal area of architectural distortion or apparent spiculated mass is persistent in all projections.
US: there is a focal area of distortion which measures 0.58 x 0.51 cm. The irregular mass has posterior acoustical shadowing and increased vascular flow.
Birad 4b moderately suspicious for maliganany us guided core needle biopsy is needed.
Ok so my confusion comes in with the fact that
1. Spiculated = bad
2. Posterior acoustic shadowing = bad
3. Increased vascularity = bad
4. Irregular shape = bad
I don't see anything positive about this. These decriptors seem like a higher birad than 4b. I wonder what he saw that puts me 4b. I wish these doctors would tell you "it looks like this BUT because of this my suspicion is decreased. Hopefully I will hear from my docs tomorrow to schedule biopsy. Waiting is the worst part. I just want to know good or bad so I can get on with life whichever path this takes me down. I feel like once I know for sureI will have more control. If b9 yay and move on or if malignant figure out what has to be done and do it. I know whatever it is it's early stages as it wasn't there 6 months ago.
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At this stage of the game, I watched a lot of Netflix and tried not to think about it. I ordered a book from Mayo Clinic (and I admit, a couple of others, but Mayo's is the best overview). Even after surgery, I waited to do real research until I really knew what I was dealing with.
Waiting is hard. If there is anything you can do for distraction, do it! Also, seeing your doc for some Ativan or other sleep aid can be helpful.
No matter what the answer is, dealing with the realities may be easier than dealing with the speculations.
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If it is any consolation, lots and lots of women who come through here on the "not diagnosed" threads with spiculated masses, posterior shadowing, increased vascularity, etc. still have their biopsies come back as benign fibroadenomas. There is a "typical" appearance on imaging of fibroadenomas, but in reality, lots of them aren't typical in appearance.I hope your biopsy is benign as well.
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luvbab- well I like the last post lol! Let's hope you fall into Melissa's category!! The waiting stinks! We are rooting for you....lots of positive thoughts your way.
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thank you Melissadallas. That actually does help a little bit to hear that. Here's to hoping!
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The statistcs on Bi-rads 4b are intermediate- Anywhere Between 11% and 50% are diagnosed with cancer, so more are not than are
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According to Wikipedia (parenthetical observations mine):
BI-RADS Assessment Categories are:[5]
- 0: Incomplete (anomaly noted, further diagnostic imaging required)
- 1: Negative (no anomaly)
- 2: Benign (anomaly, but obviously benign—followup on usual screening timetable)
- 3: Probably benign (anomaly, probably benign—shorter-interval followup advised)
- 4: Suspicious (anomaly possibly malignant—need biopsy to rule out)
- 5: Highly suggestive of malignancy (anomaly very probably malignant—need biopsy to confirm)
- 6: Known biopsy – proven malignancy (proceed to treatment)
Also from Wikipedia:
Some experts believe that the single BI-RADS 4 classification does not adequately communicate the risk of cancer to doctors and recommend a subclassification scheme:[7]
- 4A: low suspicion for malignancy
- 4B: intermediate suspicion of malignancy
- 4C: moderate concern, but not classic for malignancy
80% of all BIRADS 4 biopsies turn out benign. That's an average over all 3 subclassifications, so 4B is anywhere from 50-89% likely benign. I was in that unlucky 50%—you might think the percentage is even higher given all the posts here—but bear in mind the overwhelming majority of BCO posters don’t even find this site until we’ve been diagnosed, so those whose biopsies came back benign don’t usually post here.
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thank you chisandy.
Well my biopsy is scheduled for Oct 25th. At first when they called me they told me the first available appt wasn't until nov 4th (that's 3 weeks after abnormal mammo & us ... WTH). She told me with breast ca awareness mo they are really busy. Then she told me that the radiologists were reviewing all the reports and making a list of those that need to be bumped up sooner, and I was on the list. I was told they had to enter me in computer under nov 4th to "get the process started" and then they would call me back with the new date. 30 min later she called and said I was bumped up to Oct 25. So I am relieved I don't have to wait so long for answers but also slightly concerned l was "on the list" of needing to be biopsied sooner rather than later. I am a lot calmer yesterday and today and feel relieved that within 2 weeks I will know what's what either way.
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whatever happened luvbabyp
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Jenn, luvbabyp, based on her profile, hasn't logged into the sight since Nov. so you may want to PM her. She should get an email alert that she has a private message waiting.
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Jenni - most women complete treatment and go on with their lives. They do not continue to post on BCO and usually don't want to think about breast cancer. Since she dropped out, she probably does not want to discuss it.
I haven't chosen to get email alerts for private messages - so I would never know if I didn't log on.
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im 4B with ultrasound and mammo yesterday with 2.9 cm palpable mass...So sad and cannot sleep... Always thinking and even dreaming about it...Doctor wants me to do biopsy...Is this a sign of B cancer?
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I’m in the same boat, I have a biopsy scheduled for next week. 2 suspicious masses that did not show up on my mammo 9 months ago. I felt a lump and had it looked at by my doc. Diagnostic mammo and u/s found additional mass. I’m worried sick. I work in the medical field and majority of the details of each mass point at malignancy. Trying not to freak out but man it’s hard! I hope everything turns out ok for you
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