Mammo report

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Grammy2be
Grammy2be Member Posts: 89

evaluation of the right breast demonstrates small focus of subtle hypoechogenicity with shadowing at 12 o'clock location that could not be consistently reproduced with multiplanar imaging. There is a complex cyst at 4 o'clock location of the right breast 4 to 5 cm from the nipple measuring 1.0 x 0.4 x 0.9 cm correlating with the stable well-circumscribed mass seen on the mammogram.


I was told in this report that I need a biopsy. Does this mean they are biopsing the cyst or the area at 12:00? Thank you for any help!

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  • MTwoman
    MTwoman Member Posts: 2,704
    edited September 2017

    Grammy, so sorry that you're here with breast health concerns. I would encourage you to ask your team which area they are going to biopsy and why. Biopsies are routinely ordered for complex cystic masses. If they can't "consistently reproduce" the "small" area, how are they planning on to "see" it for biopsy?

  • Grammy2be
    Grammy2be Member Posts: 89
    edited September 2017

    Thank you MTwoman. My understanding is the area could be seen on 3d mammogram but not ultrasound.

  • Grammy2be
    Grammy2be Member Posts: 89
    edited September 2017

    Can anyone tell me what all this means? I am waiting for a call back from my GP and my GP is also going to speak with the radiologist. Thank you.


    Impression:

    Unchanged, persistent irregular focus of asymmetry in the central right breast seen only on the craniocaudal view as described above. Recommend 3-D mammography guided biopsy to exclude malignancy. The lesion would be best amenable to 3-D mammography guided biopsy as it is seen on the on one view on tomosynthesis and cannot be consistently seen as a lesion on ultrasound.


    evaluation of the right breast demonstrates small focus of subtle hypoechogenicity with shadowing at 12 o'clock location that could not be consistently reproduced with multiplanar imaging. There is a complex cyst at 4 o'clock location of the right breast 4 to 5 cm from the nipple measuring 1.0 x 0.4 x 0.9 cm correlating with the stable well-circumscribed mass seen on the mammogram.



  • djmammo
    djmammo Member Posts: 2,939
    edited September 2017

    Grammy

    The short version is that there is something seen on the right the radiologist is not comfortable letting go since, even thought it is difficult to consistently reproduce, looks abnormal enough the they feel it should be biopsied. They recommend the method of biopsy be 3D mammo as this is better at localizing something only seen on mammo view. I have made this kind of call in the past a few times and it was either nothing or a very very early abnormality.

    Let us know how the biopsy goes and what the result is when you know.

  • Grammy2be
    Grammy2be Member Posts: 89
    edited September 2017

    Thank you djmammo! Will that be a sterotactic biospy?

  • djmammo
    djmammo Member Posts: 2,939
    edited September 2017

    Grammy2be

    Technically yes, but performed on a 3D mammo unit likely sitting up rather than the classic stereo bx where you lie on your stomach.

    Here is some info on the procedure from a private practice's website (with which I have no affiliation): CLICK HERE

  • Grammy2be
    Grammy2be Member Posts: 89
    edited September 2017

    Thank you. Looks like I am going to have to travel a bit, 1.5 hours in bad traffic to have this type of biospy done. I wonder if a wait and check in 6 months follow up as I had been doing would be okay.

  • Grammy2be
    Grammy2be Member Posts: 89
    edited September 2017

    GP called and feels the biospy should be done via the 3D, as the local hospital could not guarantee they could find the right area to biospy. I was able to get an appointment for Sept 18, only 45 minute drive, so much closer. I am still a bit confused as to whether the complex cyst is a corcern at all? I am 56, menopausal and have not had any cysts for a couple of years until this one!

  • mustlovepoodles
    mustlovepoodles Member Posts: 2,825
    edited September 2017

    You need to ask the physician who will be doing the biopsy. 

  • djmammo
    djmammo Member Posts: 2,939
    edited September 2017

    Grammy2be

    Specifically, did the report say "complex cyst" or "complicated cyst"? Some rads who do not read breast imaging all the time use them interchangeably but they are not synonymous. If interpreted correctly a complicated cyst is benign and a complex cyst can go either way as it contains solid elements. You might ask them to clarify this and ask whether or not it needs biopsy as well.

    Click here for a brief discussion of cysts

  • Grammy2be
    Grammy2be Member Posts: 89
    edited September 2017

    This is the whole report:


    EXAM: DIGITAL BILATERAL DIAGNOSTIC MAMMOGRAM WITH CAD WITH TOMOSYNTHESIS AND BREAST ULTRASOUND

    HISTORY: 6 month follow-up for an abnormality in the right breast. Patient denies any palpable lump or any other breast related symptoms.

    TECHNIQUE: Digital diagnostic mammographic images of both breasts are reviewed and analyzed by computer-aided detection. Low-dose full-field Digital Breast Tomosynthesis examination was performed with 2D and 3D acquisitions. Right breast ultrasound was performed with particular attention to the central region of the breast.

    COMPARISON: Mammogram dated 3/1/2017 and mammogram and ultrasound dated 8/29/2016 and 8/31/2016 respectively.

    FINDINGS:
    Mammogram:
    Tissue Density: The breasts are heterogeneously dense, which may obscure small masses.

    The previously mentioned focus of asymmetry seen on the craniocaudal view in the central right breast 4 cm behind the nipple remains stable on 2-D mammography as well as on tomosynthesis. A previously seen ovoid well-circumscribed mass in the middle third of the medial aspect of the right breast also remain stable, it has smooth margins on tomosynthesis. No dominant mass, suspicious groups of macro calcifications or any significant interval changes are seen in the left breast.

    Ultrasound: Ultrasound evaluation of the right breast demonstrates small focus of subtle hypoechogenicity with shadowing at 12 o'clock location that could not be consistently reproduced with multiplanar imaging. There is a complex cyst at 4 o'clock location of the right breast 4 to 5 cm from the nipple measuring 1.0 x 0.4 x 0.9 cm correlating with the stable well-circumscribed mass seen on the mammogram.

    IMPRESSION:
    Unchanged, persistent irregular focus of asymmetry in the central right breast seen only on the craniocaudal view as described above. Recommend 3-D mammography guided biopsy to exclude malignancy. The lesion would be best amenable to 3-D mammography guided biopsy as it is seen on the on one view on tomosynthesis and cannot be consistently seen as a lesion on ultrasound.

    ASSESSMENT: BI-RADS Category 4: Suspicious findings.

  • djmammo
    djmammo Member Posts: 2,939
    edited September 2017

    Grammy

    image

    There is no description of the internal make up of this cyst so I can't comment on whether the correct term was used. It does say "stable" though, and that is the key. It depends on how long it has been stable or unchanged. If it is unchanged from your mammo and US exams from August of 2016 then that might be why they are not planning to biopsy it. Worth inquiring I think.

  • Grammy2be
    Grammy2be Member Posts: 89
    edited September 2017

    Thank you djmammo. I will ask.

  • Grammy2be
    Grammy2be Member Posts: 89
    edited September 2017

    The more I read this the more confused I am on exactly what it is that needs biopsied, no mention of a lump or any description of anything at all!?

  • djmammo
    djmammo Member Posts: 2,939
    edited September 2017

    The target for the biopsy is well described in the Impression of that report. It is not a lump, but an area of tissue that looks suspicious to them. This is something that could become a lump in the future if the biopsy came back abnormal. Let us know how the biopsy goes.


    image

  • Grammy2be
    Grammy2be Member Posts: 89
    edited September 2017

    Oh, ok an area of tissue. Thank you djmammo. Part of the problem is all this waiting until the 18th for the biopsy.

  • Grammy2be
    Grammy2be Member Posts: 89
    edited September 2017

    I had the biopsy today. Radiologist said she expects benign results

  • Grammy2be
    Grammy2be Member Posts: 89
    edited September 2017

    Getting a little impatient for final word. Radiologist was supposed to call me on Thursday, but didn't. I called my primary Dr. on Friday and never got a call back, so hopefully on Monday. I am glad at the time of my biospy the radiologist said she expected benign results, so at least I know it is mostly likely fine.

  • Grammy2be
    Grammy2be Member Posts: 89
    edited September 2017

    Got my results today, benign with schlerosing adenosis. Repeat mammo in 6 months

  • Grammy2be
    Grammy2be Member Posts: 89
    edited September 2017

    Got my results today, benign with schlerosing adenosis. Repeat mammo in 6 months

  • bew66
    bew66 Member Posts: 81
    edited September 2017
  • Grammy2be
    Grammy2be Member Posts: 89
    edited September 2017
  • Snosafred
    Snosafred Member Posts: 33
    edited September 2017

    Great News!!!!!

  • Grammy2be
    Grammy2be Member Posts: 89
    edited September 2017

    Thanks Snosafred.


    Bew66- I hope you get good results today!

  • bew66
    bew66 Member Posts: 81
    edited September 2017

    Thanks Grammy2be, I hope I hear something today.  Waiting is tough.

  • Grammy2be
    Grammy2be Member Posts: 89
    edited September 2017

    Are any of you seeing your family Dr. to coordinate your care for the mammos etc? I was referred to a breast specialist by my Dr. years ago when I was getting repeated call backs for cysts but I never made an appointment. Now that I am getting older (56) maybe I should? I hate to waste the $ though if it is basically the same care. My mom and her mom both had bc but not until they were in their early 60's. I read here that the sclerosing adenosis may slightly increase my risks but in other places they say there is no increase in risk??

  • jbdayton
    jbdayton Member Posts: 700
    edited September 2017

    So happy for the good report.

    I personally would consider being followed by a breast specialist if possible.

    I still do my annual followup mammograms and ultrasounds with my breast specialist who schedules my tests on days that she is working at the imaging center. She reviews the images and comes in and talks to me for immediate results. She is also there to do an immediate biopsy if needed.

  • Grammy2be
    Grammy2be Member Posts: 89
    edited September 2017

    Thank you jbdayton. I hope you are doing well!

  • Snosafred
    Snosafred Member Posts: 33
    edited September 2017

    I was told I have fibrocystic right breast and fibroadenoma in left breast. Need to have ultrasound every 6 months

  • Grammy2be
    Grammy2be Member Posts: 89
    edited September 2017

    snosafred

    I am getting weary of the rechecks. I have been going every 6 months for the past 18 months. I don't understand in my case with the benign results and stability why I even need them. I know better safe than sorry but that is a lot of radiation!

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