So confused and worried after Birads 5

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latinmrs
latinmrs Member Posts: 14
edited April 2018 in Not Diagnosed But Worried

I had annual mammogram (3D), which showed architectural distortion. This mammo was read by Dr. A. who recommended an ultrasound. Had ultrasound, which was read by Dr. B who recommended US guided biopsy. Report was as follow:

There is a 1.4 cm x 1.2 cm x 1.1 cm irregular mass in the left breast at 3 o'clock posterior depth 6 cm from the nipple.This irregular mass is hypoechoic.There are related calcifications.There also is a benign 6 mm oval simple cyst in the left breast at 3 o'clock posterior depth 6 cm from the nipple.This oval simple cyst is anechoic.No abnormalities were seen sonographically in the left axilla.

IMPRESSION: HIGHLY SUGGESTIVE OF MALIGNANCY - FOLLOW-UP RECOMMENDED The 1.4 cm x 1.2 cm x 1.1 cm irregular mass in the left breast at 3 o'clock posterior depth is highly suggestive of malignancy.An ultrasound guided biopsy is recommended.The 6 mm oval simple cyst in the left breast at 3 o'clock posterior depth is benign.

Ultrasound BI-RADS: 5 Highly suggestive of malignancy

My pcp referred me to a breast surgeon who had Dr. C review ALL of my images and he confirmed biopsy required. Dr. D was to perform biopsy, but neither the tech nor the Dr. could find the mass on the US. Sent me right over for another 3D mammo on left breast, which showed him the distortion. Tried again and could not find mass, but confirm a biopsy should be performed. Stereotactic biopsy scheduled for Tuesday.

I'm obviously very worried and confused at the same time. I don't know what to think...4 different doctors reading my images, but 1 can't find it on the US? This just makes everything more stressful...is it Birads 5 or not?

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  • bew66
    bew66 Member Posts: 81
    edited October 2017

    latinmrs, I'm so sorry you are going through this. I can't really tell you anything except that I understand how scary and confusing this is for you. I had architectural distortion on mammogram too, which they could not find with ultrasound (which BTW, is good that it doesn't correlate with mammo) and underwent stereotactic biopsy. One thing I have noticed, it seems that despite all the diagnostic imaging that we have, there is still so much variation from individual to individual, that it is quite challenging for the docs to be able to come to an agreement on what they are seeing. I don't know if that makes any sense....I sometimes have a hard time conveying my meaning. In other words, radiology is almost as much art as it is science.

    Good luck on Tuesday. It's an uncomfortable procedure, but mine was not the least bit painful. Waiting is the hardest part. Sending positive vibes to you for b9 results.

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  • Grammy2be
    Grammy2be Member Posts: 89
    edited October 2017

    latinmrs

    I had a similiar situation in that the area they wanted to biospy could not be consistently found on ultrasound, so they did the sterotactic biospy guided by 3D mammo. Like bew66 I only felt some discomfort in my ribs due to sitting and the breast being in the compression. No pain from the biopsy. Hope it is b9!

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  • latinmrs
    latinmrs Member Posts: 14
    edited October 2017

    Thank you both for your responses. It's very frustrating and stressful at the same time. I'm hoping for b9 results also, but can't help worrying.

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  • MamaBee23
    MamaBee23 Member Posts: 31
    edited October 2017

    latinmrs, I also had a bi rads 5 and spent many weeks in a complete puddle of tears and stress. My radiologist and the US tech both cried with us after performing my core needle biopsy because they were so certain it was malignant and felt badly for me. The biopsy results came back benign but discordant. I was referred to a breast surgeon for an excisional biopsy. It was a one month wait for the consult and another month for the surgery. I was a WRECK! The results came back last week and it was BENIGN!

    Take one day at a time. Breathe!!! Know that it is absolutely possible for a bi rads 5 to come back benign..so stay as positive and hopeful as you can. <3

    Hoping that your results are benign too!

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  • latinmrs
    latinmrs Member Posts: 14
    edited October 2017

    MamaBee23 thank you so much for sharing your story! I am very hopeful that all this worry is for nothing. Waiting is always the hardest, especially when you have no patience, lol. I know that no matter what the outcome is, it's all going to be ok as my mass is very small. Although I know I'm not alone, it helps to hear other people share their stories.

    Grammy2be and bew66 how did your results turn out?

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

    latinmrs

    From the description of the mammogram alone, having the biopsy is necessary. Whether by US or stereo is not relevant at this point. Architectural distortion + calcifications are enough for a biopsy even without the US.

    ---------------------------------------------

    That being said, I am personally curious of the details of Dr's A through D and where the US exams were done. The description of the mass on US is very specific. I will guess that was done at a center that does breast often and was read by a radiologist. I am also curious as to why the biopsy was not done by Dr B who did the US that found the mass. That has always been the custom at the locations where I have practiced.

    The other question is who performed the US that did not see the mass? Was that at an imaging center or the surgeon's office? Additional information regarding the experience of the US techs and the quality of the US machines used would be on my next list of questions, again just my curiosity.

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  • latinmrs
    latinmrs Member Posts: 14
    edited October 2017

    djmammo the original mammo and US were done at an diagnostic center and were both read by radiologists (2 different). I don't believe they perform biopsies there. My pcp referred me to a surgeon who really just then sent me to the Breast Center at the hospital for the biopsy. The hospital radiologist is the one who was to perform the biopsy, but couldn't find the mass. He then had me do another 3D mammo to locate it, brought me back into the room and neither the tech nor he could see it. He confirmed to me the mammo did show architectural distortion and calcifications ("that could have only been found on a 3D image"). I have been told that the radiologist who was to do the biopsy is "one of the best" and is Chief of Diagnostic Imaging at the hospital. I don't know what that means exactly, but I guess that he should be good, right?

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

    latinmrs

    Let us know the results of the biopsy when you can. Good luck.

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  • bew66
    bew66 Member Posts: 81
    edited October 2017

    latinmrs, mine came back b9. I was so terrified, waiting for the results. Dr Google was not my friend, and yet I could not stop myself from consulting him!  I'm agnostic, so I won't say I'm sending prayers, as that would be dishonest, but I will be thinking of you and sending all the positive energy I can muster!  Please keep us posted!  We all understand and we care! 

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  • latinmrs
    latinmrs Member Posts: 14
    edited October 2017

    Had the Stereotactic biopsy today. It was more difficult than they expected as they could see it clearly on the mammo, but couldn't locate it as easily on the machine for the biopsy. After quite a while, they found it and got the samples. Checked it on x-ray to confirm calcifications were collected. They're very fine, but they showed me. Now we wait for the results...

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  • Tpralph
    Tpralph Member Posts: 487
    edited October 2017

    Thinking positive thoughts for you and a b9 result!

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  • latinmrs
    latinmrs Member Posts: 14
    edited October 2017

    Results are finally back...Negative!

    FINAL DIAGNOSIS: Benign breast parenchyma with stromal sclerosis, patchy adenosis and microcysts. Scant intraductal microcalcification.

    Surgeon said she will check with the radiologist as to whether they think it's concordant or discordant. If concordant, I do a 6 month follow-up 3D mammo and ultrasound. If discordant, an excision is required. My only question is wouldn't the radiologist see the report and wouldn't they have already made a decision? Seems a little backwards to me, but I'm gonna look at the positive, Negative results.

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

    latinmrs, I'd bet that (with such potentially good news) the surgeon just wants to dot the i's and cross the t's to make sure that they haven't missed anything. If the radiologist believes that the pathology explains the imaging results (i.e. concordance) then that will be the final "blessing" that you are good for 6 more months to follow up. congrats and hoping that the radiologist concurs!

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  • MamaBee23
    MamaBee23 Member Posts: 31
    edited October 2017

    great news!!!! Congratulations! :)

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  • bew66
    bew66 Member Posts: 81
    edited October 2017

    So happy for you!

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

    It is mandatory/routine for the radiologist to dictate an addendum to the biopsy report after receiving the path report to indicate concordance. It is not something out of the ordinary that needs to be requested.

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  • Canuck-Girl
    Canuck-Girl Member Posts: 9
    edited October 2017

    Just saw this...yahoo for you! Are the calcifications the reason they want to do a follow up in 6 months? So very happy for you. Thank you for sharing your story.

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  • latinmrs
    latinmrs Member Posts: 14
    edited October 2017

    Thank you all so much for your kind words and encouragement! Waiting was definitely the worst part of it all.

    Canuck-Girl - The follow up is routine. They'll check to make sure there have been no changes to the lesion.

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  • latinmrs
    latinmrs Member Posts: 14
    edited April 2018

    I had my 6 month follow-up mammo and US yesterday. The doctor wants to do another biopsy of the same area, which is now scheduled for Tuesday. I asked if there has been a change, the doctor said it's not that it has changed, but the calcifications that are bothersome. He preferred to do the biopsy rather than "watch and wait". I m trying not to freak out, but if original results were negative, I'm just not sure why it requires another biopsy.

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