Follow up ultrasound with biopsy after MRI/Bi-rads 4

Frenchiegal83
Frenchiegal83 Member Posts: 49
edited May 2018 in Waiting for Test Results

Hi all, I always gravitate back to this site when it's time for my follow up MRIs due to dense breast tissue/nipple discharge. My last MRI results are below. I'm going in for a follow up ultrasound on both breasts Monday and if they can visualize it, they'll set up another date for a biopsy (because waiting long periods of time in between is always a good time ) I'm nervous but encouraged that the shape of the masses are oval, at least everything I've read seems to point to benign, but if I'm psyching myself out & you have had malignant oval shaped tumors, please let me know. One of my concerns was that the location of one of the masses was so deep (NP said posterior?) that she may not be able to get access to it through ultrasound and the placement of it rules out the ability to get it with MRI guided biopsy. I guess I don't understand if you can see it on MRI why you wouldn't be able to get it with MRI or Ultrasound? Is it good news it's deep? Does it matter? The note below is from the NP, the radiologist report hasn't been posted yet. Tried talking to family and friends but they don't get it. The "one second I'm fine, the next second i'm wandering down those Oh f*ck what if it is cancer thoughts" Just thankful to have this site, hope everyone's weekend is going as well as it can be.

History of Present Illness Recent breast MRI done due to over one year h/o pinkish nipple discharge with no real image findings. Dec MRI should probable inframammary lymph nodes with repeat 6 mo MRI recommended. Patient contacted with results and recommendations: IMPRESSION: 1. 1.1 cm oval mass in the left breast at 4:00 posterior depth. Recommend second look ultrasound and biopsy by method of best visualization (although this mass likely will not be amenable to an MR biopsy given its posterior location). 2. BI-RADS 4: Suspicious Abnormality-Biopsy Should Be Considered. ***BREAST BIOPSY RECOMMENDATION*** Patient notification date/time 05/15/2018 at 3:00 PM, 0 business days after exam interpretation. 3. 0.7 cm right breast mass central to the nipple posterior depth. Recommend second look ultrasound. If not visualized, recommend a 6 month breast MRI follow-up. 4. 1.3 cm right breast mass 4:00 middle depth. Recommend a second look ultrasound. If not visualized, recommend a 6 month breast MRI follow-up given that this may be several small adjacent foci. Right and left breast ultrasounds ordered. Patient will be contacted with appointments. States understanding. Assessment/Plan Right and left breast ultrasounds ordered. F/U as indicated

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  • Frenchiegal83
    Frenchiegal83 Member Posts: 49
    edited May 2018

    Anyone have insight on how to decipher all of this? It's a copy of my MRI report, I know that circumscribed margins are good along with the oval shapes but I don't understand what the background parenchymal enhancement or the "motion: mild/moderate" or the "Mixed plaeteau and washout enhancement" means?


    FINDINGS: Background parenchymal enhancement: Moderate-severe and symmetric which could obscure (reduces the MR sensitivity for detection of) a small or noninvasive malignancy. Amount of fibroglandular tissue: Heterogeneous fibroglandular tissue. Motion: Mild/moderate. RIGHT BREAST: There is a 0.4 x 0.7 x 0.5 cm (width, AP, CC) oval shaped mass with circumscribed margins located central to the nipple posterior depth. There is mixed plateau and washout enhancement. There is a 0.7 x 1.3 x 0.7 cm (width, AP, CC) oval shaped mass with circumscribed margins located at 4:00 middle depth. There is predominantly persistent enhancement. LEFT BREAST: There is a 0.8 x 1.1 x 0.9 cm (width, AP, CC) oval shaped mass with circumscribed margins located central to the nipple posterior depth. There is predominantly persistent enhancement. AXILLA: Unremarkable. VISUALIZED CHEST AND UPPER ABDOMEN: Unremarkable. IMPRESSION: 1. 1.1 cm oval mass in the left breast at 4:00 posterior depth. Recommend second look ultrasound and biopsy by method of best visualization (although this mass likely will not be amenable to an MR biopsy given its posterior location). 2. BI-RADS 4: Suspicious Abnormality-Biopsy Should Be Considered. ***BREAST BIOPSY RECOMMENDATION*** Patient notification date/time 05/15/2018 at 3:00 PM, 0 business days after exam interpretation. 3. 0.7 cm right breast mass central to the nipple posterior depth. Recommend second look ultrasound. If not visualized, recommend a 6 month breast MRI follow-up. 4. 1.3 cm right breast mass 4:00 middle depth. Recommend a second look ultrasound. If not visualized, recommend a 6 month breast MRI follow-up given that this may be several small adjacent foci. The patient will be scheduled for biopsy by a mammography NP. The patient's

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  • Frenchiegal83
    Frenchiegal83 Member Posts: 49
    edited May 2018

    Can anyone help me decipher my ultrasound reports? Google is kind of helpful but I'm trying to understand overall what is going on in layman's terms when I'm comparing my MRI to my ultrasound is a little confusing.

    Left side: HISTORY: 34-year-old female presents for second look ultrasound of MRI findings Ancillary medical support personnel/chaperone: Christina Ramos RT(R)(M). FINDINGS: ULTRASOUND: Focused ultrasound of the left breast 4 o'clock 4 cm from the nipple posterior depth demonstrates a 0.7 x 0.4 x 0.5 cm oval shaped hypoechoic mass with Not circumscribed (angular) margins. There is no significant internal vascularity. The mass is oriented parallel the skin and demonstrates no significant posterior features. This mass correlates with the MRI finding. IMPRESSION: 1. 7 mm hypoechoic left breast mass as described above. 2. BI-RADS 4: Suspicious Abnormality-Biopsy Should Be Considered. ***BREAST BIOPSY RECOMMENDATION***

    Right: ULTRASOUND: Lesion number 1: Focused ultrasound of the right breast at 4:00 o'clock 1 cm from the nipple posterior depth demonstrates a 0.8 x 0.3 cm oval shaped hypoechoic mass with circumscribed margins. There is no significant internal vascularity. The mass is oriented parallel the skin and demonstrates no significant posterior features. This mass correlates with MRI finding. Lesion number 2: Focused ultrasound of the right breast at 4:00 o'clock 3 cm from the nipple anterior depth demonstrates a 1.0 x 0.4 x 0.6 cm irregular shaped hypoechoic mass with Not circumscribed (angular) margins. There is peripheral, but no significant internal vascularity. The mass is oriented parallel the skin and demonstrates posterior shadowing. This mass correlates with MRI finding.


    I would really appreciate the feedback. Biopsies are scheduled for 13 June.

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  • JoyceA
    JoyceA Member Posts: 829
    edited May 2018

    When I started my journey after an abnormal mammogram and ultra sound, I had an MRI and was referred to a surgeon. I was told the only way of knowing what kind of mass I had was biopsy results. The waiting is awful. I will tell you that my friend had an abnormal mammogram and ultra sound the same week I did. I was given a bi rads 5 and she got a bi rads 4. We had biopsies a week apart. Her mass was benign. I hope you hear the word benign after your biopsy. Joyce

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  • Frenchiegal83
    Frenchiegal83 Member Posts: 49
    edited May 2018

    Thank you so much Joyce, yes the waiting is the worst :( I appreciate the kind words and encouragement!


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