Spiculated density on 3D mammogram

My mother had a 3D mammogram that showed a 1cm spiculated density at the 3 to 4:00 position of theleft breast. Heterogeneously dense breasts which may obscure small masses. No other abnormalities were noted. First, the radiology dept. didn't give her doctor the results, and the radiology dept. was calling a phone number my mom never had, and she ended up seeing her results herself on the patient portal, she called her doctor's office herself. So yesterday 9 days after her mammogram the doctors office scheduled her for a mammogram and US tomorrow. Also the Bi-RADS score given for the mammogram was a 0. I'm confused why the Bi-RADS score of zero, isn't a spiculated mass usually a 4 or 5? Also given that spiculation is a concern for malignancy, why not biopsy? She also said she was told before she has dense breasts, which I know can be a higher risk for breast cancer, yet she has been on HRT (which they told her to remove the patch), I’m concerned why they would have had her on that if she already had dense breasts. I’m just concerned that everything is being done the appropriate way, and since they already didn’t handle things the best and caused a delay...it doesn’t give me the most confidence. I’m just concerned if those masses are usually biopsied why aren’t they doing it, or at least the same day after the tests. Is this common? Instead of wait for days after these tests, schedule a biopsy, and then wait for that. I know not every finding needs biopsied, but from what I’ve heard spiculated ones seem to? I’m just really worried, I already lost my Dad 12 years ago.

Steelers43

There are a number of things that have to transpire from the time the lump is found to the time it is removed (if it comes to that) and they need to be done in a particular sequence, one that is used for every patient that is found to have an abnormality, every day, month after month etc. Nothing is removed as soon as it is found. And in any case, 9 days is not a significant a delay.

The situation you are describing is routine. Same day biopsies are rare except in very large breast centers. Most breast centers are very busy with many other patients needing imaging and biopsy already scheduled from the week before. A breast biopsy is not considered an emergency and is scheduled separately from the imaging studies in the next available biopsy slot.

Birads 0 or B0, means we need specialized images to confirm what the first mammogram showed followed by an ultrasound. Many times the finding is spurious and related to positioning or compression on the original mammogram (B1). Other times the finding is real and benign requiring no further action (B2). Only after the diagnostic work up is B4 or 5 assigned but only if they think its a cancer and recommend a biopsy. We are not allowed to use a B4or B5 on a screening mammogram report.