Bi-Rads 0, but findings scream Bi-Rads5, waiting on MRI

I had my 6 month mammogram Monday. Went in expecting some level of drama as my mammograms are never normal (usually end up with some kind of biopsy). Anyway, started the process with a 3D mammogram, and of course radiologist wanted extra views (expected this, not worried yet). Then they wanted to do an ultrasound of an area in my left breast (again, expected this, not worried yet). In the room where the US is done, they have an image from my mammogram up on the screen and I get a look at the area they are investigating. Now I start to worry as it is clearly a spiculated mass. US tech performs US on area of concern, then also does an US of my axillary nodes. This is cause for concern, as they've never done and US of this area in my history of imaging. I just kind of laughed and told the tech good luck finding nodes, they removed 14 of them back in 1999.

After all of this, radiologist still isn't happy (she's very thorough, I trust her explicitly). So she now has given me an order for a breast MRI with specific instructions to schedule it for 10 days after the start of my next menstrual cycle.

Oncologist called with my mammogram report yesterday:

Indication: Multiple prior surgical procedures bilaterally including lumpectomy in 1999 and recent excisional biopsy on the left.

Comparison: 9/5/18, 8/14/18, 7/23/18, 6/15/16

Findings: The study is reviewed by CAD. Tomosynthesis images are obtained in two projections.

There is heterogeneously dense tissue bilaterally, limiting sensitivity. Biopsy marker is present adjacent to several stable calcifications in the upper outer right breast middle depth. Surgical clips and distortion are seen in the left breast posteriorly. There appears to be a new spiculated density in the posterior upper outer left breast. Compared to prior studies however, the patient has undergone interim excisional biopsy which may have been more anterior.

Ultrasound of left breast demonstrates an irregular hypoechoic attenuating lesion at 2:00, 5cm from the nipple, measuring 1x1.1x0.9cm. No definite vascularity is seen within the area. Scanning of the axilla demonstrates 2 deep nodes that do not appear to contain a fatty hilum.

Impression: Spiculated mass upper outer left breast, scarring versus suspicious finding. There are also deep nodes that appear indeterminate. Breast MRI is recommended to further assess. If MRI cannot be obtained, then biopsy of the upper outer quadrant mass in the left breast under ultrasound guidance is recommended.

Result code (0) incomplete: Need additional imaging evaluation

Follow Up (0) needs additional imaging.

Unfortunately, the whole spiculated appearance of the mass (seriously looks like a well defined starfish), and the lack of fatty hilum in the nodes doesn't bode well. There is some hope the mass could be scar tissue (I have had 2 core biopsies and 2 excisional biopsies in that area in the last 3 years), but it does feel like the proverbial other shoe is about to drop.