Mammogram and Ultrasound results

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Sam183
Sam183 Member Posts: 60

so I have read my report from my mammogram and ultrasound, and I’m a bit confused.

Says “Impression: Suspicious of Malignancy-follow up recommended” What exactly does “Color flow imaging demonstrates that there is increased vascularity” mean?

Also at the bottom it says: Bi-RADS 4/5 biopsy Code: Mammogram Bi-RADS 0 indeterminate what does this mean also? Any ideas would be appreciated thank you

Biopsy scheduled for the 21st.

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Comments

  • Andie1209
    Andie1209 Member Posts: 17
    edited May 2019

    Bi-Rads 0 means more imaging is needed before they can determine what your actual score is. Assuming you had your mammo, they rated it a 0 because they saw something that needed to be looked at via ultrasound and/or diagnostic mammo. You then had the follow up ultrasound and/diagnostic mammo, and they gave you a __? Assuming it's a 4 or 5...I've never seen 4/5. In order to do a biopsy, your score must be at least a 4 (sometimes they do 4a, 4b, and 4c). 80% of 4’s come back benign. A score of 5 means HIGHLY suspicious of cancer

  • Sam183
    Sam183 Member Posts: 60
    edited May 2019

    Thank you.

    I have looked and looked because I know about the subcategories for Birads 4, but it just has Birads 4/5 for the Ultrasound. And of course it says the color flow imaging de

  • L8Blmr
    L8Blmr Member Posts: 133
    edited May 2019

    Sam183, sorry you didn't get a reply. Check out "Interpreting Your Report" thread. It was started by djmammo, a Board Certified Diagnostic Radiologist. Post your results and questions, he is pretty good at responding. Wishing you the best.

  • Sam183
    Sam183 Member Posts: 60
    edited May 2019
  • Alicethecat2
    Alicethecat2 Member Posts: 105
    edited May 2019

    Hello Sam

    I'm sorry that you have not had too many replies to your posts. It's quite probable that they haven't been seen by that many people. This is a huge board...

    The other thing is that unless we say we are - and it is apparent by the quality and the evidence of the reply - most of us aren't doctors or radiologists. We just try and do the best we can as patients, former patients or people who've discovered lumps and bumps and found them to be benign so we really can't give advice on clinical matters. We are just not qualified to do that.

    However, we can share our experiences and what has worked for us. There's also a thread for people who post links about research papers. I found that very useful as a tool for discussion with my oncologist.

    But what we can do is hold your hand while you wait and see what your baseline is.

    I hope things go well for you.

    Alice



  • Sam183
    Sam183 Member Posts: 60
    edited May 2019

    thank you

    I’m just trying to understand everything as of right now. I know I won’t get definite answers until after my biopsy, and the results come in

  • Michelle_in_cornland
    Michelle_in_cornland Member Posts: 1,689
    edited May 2019

    Birads 4/5 means that you should try to get your house in order. Prepare food to freeze, get caught up on chores, etc. If it does come back positive for breast cancer, a surgery consult will be scheduled and things happen very quickly from there on out. I did not have that luxury....went in for annual mammogram on a Monday//ultrasound Tuesday...with birads 4 determination....biopsy Wednesday and call back on biopsy on the following Monday. Surgery was two weeks later. I went into full panic mode and did not accomplish anything for at least 1.5 weeks. It would have been a great time to get some heavy duty walking in and build up my endurance. If it comes back as nothing, then you are ahead of the game.

  • Sam183
    Sam183 Member Posts: 60
    edited May 2019

    Thank you for response Michelle, my mass is only 1 CM directly under my nipple, with increased vascularity. 2 days AFTER my ultrasound and Mammogram, I noticed an indention (looks like a dimple) on the lower inside part of the same breast. The indention (dimple) isn't even close to where the mass is (which is directly under my nipple)Very light and only visible when my arms are raised (even then it's still light) and also visible when I hold my breast up (like hold it up with 1 hand from the bottom)

  • Toyamjj
    Toyamjj Member Posts: 151
    edited May 2019

    I agree with Michelle, in between getting my birads score and actual dx it gave me time to wrap my head around the fact that it was most likely cancer. I even reached out to one of the top BS in the Boston area and immediately made an appointment and while on the phone the assistant making the Appt told me that she fills up fast and that I was doing the right thing by being proactive.

    Sending good energy and positive vibes your way!

  • Sam183
    Sam183 Member Posts: 60
    edited May 2019

    Thank you. I live in Houston and I'm going to The Rose Clinic and my Doctor is one of the co-founders of the Clinic. She’s amazing so far. Very reassuring, I’m still hoping everything comes back fine, it’s just if she honestly thought it was something like a papilloma, she wouldn’t put “suspicious of malignancy” and The color flow imaging shows increased vascularity and I don’t think think i would get a BIRADS score of 4/5

  • Michelle_in_cornland
    Michelle_in_cornland Member Posts: 1,689
    edited May 2019

    Sam, it is great to hope, but better to ground yourself in reality. Increased blood flow and a birads of 4/5 means that the radiologist saw something like a spiculated mass. No one that has been through breast cancer surgery/treatment/anti hormonal therapy, is going to sugar coat this for you. Go in with your eyes wide open and take someone with you that can take notes. Use this time wisely, because how you prepare yourself physically and mentally, can help determine surgery outcomes. Assuming that you will be diagnosed with breast cancer, increasing your stamina will help your recovery. Also, mentally focusing on how you will recover and having an idea of who can help you, can be very valuable. With 1 in 8 women (which I think is more like 1 in 5 women) getting breast cancer, we have between a 12 and 20 percent chance of getting diagnosed. Another tip that I have is to start increasing the amount of protein in your diet. Protein will help you heal faster, if and when you need surgery. If you smoke, stop...if you drink..stop. Both increase your chances of having breast cancer. Your lungs will have to be clear and meet a certain standard to have surgery.

  • AliceBastable
    AliceBastable Member Posts: 3,461
    edited May 2019

    Don't forget to have some fun while you wait this out. It never occurred to me to "prepare" as such. But I did make time for lots of outings with my family last year between appointments, tests, and surgeries. It was nice to have those days to think about during some of the gloomier days.

  • Sam183
    Sam183 Member Posts: 60
    edited May 2019

    thank you

    Yes I am trying to prepare myself mentally and physically. Still try to stay positive. But with my family history it can be a bit difficult. My grandmother has breast cancer twice (passed away the second time she got it) and my aunt and sister have had a benign breast mass removed. But thank goodness summer is coming up. So I’ll be planning a lot of stuff to do with my kiddos to keep my mind busy.

    Would the indention (dimple) be caused by the mammogram I had? It’s not anywhere near my mass, and it’s very light. Can only see it when arms are raised and if I hold my Breast up with my hand.

  • Michelle_in_cornland
    Michelle_in_cornland Member Posts: 1,689
    edited May 2019

    Sam, the answer will come soon enough. Mammograms usually do not produce breast damage/dimpling. There are times when a developing mass can put pressure on an area and tug at another. Are you home full time or do you work outside of the home? Keeping breast cancer in perspective .....it is a condition that can be treated....helps to calm the mind. Start educating yourself on lumpectomy vs. mastectomy. If you need a plastic surgeon, look for an oncoplastic surgeon. They can cut around the nipple to remove any mass, and stitch it back up. I have no visible scar from my surgery.

  • Sam183
    Sam183 Member Posts: 60
    edited May 2019

    I have been reading a lot on those. Which if it is cancer, im leaning towards a maste

  • Michelle_in_cornland
    Michelle_in_cornland Member Posts: 1,689
    edited May 2019

    Sam, many have a first reaction to cut off their breasts. I know that was my reaction. But, then I learned more about oncoplastic surgery and lumpectomy. Even cutting off your breasts does not guarantee you won't get breast cancer. My friend is now having her implants removed, due to encapsulation and is going flat. She wishes that she had done a lumpectomy, as she had dcis. No matter how hard we try to minimize our scary possibilities, the bottom line is that we can only do so much. Hope for the best and prepare for the worst. Breast cancer is scary as hell, and it does not have to be. If you become overly frightened or have panic attacks, see a therapist. I worked with one for the 1.5 weeks that I was in shock, and it was a great benefit. When you are facing down your greatest fear, it is best to do it with guidance.

  • Sam183
    Sam183 Member Posts: 60
    edited May 2019

    I understand. I would ask mY doctor what my best option is and her suggestion if/when the time comes

  • Rah2464
    Rah2464 Member Posts: 1,647
    edited May 2019

    Michelle in cornland wouldn't it be wonderful if as part of the treatment process you were automatically assigned to a therapist? Ah a girl can dream. Glad you did that for yourself. My sister happens to be a mental health therapist so I was on the phone with her a lot. Made me think about the ladies who do not have access to a resource like that.

  • edwards750
    edwards750 Member Posts: 3,761
    edited May 2019

    I totally agree about having a therapist on call. I did have s nurse navigator and she was great. Doctors know and can treat the physical impact of a BC DX but the mental/emotional aspect is another matter entirely. I luckily had a friend who was a RN at St. Jude and had had BC. She was a godsend. I peppered her with questions.

    I went through the process in a fog though. I didn’t break down until my BS called with the Oncotype results which were good. It allowed me to dodge chemo.

    I was prepared for the worst because I had never been called back in the office to have another mammogram because one breast was bigger than the other. I just knew then.

    We are all here so there are plenty of reasons to be optimistic. It’s no longer the death sentence and I’m 8 years out in August God willing.

    Keep the faith and keep us posted.

    Diane

  • Schweety
    Schweety Member Posts: 58
    edited May 2019

    I had dcis in May of 2000 lumpectomy with rads, July of 2018 idc, lumpectomy but hormone blocker side effects made me stop within 2 months. Monday had a mamo with follow up diagnostic mamo and then ultra sound. Doc said 1 cm area of concern he would suggest biopsy. What the hell????? This area in no where near the other 2, it is down under the nipple almost behind the nipple. Isn't this a rare spot for cancer to show it's ugly head?? and so soon after the other cancer? 

  • Sam183
    Sam183 Member Posts: 60
    edited May 2019

    schweety, that’s what I have. 1 cm directly under the nipple. But o also now have a breast indention (dimple) that’s no where near my mass. Biopsy scheduled for Tuesday the 21s

  • Schweety
    Schweety Member Posts: 58
    edited May 2019

    Sam81 I was reading up on Pagets and the article said that with Pagets it is not uncommon that there is more cancer in the breast. I don't know if what you or I have is that. The radiologist did not mention that at all and I thought quite frankly that he was a bit vague.... the word concerning to me is a step down from suspicious so I am considering just not having the biopsy. 80% of biopsies are benign and my Oncodx was 1 with clear margins...grade 2 stage 1A on the last cancer a year ago....seems like overkill excuse the phrase plus I am 69 years old Monday, with other health issues....diabetes, RA to name a few. 

    When is your biopsy?   

  • Sam183
    Sam183 Member Posts: 60
    edited May 2019

    My Biopsy is onTuesday the 21st. My mammogram Bi-RADS WAS 0 indeterminate but my ultrasound Bi-rads was 4/5 (I don’t understand the difference between the mammogram and ultrasound Birads. Why they are 2) and I don’t understand why my ultrasound Birads is a 4/5 I honestly thought you could only get 1 Birads score. Would they be able to see Paget’s on a mammogram and/or Ultrasound?

  • Sam183
    Sam183 Member Posts: 60
    edited May 2019

    also with paget’s comes itching, oozing, flaking skin... etc I don’t have any of that

  • Michelle_in_cornland
    Michelle_in_cornland Member Posts: 1,689
    edited May 2019

    A therapist can help keep you focused and not drift off on tangents. Ultrasound can see objects that mammograms cannot. If there is hormone positive cancer, taking medication is very important. The chance that anyone has a rare form of Breast cancer is unlikely. Sam, you will find out what u have soon enough

  • Sam183
    Sam183 Member Posts: 60
    edited May 2019

    I know. Been helping my friend paint her house yesterday and today. Really helped get my mind off this for a little while. Now I’m starting to get nervous for the Biopsy. I’ve heard it hurts and then I hear it doesn’t.

  • Michelle_in_cornland
    Michelle_in_cornland Member Posts: 1,689
    edited May 2019

    Sam,

    What state are you in? I am in Illinois!!! Breast cancer is very common and is caught early. One reason that the ultrasound finds echos in the breast, is because the tumor grows from top to bottom, not sideways. So, it is taller than wide. That is how mine appeared. The good news is that oncoplastic surgery can create an incision on the areola and no one will know the difference. It is really important to find an oncoplastic surgeon, which is a highly specialized area. Biopsies do not hurt, it is nerve wrecking....yes wrecking....

  • Sam183
    Sam183 Member Posts: 60
    edited May 2019

    I live in Texas. I have noticed today that my right under arm is a Little swollen/puffy. I noticed it this morning, and it's still Like that. I blew it off this morning because I just assumed it might've been because I was painting yesterday, but that would not affect my under arm I would think. I would post a picture but I don't think I'm allowed to. And it is my right breast that has the 1 cm mass directly under/in my nipple

  • Michelle_in_cornland
    Michelle_in_cornland Member Posts: 1,689
    edited May 2019

    Sam, you are going to feel alot of "things" over the next few weeks. You need to stop looking at yourself, until after the biopsy and results. Our imaginations and fears can get the best of us during this time. Have you had medical anxieties in the past? How did you deal with them? I can't imagine being in Texas in the heat. Here in Illinois it was in the high 80s. Can you work on some meal prep // crock pot meals to freeze, just in case? Maybe a trip to the store to stock up on foods that are easy to fix? My world stopped when I was diagnosed and I literally froze mentally, emotionally and physically. I could not do anything. Looking back, if I could give myself advice, it would be as follows: 1. breast cancer is common 2. you will get through this 3. take care of what you can now, because later you won't be able to, for a few weeks 4. Keep a diary/journal on goals, accomplishments, appts. (I did that and it was an amazing body of work when I was finished.) Was I scared in the beginning.....very scared. Am I scared now, no I am not. You may learn things that you never thought of before, you may meet new people and new friends because of this situation. Don't be scared, because you are going to be okay.

  • Schweety
    Schweety Member Posts: 58
    edited May 2019

    I never even heard of bi rads.  Good luck on Tuesday. This just really sucks!

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