Worried and Confused by Mammogram Report

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WrigCam9614
WrigCam9614 Member Posts: 8
edited October 2019 in Not Diagnosed But Worried

Hi, I’m new here. I’m 41 and had a diagnostic mammogram and ultrasound sound yesterday. Little bit of background—my maternal grandmother and mom both were diagnosed with breast cancer post menopause (my grandmother at 62, my mom just last year at 80 years old). My mom did genetic screening and was negative. I did it as well and am negative; however I do have 2 VUS’s that say “most likely benign in main database, neither of which are related to BRCA or the other main ones. I have had 3 mammograms to date. First was in 2017 and was normal, 2nd was last year and was ordered as a diagnostic due to my mom’s br cancer diagnosis. I had a biopsy, it was benign, small fibroadenoma. That experience threw me into a tailspin of anxiety this past year even though it was benign results. Which brings me up to date with my recent experience yesterday. Had another diagnostic mammogram. They kept me there for over 2 hours, did more mammogram pictures and ultrasound. The radiologist came in and told me there’s an area of asymmetry that’s probably benign but she wants me to come back for a 6 month diagnostic mammo and also recommended an mri. The report says somdifferent—she called it “a questionable subtle area of architectural distortion that is probably benign” and it’s graded B-Rad 3. What I’m worried about is that the area they are looking at is in another spot on my breast than where they biopsied last year. I’m worried about the description of architectural distortion even though she said it’s probably benign. I’m scheduled for an mri in 2 weeks and am super anxious it will show cancer. Reaching out to anyone who may have additional thoughts on this or a similar experience. Much thanks for reading this long post!

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  • Moderators
    Moderators Member Posts: 25,912
    edited October 2019

    Hi WrigCams, and welcome to Breastcancer.org,

    We're so very sorry you're here and worrying, but we're glad you've found us. Our community is full of helpful members always willing to lend some advice and support. You're sure to get some replies soon, but we wanted to let you know we're thinking of you and sending good thoughts your way. Please keep us posted with what you find out!

    --The Mods

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  • gb2115
    gb2115 Member Posts: 1,894
    edited October 2019

    Hi WrigCams---sorry you had a worrisome mammogram and now have to wait on more testing. I think as far as things go, birad 3 means they think it's ok but want to make sure. It's going to be hard to wait on the MRI, but try to keep yourself busy and distracted until then!!

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  • WrigCam9614
    WrigCam9614 Member Posts: 8
    edited October 2019

    Thank you both for your responses. I’ll post my outcome after the MRI. I’m currently scheduled for it on 11/1, but after yesterday’s experience I’m going to try to get it moved up. I had scheduled it before the mammo b/c my doctor said, let’s just do it. I have heterogeneously dense breasts, and had asked about doing an MRI because of that. Anyway, I’ll try to stay busy and get out of my head. Thank you for the support. I’m posting my mammogram report on here. Here it is

    IMPRESSION

    Question of subtle architectural distortion in the right breast is probably benign. Follow-up in 6 months is recommended with a diagnostic right breast mammogram. Of note, patient is also scheduled for breast MRI in early November.

    The results of this examination were reviewed directly with the patient by a member of the Breast Health Center, and a written summary report was provided to her.

    Due to the finding of heterogeneously or extremely dense breasts, the following text has been sent to the patient as required by California

    Senate Bill 1538:

    Your mammogram shows that your breast tissue is dense. Dense breast tissue is common and is not abnormal. However, dense breast tissue can make it harder to evaluate the results of your mammogram and may also be associated with an increased risk of breast cancer. This information about the results of your mammogram is given to you to raise your awareness and to inform your conversations with your doctor. Together, you can decide which screening options are right for you. A report of your results was sent to your physician.

    BI-RADS Category 3 : Probably Benign

    Narrative

    Bilateral Digital Diagnostic Mammogram with Computer-Aided Detection with Tomosynthesis, Right Breast Ultrasound Limited

    10/18/2019

    FILMS COMPARED

    The present examination has been compared to prior imaging studies performed at Breast Health Center on 10/13/2017 and 10/15/2018, and at St Joseph Hosp on 11/26/2013.

    BILATERAL MAMMOGRAM FINDINGS

    The breasts are heterogeneously dense, which may obscure small masses. There is a question of architectural distortion seen in the MLO and lateral view only in the posterior upper region of the right breast, too subtle for stereotactic guided biopsy.

    The left breast appears unremarkable.

    RIGHT ULTRASOUND FINDINGS

    A targeted ultrasound was performed of the upper right breast at 10-12:00, 4 cm from nipple. No sonographic correlate is identified.

    Component Results

    There is no component information for this result.

    General Information

    Collected:

    10/18/2019

    Resulted:

    10/18/2019

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  • djmammo
    djmammo Member Posts: 2,939
    edited October 2019

    WrigCam9614

    The fact that the mammo finding is seen in only one projection, and that there is no mass seen on US is a good sign. The likelihood of the mammo finding representing cancer is lower in light of these findings. A radial scar on the other hand can have these particular findings.

    The MRI should give you the answers you are looking for, and given the above, waiting a week or so for the MRI shouldn't be a problem. Let us know what it shows.

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  • WrigCam9614
    WrigCam9614 Member Posts: 8
    edited October 2019

    Djmammo,

    Much thanks for your thoughts on all that. I’ll post my results once I get them. The waiting and not really having answers whether findings are normal or not, but are “probably benign,” is worse than knowing definitively one way or the other. I’m so thankful for this forum. Again, thank you to all of you that have taken the time to respond to me

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  • WrigCam9614
    WrigCam9614 Member Posts: 8
    edited October 2019

    Moved my MRI up to today. Below is the report. Really frustrating to still not have answers. Does this seem like it could be something bad? Everyone seems to be hedging. Ultrasound next, I guess along with more biopsies.


    MRI BREAST BILATERAL WWO CONTRAST 10/21/2019 3:45 PM

    CLINICAL INFORMATION: 41 year old woman with a family history of breast cancer, Tyrer-Cuzick score 35%. History of right breast ultrasound guided core biopsy demonstrating fibroadenoma.

    COMPARISON: Diagnostic mammogram dated 10/18/2019.

    TECHNIQUE: Bilateral MRI with and without contrast was performed with a dedicated breast coil. T1 and T2-weighted sequences included: axial T2 weighted with fat saturation and high resolution TI fat suppressed 3D gradient echo precontrast and dynamic postcontrast. Three dimensional maximal intensity projection reformation imaging was also obtained. Gadolinium based contrast (6.9 cc of Gadavist) given by IV without adverse reaction. Computer aided detection analysis was utilized in the interpretation of this study (Sentinelle Aegis system).

    FINDINGS: The breasts demonstrate heterogeneous fibroglandular tissue.

    There is moderate background enhancement, which limits sensitivity of this MRI.

    Right breast:

    Postbiopsy marker clip is seen in the posterior inner right breast (series 4, image 152). This is at the posterior margin of an enhancing T2 hyperintense 11 x 4 x 8 mm mass with persistent type I kinetics, likely representing the previously biopsied fibroadenoma.

    There is nonmass enhancement in the upper inner right breast, middle depth, which measures 8 x 7 x 10 mm (post gadolinium axial image 117, sagittal image 50). This is associated with type I persistent kinetics. It is unclear whether this corresponds to the area of questioned architectural distortion on prior mammogram.

    Left breast:

    Scattered cysts measure up to 8 mm in the central left breast.

    A 5 x 4 x 5 mm focus of enhancement is seen in the upper, central to slightly outer left breast at 12:00-1:00, posterior depth (series 501, image 106; series 505, image 115) which is associated with T2 hyperintensity (series 3, image 18) and type I persistent kinetics.

    Other:

    There is no axillary or internal mammary lymphadenopathy.

    IMPRESSION:

    1. Right breast: BI-RADS 4A: Low suspicion. Recommend second look ultrasound of nonmass enhancement in the upper inner right breast, to be followed by MRI guided core biopsy if no sonographic correlate is identified.

    2. Left breast: BI-RADS 3: Probably benign. Recommend second look ultrasound of a 5 mm enhancing focus in the upper, central to slightly outer left breast, to be followed by MRI in 6 months if no sonographic correlate is identified.

    Additional imaging, including targeted ultrasound, is recommended. Patient will be notified by the BHC staff to schedule additional imaging.


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  • djmammo
    djmammo Member Posts: 2,939
    edited October 2019

    WrigCam9614

    The news is good as regards any findings to suggest hard evidence of an invasive ductal carcinoma.

    Non-mass enhancement can be totally benign, DCIS or anything in between.

    They mention the previously biopsied benign fibroadenoma.

    Nodules less than 5mm are usually ignored if there are enough of them around as normal breast tissue looks like this. Those above 5mm if solitary with abnormal kinetics are usually investigated. At 5mm it depends on what else is going on and since you are having an US for the one finding, might as well look for this too.

    US after an MRI ("second look US") is routine since you want to know if its a significant finding plus if you can biopsy under US it goes much faster than an MRI bx since there is very little set-up in comparison.


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  • Alegna_Natuj
    Alegna_Natuj Member Posts: 14
    edited October 2019

    Hello DjMammo! How are you today? I just want to know what does “There is no discrete fatty vascular hilum” means? is that good or bad Apparently I have 2.7cm irregular , indistinct margins located at my right breast.

    BIRADS 5 - Highly suspicious

    What are the odds me having breast ca? No history otherwise healthy 54 y.o woman menopausal

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  • Alegna_Natuj
    Alegna_Natuj Member Posts: 14
    edited October 2019

    Hello DjMammo! How are you today? I just want to know what does "There is no discrete fatty vascular hilum" means? is that good or bad Apparently I have 2.7cm irregular , indistinct margins located at my right breast.

    BIRADS 5 - Highly suspicious

    What are the odds me having breast ca? No history otherwise healthy 54 y.o woman menopausal

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  • djmammo
    djmammo Member Posts: 2,939
    edited October 2019

    Alegna_Natuj

    See reply to PM

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  • WrigCam9614
    WrigCam9614 Member Posts: 8
    edited October 2019

    Thanks, Djmammo. I have the 2nd opinion bilateral diagnostic ultrasound scheduled for tomorrow morning. Since it's diagnostic, will the just go ahead and do a biopsy if they see something, or will I most likely have to schedule that? Do you have any gut feeling on what it is that they could be seeing? Breast cancer does run in my family, my maternal grandmother and my mom, but both were diagnosed later--my grandmother at 62, my mom last year at 80. My mom and I have both done genetic testing, which is negative, although I do have 2 VUS's, neither of which are for the main genes like BRCA 1 or 2 or any of the other main ones. One of my friends forwarded my results to a genetic counselor that specializes in cancer and she said my 2 vus's are listed in the main database as benign. I guess in the end, it's all just a roll of the dice for everyone. I'm just waiting on information and am anxious. One more question--will this most likely be my normal going forward; i.e., getting checked every 6 months from now on? Or eventually back to yearly? Thanks for your input.

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  • WrigCam9614
    WrigCam9614 Member Posts: 8
    edited October 2019

    Had the diagnostic bilateral ultrasound this morning and nothing was found. So now I have to go back to MRI for MRI guided core biopsy. The radiologist I spoke with this morning says she's unconcerned, but thinks it's wise to have it done. She told me the spot she had been concerned about on the mammogram images were not at all a point of concern on the MRI images, which makes her feel better. I am still very nervous and just want to get it all over with. Scheduling for the MRI biopsy is proving to be time consuming. Will keep updating here as I get results.

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  • emilynn
    emilynn Member Posts: 28
    edited October 2019

    I hope that they can see you soon and that the biopsy goes well.

    I am 38 and my mother had breast cancer at 62 years of age. She was stage 1 when they found it and underwent surgery, radiation, and has been cancer free for a few years now. I was told with the family history to go ahead and get a baseline mammogram...just in case to have a point of reference for later. Turns out it wasn't so simple.

    I have had two mammograms, and ultrasound, a stereotactic biopsy, surgery to remove a radial scar, and I thought we were good to go from there. I just had a six month checkup MRI because I am now classified as high risk. They just called today to say I have to have another ultrasound for another area of concern. All that to say...I do understand the worry that goes with waiting and not really fully understanding what is going on, what is "normal", etc. I am still waiting on the write up from the MRI to see exactly what it said. All I know so far is that it is a different area, not related to scar tissue from my surgery.

    I am also not sure what I should be asking.


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  • WrigCam9614
    WrigCam9614 Member Posts: 8
    edited October 2019

    Hi emilynn,

    Ugh I'm so sorry you're having to play the waiting game, too. I wish you nothing but normal results and all the best. This stuff is really stressful, but it's good to get checked out. Regardless of the outcome for both of us, we will be ok, right?! And also, if there is anything not good, hopefully they've caught it really early and it will be ok in the end. If you can, keep me posted on your results. I'll post again on here once I know something. I called today to get the MRI biopsy out of the way and they can't get me in until November 12th! The woman I spoke with said she will call me if anything opens or if there's a cancellation. I told her I'd probably call them every day to check myself and she said to go for it. Not to be annoying, but I just want to have this behind me and know something for certain.

    Take care of yourself and keep me posted. This forum has been so wonderful with responses and opinions. When you get your report, think about posting it here and someone will get back to you. Djmammo has been really great with information and his thoughts on mine.

    I will be praying for the best for you. :)

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  • arizonaboundgal
    arizonaboundgal Member Posts: 88
    edited October 2019

    WrigCam and Emilynn. Thinking of you ladies tonight and wishing for only the best news! The wait absolutely SUCKS!!

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  • WrigCam9614
    WrigCam9614 Member Posts: 8
    edited October 2019

    Arizonaboundgal, thank you. I'll keep updating as I get results. I'm trying to get my biopsy moved up sooner. Right now I have to wait until November 12th.

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  • emilynn
    emilynn Member Posts: 28
    edited October 2019

    Thanks so much WrigCam and arizonaboundgal!

    WrigCam...I hope that they can fit you in sooner if possible. I feel like calling everyday to see when my MRI report is going to be available for me to see...so I understand wanting to keep calling!

    My follow up with my doctor is November 13th...and my ultrasound is Oct. 28th. I don't know if she will call sooner with results or if I wait to the 13th.

    When I had the MRI they said that as soon as they said one thing (that the doctor would call or not before the follow up) that the opposite would happen. I will post with results and such when I find something out. If my MRI results ever show up on my digital health record I think I might feel better. They read me a little bit and I wrote down fibroglandular tissue, axillary nodes, two masses in RT side (8-9mm and 5mm) and Left upper a mass 5mm. No other masses were noted on my mammogram in April so I am really confused on what all this is showing up on the MRI and what it all means.

    I need to just chill...but easier said than done.

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