Appreciating all the support. Heres my written results.

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Giraffeattack
Giraffeattack Member Posts: 9
edited November 2019 in Not Diagnosed But Worried

If @djmammo could explain what a couple things mean i would appreciate it.

FINDINGS: physical exam by our clinic nurse sharon identified asymmetrically prominent nodularity in the superior right breast without a dominant mass. This was marked with a triangular marker for imaging correlation.

The bilateral diagnostic mammogram shows extremely dense breast parenchyma with questionable architectural distortion in the inferior subareolar right breast.

Targeted ultrasound of the area of palpable concern identifies an oval parallel orientation circumscribed 8mm mass at the 2:00 position 4cm from the nipple that is compatible with benign fibroadenoma. However, ultrasound of the inferior subareolar right breast shows apparent mild thickening of the periareolar skin with questionable effacement of the tissue planes between the subcutaneous fat and the underlying dense fibroglandular tissue.

The combination of clinical findings of patient reported right spontaneous nipple discharge and asymmetric right breast fullness, and asymmetry with distortion in the inferior subareolar right breast on mammography that shows poor tissue definition on ultrasound is mildly suspicious.

Since there is no clear imaging target for biopsy, i recommend the patient pursue a surgical consult for clinical assessment and determination for any target for surgical biopsy.

I am confused about 2 things, first of all, i had ONE instance of clear nipple discharge, so why does that factor into anything and the second thing is that it sounds like i just have a benign fibroadenoma, so why couldn't they find a target to biopsy? I am rated BIRADS 4.

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  • Beesie
    Beesie Member Posts: 12,240
    edited November 2019

    Giraffeattack, glad to see you back!

    Hopefully djmammo sees your post and responds.

    Until then, my interpretation of your report is that the area of concern for which you are being referred to the breast surgeon is not the fibroadenoma. The fibroadenoma, which is the lump you can feel, is 4cm from the nipple. It has been assessed to be benign. But you also have an area of distortion and thickening that is below the right nipple. This is probably why your comment about spontaneous nipple discharge, even if it only happened once, is being referenced. Same with your comment about right breast fullness.

    So from my reading, the surgical consult is specifically to further assess the area near the right nipple, where the skin is somewhat thickened, where there is asymmetry with distortion in the imaging, and where you've had nipple discharge.

    Given this, I think getting a second opinion, from a breast specialist/surgeon, seems like a good idea.

    As for the BIRADs 4, this just means that a biopsy is recommended. The range of malignancy for BIRADs 4 is from >2% to 95%, with an average probability of malignancy for BIRADs4 of 30%.

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  • Beesie
    Beesie Member Posts: 12,240
    edited November 2019

    Giraffeattack, I'm sorry to see that you've deleted your post. I was hoping that djmammo would see it and would be able to provide some clarity.

    I was concerned that so many of us had responded to your original thread that we might have been "piling on" and scared you away because we seemed to be pressuring you to see the breast specialist. I hope that there was nothing I said in my response here that caused you to delete the information you provided from your imaging report. And I hope you didn't delete the information because of lack of response - I notice that djmammo hasn't signed onto the site for a couple of days.

    I hope you do return and let us know what you've decided to do and how you are doing.

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