BIRADS “0” After Diagnostic Mammograms

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KARW41
KARW41 Member Posts: 98
edited November 2019 in Not Diagnosed But Worried

I don’t have health insurance other than at the VA right now. Before I lost the insurance, I had a screening mammogram done. It came back unclear as it nearly always does with these dense breasts. This time, though, I went to the VA for a diagnostic mammogram. They did many views and couldn’t make up their minds. The radiologist said he had to give me a BIRADS zero based on not being able to tell what was what. Basically, parts of the microcalcifications “piqued his interest.” Since my Mom- still alive age 78- had breast cancer three times, an initial case, a recurrence, and a third time separately, I’ve been getting mammograms since age 39, and now am 50, about the age my Mom was when she first got breast cancer. The radiologist says I need to get more past mammograms for him to review than just the ones I provided. The first private provider won’t release to me the past ones from across the country I provided to them before the screening mammogram, so I am starting over, trying to get past mammograms from across the country in Virginia (moved to California). He said after that, I can either get a mammogram assisted biopsy or wait 6 months and re-image. Last year, same breast, they saw enlarged lymph nodes and couldn’t find anything on ultrasound other than that, and I got a second opinion and that breast care center said get a 360 degree ultrasound. I did one and that shows nothing per the private provider. I paid them $190 for that to follow up from what the second opinion told me last year. I am trying to find another job with insurance and am just checking to see if anyone has ever heard of a radiologist not being able to tell if something is not benign through multiple views of diagnostic mammograms. He said no masses show up (matches what 360-degree automated ultrasound just said two months ago).

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

    "am just checking to see if anyone has ever heard of a radiologist not being able to tell if something is not benign through multiple views of diagnostic mammograms."

    Yes, that's not uncommon at all, particularly for those who have dense breasts. This is why follow-ups often include not just a diagnostic mammo but also an ultrasound, and it still remains unclear, either an MRI and/or a biopsy. In fact most breast biopsies are not done because the Radiologist suspects cancer, but rather are done because the Radiologist cannot rule out cancer. The imaging doesn't scream "breast cancer" but the possibility is there, and that's why the biopsy is done. This is why most breast biopsies - about 70% - end up being benign.

    Microcalcifications as a rule don't show up on ultrasounds. That's the bad news. The good news is that microcalcifications, if they do represent the presence of a breast cancer, usually mean either DCIS (a pre-invasive condition) or early stage breast cancer.

    Are your lymph nodes still enlarged or has that issue resolved? If they are still enlarged, personally I would opt for the biopsy now. If they are not, then the 6 month recheck is a probably a reasonable option.

  • KARW41
    KARW41 Member Posts: 98
    edited November 2019

    Thank you very much. That helps a lot. This is the VA so they won’t do an MRI- they would just do the stereotactic biopsy, I believe.

    Yes, the ultrasound didn’t show anything with the micro calcifications.


    I just Googled DCIS and what you wrote helps on that too.

    I also have had or always will have late stage Lyme disease so the lymph nodes could have been from that, although it was just on the right side.

    No one told me they were enlarged this yearbut the screening ultrasound didn’t seem to go to that area.

    Given what my Mom went through, I would definitely do a biopsy if it is recommended.

    I already had two biopsies for fibroadenomas, in the other breast. Thank you so much for responding and helping me out.

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

    I'm glad that I could help.

    I hope you are successful at getting your past imaging. Please let us know how it goes and whether you decide on the biopsy or the 6 month follow-up. Good luck either way!

  • KARW41
    KARW41 Member Posts: 98
    edited November 2019

    THANK YOU so much!! I am just so grateful you responded!!!! :)

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