US Report and Biopsy

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Hotch
Hotch Member Posts: 2
edited February 2020 in Not Diagnosed But Worried

My partner had her annual mammogram which looked good. Due to her dense breast and family history with breast cancer (older sister), the doctor ordered an ultrasound (US). We live in a major city and both the US and biopsy were done at the same imaging center.

US report findings noted three cysts in one breast; two with 'inspissated debris' and one with 'debris' (size and location provided for each). In the other, two cysts with 'debris' (size and location provided for each) and also an "hypoechoic irregular bordered oval mass, .5x.5x.5cm', (location provided). 'Suspicious. Recommend biopsy. No adenopathy demonstrated.'

Noted under 'Impression: 'Suspicious .5cm mass in left breast (location provided). Recommend US guided biopsy with clip placement.'

Noted under 'Assessment: BI-RADS Category 4: Suspicious'.

Her GP reviewed the US report and agreed with continuing with the biopsy.

Core biopsy on the mass completed yesterday and everything went well. Awaiting pathology report (2-3 business days). Two doctors performed the procedure. One doing the ultrasound and one guiding the needle.Three samples were taken. Note on report states; 'A sonographically visualized residual lesion present post core biopsy was smaller than prebiopsy'. Radiologist, think it was the radiologist, said that was usually a good sign. Right after the US, a mammogram was done to make sure the clip is in the right place.

I'd appreciate if someone could provide an overall interpretation of the report and procedure.

Also looking for clarification on what ' Inspissated debris' is and it's relevance, if any. My understanding is that it's a thick, pulpy debris.

In the original US report, why wasn't a sub-category (A/B/C) noted? Is it not typical to be part of the report? Report seems a little brief in information and details to others I've seen here and other sites. Maybe fine at this stage?

Thanks in Advance

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  • MinusTwo
    MinusTwo Member Posts: 16,634
    edited February 2020

    If you'll post the report on the thread listed below, perhaps djmammo can provide some clarification.

    https://community.breastcancer.org/forum/83/topics...


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  • Hotch
    Hotch Member Posts: 2
    edited February 2020

    MinusTwo:

    Getting the biopsy report today. Will post both to provide the complete picture.

    Thanks for the reply and suggestion.
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  • Beesie
    Beesie Member Posts: 12,240
    edited February 2020

    "In the original US report, why wasn't a sub-category (A/B/C) noted? Is it not typical to be part of the report?"

    Nope, it's not typical yet. I think more and more Radiology centers are starting to use the BIRADs 4A, 4B and 4C distinctions, but most still don't.

    Hope the biopsy is benign

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  • Pjtal
    Pjtal Member Posts: 4
    edited February 2020

    This is my first post, I have not officially been diagnosed. I had a mammogram and ultrasound last Monday, where the radiologist sent me to a surgeon the next day for a lumpectomy, which is this coming Wednesday 2/5.

    The radiologist report is BIRADS 4b suspected malignancy.

    My husband and brother are both in remission for Stage IV.

    Is there anyone here that got this type of report (I'm sure there is, duh) but, maybe willing to share experience? Thank you.

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  • Leawoodgal
    Leawoodgal Member Posts: 16
    edited February 2020

    you are having a lumpectomy without even having a biopsy?


    Leawoodgal

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  • Pjtal
    Pjtal Member Posts: 4
    edited February 2020

    Yes, the surgeon said he just wanted to remove.

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  • Leawoodgal
    Leawoodgal Member Posts: 16
    edited February 2020

    I guess I have never heard of lumpectomy before biopsy.

    Best

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  • Beesie
    Beesie Member Posts: 12,240
    edited February 2020

    Pjtal, although it's sometimes called a lumpectomy, since the purpose of your surgery is to determine whether your mass is cancer - and it might not be - it more accurately is called an excisional (or surgical) biopsy. Since the basic procedure is the same, some docs and hospitals do call the operation a lumpectomy, but that can lead to confusion since you don't, and with luck won't, have a diagnosis of breast cancer.

    In most cases, a needle biopsy is done prior to an excisional biopsy, even if doctor feels quite certain that the mass should be removed, whether it is benign or malignant. The needle biopsy would provide important information to the surgeon about the mass and might alter some of how the operation is done (the need for surgical margins, for example). Generally surgeons go first to an excisional biopsy only in cases where a needle biopsy isn't viable, usually because of the location of the mass. I had one situation where the surgeon and radiologist were pretty sure that good samples could not be retrieved with a needle biopsy, but they still recommended trying a needle biopsy first. As it turned out, enough was retrieved to diagnose a high risk condition (ADH). An excisional biopsy is usually recommended for ADH, to remove the entire suspicious area just to ensure that nothing more serious than ADH is lurking. So I ended up having the excisional biopsy after the stereotactic core needle biopsy, and I also ended up in the unlucky 20% who did have something more serious lurking.

    Did the surgeon explain why he is moving right to surgery rather than a needle biopsy? BIRADs 4b is associated with a malignancy rate between 10% and 50%. So it seems you are having surgery when there is a 50% chance that the mass will be benign, and the surgery perhaps would not even be necessary.


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  • Pjtal
    Pjtal Member Posts: 4
    edited February 2020

    This was a mass they were watching for the last year. It was BI-RADS 2 last year and it grew from 9mm to 22 mm and something about the edges and shapes.

    My head is spinning this happened so fast.

    Mammogram and Ultrasound Monday, Surgeon Wednesday, pre op work up Friday, with surgery scheduled Wed

    This all happened within 2 days.

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