Interpreting your report

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Tennis_mother
Tennis_mother Member Posts: 10
edited February 2020 in Not Diagnosed But Worried

Hi, I was told this is area where I need to post my report. appreciate your help. thanks

Amount of fibroglandular tissue: Scattered fibroglandular densities.

Background parenchymal enhancement: Mild.

Nonspecific foci of enhancement are present in both breasts. There is a region

of nonmasslike enhancement at the central left breast with mixed kinetics,

measuring 1.8 x 0.6 cm. (Series 501, image 108, location at -6.8).

There is no axillary or internal mammary adenopathy. The chest wall is

unremarkable.

IMPRESSION:

1.8 x 0.6 cm region of nonmasslike enhancement at the central left breast which

correlates to the area of distortion, seen only on CC view. This region

corresponds to the one view distortion on mammography. Therefore, stereotactic

biopsy using 3-D tomo symphysis is recommended.

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  • djmammo
    djmammo Member Posts: 2,939
    edited January 2020

    Tennis_mother

    These findings are fairly non-specific as MRI reports go. The good news is they did not describe anything that sounds like IDC or any actual mass for that matter.

    If this area correlates with the "one view" mammo finding it would more likely be a radial scar than a cancer but there are other things it could be including early DCIS, ADH, ALH etc.

    This is just a guess as MRI's are usually read with the mammo and the US to arrive at a more accurate diagnosis. Were there calcifications on the mammo and was anything seen on the US?

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  • Tennis_mother
    Tennis_mother Member Posts: 10
    edited January 2020

    Hi djmamo, Thank you so much for the quick reply.

    I just looked up the mamo and US report, and here is what it says:

    The breasts are heterogeneously dense, which might obscure small masses. There is an area of AD associated with calcifications in the slightly outer left breast, mid to posterior depth. This is seen on the craniocaudal view only. Targeted left breast ultrasound was performed, no suspicious solid or cystic lesion is identified in the area of mammographic concern.

    Impression:

    Indeterminate area of AD in the left breast with no sonographic correlate. MRI of the breast (with and without contrast) is recommended for further evaluation.

    By the way I am 48 years old, post menopause.

    I hope this is helpful.

    Thanks a lot again.

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  • djmammo
    djmammo Member Posts: 2,939
    edited January 2020

    Tennis_mother

    My rule-of-thumb is if AD is seen on the mammo but not on the US the odds of radial scar goes up. This is particularly true of the AD is only seen in one view of the mammo.

    When they do the biopsy, ask them afterward if any of the calcifications on the mammo are seen in the samples they retrieve. RS's do not usually have calcifications.

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  • Tennis_mother
    Tennis_mother Member Posts: 10
    edited January 2020

    Hello Dr djmammo ,

    Thank you for continuous support. I just did the biopsy this morning, and they have taken out 8 tiny samples. There is calcification, but small number and they are not grouped. The results of the biopsy should be out on Monday.

    Thanks again for your support.

    Kind regards

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  • Tennis_mother
    Tennis_mother Member Posts: 10
    edited January 2020

    Hi drmammo,

    Any thoughts following my last message? Thanks

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  • djmammo
    djmammo Member Posts: 2,939
    edited January 2020

    Tennis_mother

    We're just waiting for the results of the biopsy at this point, yes?

    The calcs may be a red herring, especially if they are see elsewhere in either breast, there are usually no calcs in a radial scar but the path report will tell you what's going on. If they are not "branching" calcs that lowers the chance of DCIS but still could be ADH or ALH which have lesser malignant potentials than DCIS.

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  • Tennis_mother
    Tennis_mother Member Posts: 10
    edited January 2020

    Hi djmammo,

    Not yet.

    Am right to say it sounds like I am in category BI RAD 4c at the moment?

    Thanks

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  • djmammo
    djmammo Member Posts: 2,939
    edited January 2020

    Tennis_mother

    I'm not able to comment on that. Let us know what the path shows.

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  • Tennis_mother
    Tennis_mother Member Posts: 10
    edited February 2020

    Hi djmommo,

    Does it take that long to get the results back? its been almost a week since I did the test! is that a good or a bad sign?

    Waiting is very tough and it has drained me.

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  • nneaga
    nneaga Member Posts: 8
    edited February 2020

    hi djmammo, I hope it’s alright, I have sent you a private message.

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  • djmammo
    djmammo Member Posts: 2,939
    edited February 2020

    Tennis_mother

    Neither good nor bad. Depends on where the pathologist is. If they are in the same building where you had the biopsy or if they are with an outside company to which the samples are FedEx'd.

    Sometimes the pathologist needs a second opinion and it gets sent to a university medical center which will take even more time, again neither good not bad news.

    Weekends and holidays will slow things down as well as vacation schedules in the path department.

    If two weeks go by, call your doc and make sure they sent the results to the correct office(s).

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  • Tennis_mother
    Tennis_mother Member Posts: 10
    edited February 2020

    Hi dlmammo,

    The results are out this morning, the cells are benign, and the diagnoses is LCIS. They want me to see a surgeon for the next steps.

    At least I am clear for now. I would appreciate your thoughts.

    Thanks a lot for your support.

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  • djmammo
    djmammo Member Posts: 2,939
    edited February 2020

    Tennis_mother

    Here are Mayo's thoughts on the subject, more valuable than my thoughts.

    Mayo Clinic LCIS

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  • Tennis_mother
    Tennis_mother Member Posts: 10
    edited February 2020

    Hi dlmommo,

    I received my report today, and it seems it is in line with you wrote earlier, radial scar. Here is what the Biopsy report says

    Left breast center w/calc - LCIS, classis type / lobular intraepithelial neoplasia, grade II (LIN ii) involving Radial Scar Lesion.

    Usual ductal hyperplasia , florid. Adenosis & columnar cell change w/Calcium phosphate. Cystic aporcine metaplasia w/ associated calcification (Calcium Oxalate crystals).

    Block 1-A

    Studies w/calponim & P63 highlighted numerous myoeptithelia cells in the region, these finding are consistent w/radial scar.

    The immunohisstonchemecal studies reveal loss of tumor cell membrane immunoreactivity w/e-cardherin & beta.

    Catenin & cytoplasmic expression of P120 catenin confirm the lobular neoplasia.

    Immunistochemical stusies also domostrate mosaic pattern of CK 5/6 cytoplasmic staining within ductal proliferation supporting usual ductal hyper plasia.

    Would you be able to comment on the report?

    Thanks a lot,

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  • djmammo
    djmammo Member Posts: 2,939
    edited February 2020

    Tennis_mother

    The first half of the report tells you what they found, and the second half are the tests done on the sample that back up their diagnosis.

    In addition to the radial scar they found LCIS, classic type / lobular intraepithelial neoplasia, grade II (LIN ii) which may need additional treatment beyond surgical removal. Here is a good introduction to the subject but your other docs will have to take it from there.


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