Should I be in the 6 month club?

ruthiew
ruthiew Member Posts: 11
edited July 2020 in Benign Breast Conditions

Two years ago, I received a callback after my annual 3D mammogram because of focal asymmetry in my right breast. After four x-rays during my diagnostic mammogram, ( at one point I wished they would do an ultrasound or MRI just to be sure I was fine), I was given the all clear, and told to return in one year for my regular screening. I also had some calcifications, which were not concerning. I requested to be monitored in 6 months, but was told that was not necessary.

Last year, I did not receive a callback. However, my report said that I had benign, stable, architectural distortion. Since I had not heard that diagnosis before, I called my doctor's office, and was told that the architectural distortion was describing the previous year's area of concern, and that there had not been any changes. I called the breast care center where I had my diagnostic mammogram the year before so their radiologist could review my films. Apparently, one radiologist described the area as architectural distortion, and another described it as a focal asymmetry. I practically begged for an ultrasound, MRI, or a 6-month checkup, but was told that was not necessary since there had not been any changes.

I had my regular screening mammogram two days ago, and because I was so nervous, I called my PCP's office for results instead of waiting. I was told everything was normal, and I should have my next mammogram in a year. I am 56 with very dense breasts and a distortion or asymmetry that has not changed in two years. I have never had an ultrasound or MRI. Should I be a candidate for the 6 month club or at least some kind of additional testing?

Also, at my mammogram this week, after the technician took a picture of my right breast, she looked at it and asked me if I had lost weight since last year. I have never been asked that question before. Her question made me nervous because I assumed she had seen increased density in the right breast. I thought technicians are not supposed to comment on what they see. Do the technicians look at previous images or just the current one? Should they be making comparisons?

Thanks in advance for the insight!

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

    6 month follow-ups are done when there is a low suspicion lesion (assessed to be <2% risk of cancer) and the Radiologist wants to monitor the lesion to ensure stability. If you had been put on a 6 month follow-up schedule as you requested two years ago, with your latest imaging you would likely be taken off it now, since you've had 2 years of stability.

    6 month follow-ups are associated with BIRADs3 imaging. Do you know the BIRADs ratings on your reports? Since follow-up was not deemed necessary, I'm guessing that the 3 years of imaging that you've referenced have all been rated BIRADs2. This means that the Radiologist assesses the imaging to represent a benign finding, however one or more conditions were noted that bear mention in the report. Do you have copies of your reports? The write-up, and how the focal asymmetry/architectural distortion is described should be helpful in understanding why a BIRADs2 was assessed rather than a BIRADs3.

    That said, if any of your imaging was rated BIRADs3, then you should have had a 6 month follow-up. It is surprising that you were not given an ultrasound 2 years ago when you had the call-back - it's customary for ultrasounds to be included in call-backs along with diagnostic (focused/magnified) mammograms. However, since you changed imaging centers, you've had two different Radiologists assess your imaging, and both agreed that no further imaging and no follow-ups were required. You've now had 2 years of stability and that's what's most important.

    As for the question the Tech asked (they can ask questions but should not offer opinions on the imaging), ignore it. Neither you nor I can read minds as to why she asked that question. All the matters is that the Radiologist reviewed your imaging and compared it to previous imaging, and that's what your report reflects.


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  • ruthiew
    ruthiew Member Posts: 11
    edited July 2020

    Thank you for your comments and the helpful information. Everything is Birads 2. I agree that at the callback two years ago I should have had an ultrasound in addition to the diagnostic mammogram. I thought an architectural distortion almost always requires more investigation to determine the cause.


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