Help understanding my report??

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Kimmyk0802
Kimmyk0802 Member Posts: 5
edited August 2020 in Not Diagnosed But Worried

Hi. I am new to all this and was a bit concerned after I actually read report. See below. After my Diagnostic mammogram and ultrasound the nurse said, oh this is nothing to worry about. Nodule is small and not breast cancer. I was a bit taken aback when I read both reports as it didn't quite sound as if it was nothing. I just want to prepare myself so I have a bit of knowledge. My biopsy's are scheduled for Thursday next week. Any help or information will be appreciated. My report:

EXAM:

Digital Unilateral left diagnostic Mammogram with CAD and tomosynthesis

Left breast ultrasound, limited

CLINICAL HISTORY:

Left breast calcifications, left breast nodule. Family history of breast cancer (mother)

COMPARISON:

8/4/2020, 6/27/2019, 6/26/2018, 6/15/2017

FINDINGS:

The patient returns for further evaluation of some calcifications and a small nodule noted in the left breast on the recent screening mammogram.

Magnification views are obtained. True lateral view with tomosynthesis is also obtained. Calcifications are somewhat indeterminate and may be associated with a small nodule. These are located at the 4 o'clock position approximately 6 cm from the nipple. There is a persistent slightly lobular nodule seen just posterior to the calcifications. This is at the 4 o'clock position approximately 8 cm from the nipple.

Left breast ultrasound demonstrates a vague nodular density with some calcifications at the 4 o'clock position 6 cm from the nipple. This measures approximately 7 mm in diameter. This is felt to correlate with the mammographic abnormality. Less than 2 cm posterior to this area is a hypoechoic cluster which may represent a cluster of small cysts. This area measures 8 mm.

IMPRESSION:

1. Indeterminate grouping of calcifications associated with small nodular density at the 4 o'clock position of the left breast 6 cm from the nipple. Biopsy is recommended. It is felt that this can be seen on ultrasound. Ultrasound-guided biopsy can be attempted.

2. Small lobular hypoechoic nodule at the 4 o'clock position approximately 8 cm from the nipple. This could represent a cluster of small cysts. Given this patient's family history of breast cancer, biopsy of this should be performed at the same time. This is amenable to ultrasound-guided biopsy.

DOB: 8/2/1964 Age: 56 years

Report

The patient has been sent a letter reflecting the findings and recommendations included in this report. Breast Composition: There are scattered areas of fibroglandular density

C4D2: BIRADS CODE 4: SUSPICIOUS

BIOPSY SHOULDBE CONSIDERED

Assessment:C4 Recommend:S Letter:C4D2R1 Recall:1


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Comments

  • Moderators
    Moderators Member Posts: 25,912
    edited August 2020

    Dear Kimmyk0802,

    Welcome to the BCO community. We are sorry that these breast changes have brought you here but glad that you reached out to our members for support. While you are waiting for others to offer their experiences you may want to check out this page which offers links to resources around Common Imaging Questions. Please let us know how we can be of help. Keep us posted on how things go for you.

    The Mods

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  • Kimmyk0802
    Kimmyk0802 Member Posts: 5
    edited August 2020

    Hi. I am not sure if I posted in the correct place. Please let me know if I need to move this.

    Thank you,

    Kimberley

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  • Moderators
    Moderators Member Posts: 25,912
    edited August 2020

    Dear KimmyK0802,

    Typically we would suggest that you post your question in the topic entitled Interpret my Report, however, djmammo. who is a radiologist who volunteers his time to our community is on a leave so you are fine leaving the post here. Other members may offer their experiences but are not necessarily medical experts.

    The MOds

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  • Kimmyk0802
    Kimmyk0802 Member Posts: 5
    edited August 2020

    thank you

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

    In the mean time - I would reach out to the doc who ordered the tests and go over the report in detail with him or her. I would want to do that before the biopsy.

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  • moth
    moth Member Posts: 4,800
    edited August 2020

    So ... I think there's a good reason we do biopsies. There's only so much imaging can tell us. I don't think there is anything to do except wait for the biopsies and pathology results. I'd suggest distracting yourself as much as possible.

    According to this Cdn radiology site, BIRADS 4 means 60-70% chance it's NOT cancer

    https://breast-cancer.ca/4biads5/

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  • Beaverntx
    Beaverntx Member Posts: 3,183
    edited August 2020

    Also djmammo has said several times that a BIRADS 4 is usually needed to get a biopsy approved by insurance.

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  • Kimmyk0802
    Kimmyk0802 Member Posts: 5
    edited August 2020

    Thanks everyone. My biopsy , both, were approved and scheduled for next week. I was just trying to understand this and gain some knowledge prior to. The dr told me it is as states and a biopsy is the only determining factor. All of which I understand but was just seeing if anyone was familiar or went through this.

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  • moth
    moth Member Posts: 4,800
    edited August 2020

    well, we all have been through it. The dread, the trying to figure out the possible trajectories, the metaphorical reading of tea leaves, the waiting...

    Take care

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  • ctmbsikia
    ctmbsikia Member Posts: 1,095
    edited August 2020

    Best of luck on the biopsies. I know how nerve wrecking it is!!! I once read a whole study on the birads system as I needed to understand the score of 3-"probably benign" I thought the word probably was a poor choice of a word for something so important-however, along with the help of these boards, when the next imagine test went to a birads 4 I had the biopsy and it was benign. I trust the system now. Just sorry you have to go through it, but the tissue sample will make it clear. Again, good luck. Let us know how it goes.

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

    Kimmy, it sounds as though the main reason for the biopsy is the first area of concern, the "Indeterminate grouping of calcifications associated with small nodular density". From that description, it could be something like a benign fibrocystic condition, or it could be something more - it's impossible to say. Good news however that the nurse commented that it does not appear to be breast cancer. It seems that the second area of concern is a cluster of cysts, and is being biopsied mostly because you will be there for the biopsy anyway - I suspect that this one might have warranted a BIRADs 3 and a 6 month follow-up if it had been the only area of concern.

    Good luck with the biopsy on Thursday. And remember that most BIRADs 4 biopsies are benign (70%-80%) and with a BIRADs 4 the biopsy is being done to rule out cancer, because the imaging alone isn't sufficent to do this, and not because cancer is suspected.



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  • meistere
    meistere Member Posts: 13
    edited August 2020

    I would also get an MRI no matter what the biopsy shows. I had a clear diagnostic state-of-the-art mammogram, a clear ultrasound and when I did the MRI w/contrast, it lit up like a Christmas tree. You need to know the actual size of anything out there b/c it will determine your treatment path - meaning if it turns out to be cancer (not that I'm hoping that!) then things may show up on the MRI that don't show up on the mammogram. Specifically - your lymph nodes and other areas of foci that might have been missed. If you mother had breast cancer then they need to be doing an MRI and mammogram switching off every time you're due for imaging. It sounds like based on your history, they need to be watching you carefully anyways. Let us know how it goes!

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

    Let's not jump to conclusions. If the biopsy is benign, there is no need for an MRI. A biopsy result trumps imaging.

    Should the biopsy find cancer, then an MRI may be of value prior to surgery, but that will be part of the discussion with the surgeon and it may depend on the type of surgery you have. With luck, none of that is anything you need to worry about.

    As for requiring an MRI because your mother had breast cancer, that's not normal screening protocol. Your breasts are not dense (scattered areas of fibroglandular density) so mammogram screenings should be quite effective.

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

    meistere - I think we need to defer to Beesie and some of the other posters who have been on here for many years and have several thousand posts. No need to rush into testing if the biopsy is benign.

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  • Kimmyk0802
    Kimmyk0802 Member Posts: 5
    edited August 2020

    Thank you everyone for all the help. I will just settle down and the await the biopsy next week. As Beesie stated the main area of concern is the grouping of calcifications per the radiologist that called me today. He stated both are birad4C and the best and only course of action as of now will be the biopsy. I will be hopeful as I do know my mother had it twice and passed away from triple negative last year. So, at least I am assured that even though a higher risk they will watch me. Again, hugs and thank you till next week when hopefully I will have a definitive answer.

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