Can anyone explain what this means?

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DiannaC13
DiannaC13 Member Posts: 7
edited September 2020 in Not Diagnosed But Worried

I went back for my repeat mammogram and ultrasound and the radiologist told me the mass is still there and that I need a biopsy. He really didn’t say what he thinks it might be other than it is suspicious. My PCP called me with an appointment with a breast surgeon but it will only be for a consult for the first visit. I am just trying to prepare myself and learn all I can so I know what questions to ask. Preparing myself is my way of having some control. Could anyone please tell me what you think of my reports please. I know the fact that it’s BIRADS 5, the Spiculation, and blood flow are not good I don’t know what the “tissues stiffening with elastography velocities up to 3,3 meters per 2nd means???? Can you help and give me your thoughts on these reports Thank you so much

BIRADS-5

Masses: Small mass with minimal speculation persists in R lower breast

Calcification: none

Architecture Distortions-None

Calcification: No new or suspicious calcifications

Assymetry: None noted

US RIGHT BREAST

SAME AS ABOVE EXCEPT IMPRESSION STATES:

At 6 0’clock 6 cm from the nipple, a small Hypoechoic irregularly marginated ,minimally spiculated mass noted This looks solid with some internal blood flow There is adjacent tissues stiffening with elastography velocities up to 3.3 meters per 2nd. Scanning of the axils reveals no enlarged lymph nodes

BIRAD:5 Highly suggestive of malignancy Biopsy should be performed


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

    ultrasound elastography measures how stiff/soft the tissues are around the lesion; growths have effects on tissues surrounding them & bodies defend themselves from growths. It just gives the person reading the u/s more info about how likely something is to be normal part of the breast versus something that needs to be looked at further. Here's a long technical article but I don't think it really helps you. This is essentially the radiologist saying - here's more evidence that this thing should be looked at rather than ignored. That doesn't mean help you or anyone diagnose it - that needs to be done with a biopsy. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC53995...

    & just wanted to say that my biopsies were all performed by interventional radiology before I saw the breast surgeon. I'm a little surprised your biopsy isn't being scheduled yet. Except for masses that require an excisional biopsy - & I don't see why this would - I think interventional radiology does the biopsy and then you see a surgeon once pathology is done. It's just done under a local with a thing that sounds like a staple gun - easy, peasy. I'd consider calling your PCP or the BS and asking about getting a biopsy referral first.

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  • AliceBastable
    AliceBastable Member Posts: 3,461
    edited September 2020
    Yeah, I think most of us didn't see a breast surgeon until we'd had a biopsy. I went to a breast center that's part of a hospital/medical complex for my mammogram, and when it came back showing a spot, that breast center scheduled me for an ultrasound and possible biopsy. They set up an appointment with one of the breast center's surgeons once the biopsy results were known. And at my first appointment with the breast surgeon, she explained the details and treatment options, and referred me to an oncologist. All very easy and seamless.
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  • Beesie
    Beesie Member Posts: 12,240
    edited September 2020

    Dianna, I can't tell you what the specific words you asked about mean, but a BIRADs5 unfortunately means that the Radiologist assesses a 95%+ probability of cancer. I've been hanging around here a long time and I've seen quite a few BIRADs5 come back benign, so that is possible, but you should prepare yourself for a diagnosis of breast cancer.

    Did the Radiologist not immediately schedule you for a biopsy? As the others have said, it's usually the Radiologist who performs the stereotactic (mammogram guided) or core needle (ultrasound guided) biopsy, not a breast surgeon. And usually patients don't see a breast surgeon until they have biopsy results. The exception is if it's questionable whether a biopsy is necessary, in which case a BS might serve as a second opinion.

    It seems to me that you should go ahead with the scheduling of the BS appointment, but you should have the biopsy done by a Radiologist prior to that appointment. That's a better use of time because it gets you into the biopsy more quickly and provides you with the biopsy results to discuss with the BS.

    Good luck with the biopsy!

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  • DiannaC13
    DiannaC13 Member Posts: 7
    edited September 2020

    Thank you all for your response to my questions! I have a consult appointment with the surgeon tomorrow afternoonand he will schedule the biopsy. ( I’m secretly hoping they will end up doing the BX at the appt) The radiologist told me he could do it but my PCP prefers the breast surgeon to do the biopsy and any further treatment needed. When my PCP called me to give me the appt time and date, she gave me the choice but she did confirm that she preferred the BS to do the biopsy. Thank you again for your responses!

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  • DiannaC13
    DiannaC13 Member Posts: 7
    edited September 2020

    Went for my consult today with breast surgeon. I am set up for a biopsy on Monday. I asked him what his gut feeling is about the mass. He said “I think it’s about a 50/50 chance. I’m really sitting in the middle”. I guess that’s good ?

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

    I'd wondered if the BS was going to send you back to the Radiologist for the biopsy; the two breast surgeons I've dealt with over the years only performed surgical biopsies and always referred needle biopsies to the Radiologist. That would have been another delay, so I'm glad that didn't happen.

    If the BS said 50/50, then clearly his assessment is different than the Radiologist's, who assigned the imaging a BIRADs5. 50/50 would fall under BIRADs4. So that's a more positive outlook than the Radiologist, which certainly is good.

    Good luck in Monday!

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