Please help with understanding report

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Cath1492
Cath1492 Member Posts: 4
edited September 2020 in Not Diagnosed But Worried

I had a diagnostic mammogram and ultrasound for a density on one breast. The radiologist told me there was "something " there but he wasn't sure what it was. He gave me the three options of waiting 6 months, MRI, or biopsy. He said that if it was cancer and I waited it would have 6 months to grow so I am opting for the MRI which I will get on Thursday.

I tried to read the report using the resources on this site, but I'm having a hard time putting it together. I'm afraid that because I'm 71 years old, my body won't be able to fight it, so I'm trying to get prepared.

Thanks so much for any help.

Ultrasound
ultrasound demonstrates an irregular margin lesion at 8:00 2cm from the nipple measuring 5x5x12mm. Lesion is slightly hypoechoic with respect to fat, demonstrates a hyperechoic rim, no flow on color Doppler and minimal shadowing. The lesion does correspond with the mammographic finding. The patient states she has had 2 significant falls to the right chest/breast and the sonographic area of concern is within the area of the soft tissue area.

CONCLUSION: irregular margin hypochoreic lesion with indeterminate features. Please see mammogram report for discussion and follow up recommendations.


Diagnostic mammogram

Multiple views of the right breast including spot compression tomosynthesis, rolled mediallateral, and full-field tomosynthesis were performed to evaluate a focal asymmetry seen on the CC view screening mammogram lateral to the nipple. The additional views confirm the presence of a 5 mm rounded area of opacity is seen on the CC view. Correlating opacity is not convincingly seen on ML or MLO view and rolled mediallateral immaging was performed demonstrating this opacity to be in the lower half of the breast. Ultrasound examination was performed and demonstrates an irregular margin area isoechoic to fat located at 8:00, 2cm from the nipple with a hyperechoic periphery. The size and location of the sonographic abnormality does correlate with the mammographic finding. No increased flow on color Doppler.

Conclusion:

Mammogram and ultrasound demonstrate a focal finding at 8:00 periareolar région measuring 5mm. The sonographic features are indeterminate. Patient states that she she's sustained 2 falls in the past few months to the right chest/breast. Differential considerations for the abnormality including a neoplasm and resolving hematoma. I showed the findings to the patient and discussed potential options.

BI-RADS: Category 3 PROBABLY BENIGN FINDINGS.

Thanks so much for reading this. Cathie

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Comments

  • redhead403
    redhead403 Member Posts: 125
    edited September 2020

    That is a small site mentioned on both US and mammo. If it were me, I would have the biopsy now as opposed to waiting. It will give you peace of mind. I am 70 so I understand how you feel. I had mammograms US and MRI.

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

    Hi Cath,

    We're so very sorry you find yourself here and worrying, but we're really glad you've found us. We know it's a scary time, but there's of support here for you while you figure out what's going on. Please keep us posted on what you find out!

    Sending good thoughts!

    --The Mods

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  • Micmel
    Micmel Member Posts: 9,450
    edited September 2020

    where is DJ Mammo? He always helps figure out reports. Hopefully he’ll be along!

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

    DJ is taking a break.

    Cath1492, I was 77 when diagnosed so your age is not necessarily a factor. The radiologist who wrote your report does not appear to be really concerned that you have cancer. When they are concerned the BIRADS is a 4, as that is prerequisite for a bopsy.

    Hope you get good information from the MRI. The various modalities (mammo, ultrasound, MRI) all see things a bit differently so don't be surprised if descriptions vary.


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

    Cath - I was also over 70. Radiologist's know a lot, but don't make treatment decisions. Who ordered the scans? Your PCP? Your OB/Gyn? That's who I would call and discuss this with first.

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

    Reading the report, it appears that both your mammogram and ultrasound saw 'something' that doesn't have the appearance of cancer but can't be clearly identified as being benign. The Radiologist assessed a BIRADs 3, which means he believes that the risk of cancer is less than 2%. Anything more than 2% risk and a BIRADs 4 would have been given, and with that comes the recommendation of a biopsy. The Radiologist also notes that the area of concern is in the same location as where you fell and hurt your breast and suggests that what is seen on imaging might be damage to the tissue or a collection of blood caused by the fall.

    As someone who's had more than my share of BIRADs3 and BIRADs4 imaging over the years, the report and description doesn't sound overly concerning to me. With that report and a BIRADs3, I would be fine to wait 6 months. But like you, I expect I would go for an MRI if one was offered. While the MRI can't provide a diagnosis, hopefully it shows the same lesion but with no associated concerning features. That would be a confirmation that this is most likely to be bruising/damage from your fall and nothing more serious than that.

    Good luck with the MRI. Let us know how it goes.



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  • Cath1492
    Cath1492 Member Posts: 4
    edited September 2020

    Thanks for all the feedback. This is a wonderful group.

    I will have my MRI tomorrow and of course, worrying. I am trying to prepare myself for whatever happens although I know that’s not possible. I have a couple more questions I have been thinking about. One is this..The report says it is a lesion with irregular margins. Doesn’t that usually mean cancer if the margins are irregular? Also, what does it mean when the ultrasound shows “no color flow?” My report seems like a combination of positives and negatives so I stopped reading it for a while, but now that the day approaches, I’m obsessing again. Thanks, Cathi

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  • MelissaDallas
    MelissaDallas Member Posts: 7,268
    edited September 2020

    Cath1492, no, it does not usually mean that it is cancer. Lots of benign things don’t appear “textbook” as to smooth edges either.The most important part of the conclusion on your mammogram is “PROBABLY BENIGN FINDINGS.”

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

    Cath, neither you nor any of us here (except for djmammo, who is off for a while) are Radiologists. We don't have the approx. 13 years of medical and specialty training that a Radiologist has. I've been hanging around here a long time and I'm pretty familiar with the terminology on imaging reports, but as MelissaDallas said, it's the Radiologist's final assessment, looking at everything together, that is most important. Your Radiologist assessed your imaging as a BIRADs3, indicating a 2% or less risk of cancer.

    No color flow is good.

    Cancerous lesions often have irregular margins but so do some many lesions. Fat necrosis (I had a BIRADs4 biopsy for that once) can have irregular margins. Trauma related lesions, which is what your Radiolgist suspects in your case, can certainly have irregular margins. Think about it. If the imaging is seeing an area of bruised tissue from your fall, would you expect it to have well defined margins? I wouldn't think so.

    Good luck tomorrow. MRIs are very sensitive; hopefully it sees the same lesion and presents it in a way that is highly suggestive of it being benign.

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  • AliceBastable
    AliceBastable Member Posts: 3,461
    edited September 2020

    image

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