Interpreting Mammograms: Assymetry

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djmammo
djmammo Member Posts: 2,939
edited July 2022 in Not Diagnosed But Worried

from the American College of Radiology's Breast Imaging Boot Camp

(some of the terms used are those taught by the famous lecturer and researcher Lazlo Tabar, MD)


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  • MTwoman
    MTwoman Member Posts: 2,704
    edited August 2017

    fascinating!

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  • LoriAnnT
    LoriAnnT Member Posts: 7
    edited July 2019

    are focal asymmetrys something to follow up?

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  • djmammo
    djmammo Member Posts: 2,939
    edited July 2019

    LoriAnnT

    Yes, especially if they are new.

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  • Taps68
    Taps68 Member Posts: 2
    edited September 2019

    Hi there. I was wondering how you made out with the focal asymmetry? I was recently told I have that.

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  • Taps68
    Taps68 Member Posts: 2
    edited September 2019

    Hi there. I was wondering how you made out with the focal asymmetry? I was recently told I have that.

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  • OlgaE69
    OlgaE69 Member Posts: 10
    edited September 2019

    Is "breast asymmetry" the same thing as "focal" asymmetry? Is that referring to comparing the two breasts?

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  • djmammo
    djmammo Member Posts: 2,939
    edited September 2019

    OlgaE69

    In general when you put the left and right mammogram images together back to back, they can look like an ink blot test (Rorschach) with one side a mirror image or the other side. Since everyone's mammogram looks different, there is no standard of normal to have in mind for interpreting them like for chest x-rays where they are all the same. We can only compare them to the other side initially, then to prior studies as time goes on.

    An "asymmetry" is an area of breast tissue (areas of white in the image) that is seen on one side and not on the other and does not appear to be a discrete mass. It is very often normal tissue

    There are two kinds of asymmetry, "focal and global", basically corresponding to "small and large".

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  • ResiliencePersonified
    ResiliencePersonified Member Posts: 22
    edited August 2020

    What about focal asymmetry 11mm with amorphous calcifications that were not there in December 2018

    FINDINGS: mammogram
    With supplemental imaging, the possible focal asymmetry in the upper
    outer quadrant of the RIGHT breast persists. It measures
    approximately 11 mm. Additionally, amorphous calcifications are noted
    in the upper outer quadrant of the RIGHT breast, not definitively
    visualized on 2/12/2014.


    FINDINGS: ul
    With supplemental imaging, the possible focal asymmetry in the upper
    outer quadrant of the RIGHT breast persists. It measures
    approximately 11 mm. Additionally, amorphous calcifications are noted
    in the upper outer quadrant of the RIGHT breast, not definitively
    visualized on 2/12/2014.

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

    Resilience - Sorry - didn't you have a different name a few days ago? What was that name?

    Djmammo is not on the boards right now so will not be able to address your issues. My suggestion is to go back to the doc who ordered the studies and insist they explain these things to you.


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

    MinusTwo, yes, she changed her name from PrettyStinkinScared.

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  • ResiliencePersonified
    ResiliencePersonified Member Posts: 22
    edited August 2020

    It was prettystinkinscared. There is an option right in settings for those who choose to. I was given that name by my therapist on Wednesday, and chose to change it to a more positive name. No other reason than that! Thanks for asking. And the only reason I asked was because I looked at his name and thought it said his most recent activity was yesterday. I am waiting on them to get back to me still. And it isn’t like I was trying to come in brand new under a different name. I’m still posting my updates under my original post so there’s nothing I’m doing that is questionable. I spoke with the very kind moderators about it first and they were very positive about it.

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  • Nadeybelle
    Nadeybelle Member Posts: 4
    edited September 2020

    I got a call back reporting focal asymmetry not readily classifiable as benign. This was a 3D mammo. I have read that there are less call backs from these machines. This makes me worry that it’s cancer, since it can see things much better. I mean, why else would they call me back?What is the % is would be?

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

    Nadeybelle, yes, there are fewer unnecessary callbacks with 3D mammos, but there still are lots of them. In the past 95% of callbacks did not result in a diagnosis of cancer. I don't know what the percent is now, but I'd guess it's still at least 80%-85%.

    Radiologists err on the side of caution. Anything that can't immediately be identified as being benign warrants a call back. Anything that has just a 2% risk of being cancer warrants a biopsy.

    Asymmetry can be a sign of breast cancer. But most often, asymmetry turns out to be nothing at all. It could just be the way your breast was squished in the mammogram machine.

    Take a look at this recent thread:

    Topic: Asymmetry on CC view of 3D screening mammogram https://community.breastcancer.org/forum/83/topics...




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  • Nadeybelle
    Nadeybelle Member Posts: 4
    edited September 2020

    Beesie, Thank you.

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  • Nadeybelle
    Nadeybelle Member Posts: 4
    edited September 2020

    Bessie, I did want to post the findings of my diagnostic mammogram and ultrasound yesterday. The doctor was so awesome. He said the word benign first, then said its 2 tiny nodes and he had to be sure they were just nodes. He had no previous scans to compare to, so it wasn’t easy. I go back in 6 months for ultrasound follow up but I don’t know why. Maybe it’s routine so he has something Moreto compare next year.

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

    Nadeybelle -- that's great news! Keep us posted how things go with your 6 month follow up.

    --The Mods

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  • Arielmc
    Arielmc Member Posts: 7
    edited June 2021

    I just got this and am confused by it's vagueness...

    I can't wait to post that it's nothing in 10 days when i get follpw-up. I have had biopsy before in left breast, but there's no mention of the chip and i believe it was in another area of breast.

    FILMS COMPARED:

    The present examination has been compared to prior imaging studies.

    TECHNIQUE:

    The following 3D digital breast tomosynthesis with 2D composite views were obtained: bilateral

    craniocaudal with tomosynthesis and mediolateral oblique with tomosynthesis.

    Computer-aided detection was utilized by the radiologist in the interpretation of this examination.

    MAMMOGRAM FINDINGS:

    The breast tissue is heterogeneously dense, which may obscure detection of small masses (density C).

    Finding 1: There is an asymmetry seen in the central region of the left breast at posterior depth.

    Finding 2: There is an asymmetry seen in the lateral aspect of the right breast at middle depth.

    IMPRESSION:

    Finding 1: Asymmetry in the central region of the left breast at posterior depth requires

    additional evaluation. Recommend additional 3D tomosynthesis mammographic projections and, if

    indicated, breast ultrasound.

    Finding 2: Asymmetry in the lateral aspect of the right breast at middle depth requires additional

    evaluation. Recommend additional 3D tomosynthesis mammographic projections and, if indicated, breast

    ultrasound.

    Based on a modified IBIS risk calculator, this patient has an approximate 18% lifetime risk of

    developing breast cancer.

    BI-RADS Category 0:

    Incomplete: Needs Additional Imaging Evaluation

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  • mamahope
    mamahope Member Posts: 1
    edited July 2022

    Is asymmetry density and architectural distortion normal 7 months after lumpectomy?

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  • Moderators
    Moderators Member Posts: 25,912
    edited July 2022

    Hi mamahope, and welcome to Breastcancer.org! We hope you find our Community to be a supportive place.

    This thread has been inactive since June 2021, so we would suggest you start your own new topic in some of the forums you'll find in the All Topics page. If you have already been diagnosed, the best place for that would be the Not Diagnosed With a Recurrence or Metastases but Concerned forum. Please, let us know what's your particular situation and we'll guide you!

    Warm wishes,

    The Mods

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