MRI-guided Biopsy report, would love some insight.

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onceabird
onceabird Member Posts: 23
edited December 2020 in Not Diagnosed But Worried

I have researched all of the components of my report, and they all seem benign, but was wondering why it recommends a follow up with the breast surgeon? Cautionary? I'd love thoughts. (History, 36 y.o. female, dx ADH in 2019, surgical biopsy/removal of area)

Report:

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RADIOLOGY/PATHOLOGY CORRELATION:

Ordering Doctor: _______
Procedure(s): MAM diag mammo RT; MR guided breast biop 

 Lauren ______'s Report Breast Biopsy MRI, Mammogram Diagnostic

Signed

23 mm non-mass enhancement in the right 3:00/central breast, middle depth (indicated he-shaped marker in satisfactory position):

FIBROFATTY BREAST TISSUE WITH 2 MM FOCUS OF INTRADUCTAL PAPILLOMA AND A BACKGROUND OF PROLIFERATIVE FIBROCYSTIC CHANGES INCLUDING EXTENSIVE SCLEROSING ADENOSIS, APOCRINE METAPLASIA, COLUMNAR CELL CHANGE, AND CYST FORMATION.
CALCIFICATIONS ARE IDENTIFIED.

Breast surgical consultation is recommended to assess optimal management based on the radiologic, pathologic, and clinical features of the finding.


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Comments

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

    An excisional biopsy is usually done on intraductal papillomas identified by core needle biopsies. In a small percentage there is an upgrade to DCIS or invasive cancer in the area around them. Even if no cancer is foundthere it is a good idea to get them out because they are an “annoyance” in that they tend to produce bloody nipple discharge and also to grow into lumps.

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  • onceabird
    onceabird Member Posts: 23
    edited November 2020

    Thank you, that is very helpful! I have already had one excisional biopsy and was hoping not to have another but that's the game I will play now, apparently.

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

    I am kind of unclear on your timeline here because it seems incomplete as to exactly what has been happening and what has been done when as far as imaging and biopsies. There was likely a diagnostic mammogram, ultrasound and MRI preceding the MRI biopsy, yes? What led to those? Ifthe most recent procedure is the MRI guided biopsy (date?), then yes, you are being referred to the surgeon, most likely for an excisional biopsy. The columnar cell change could possibly be looked at, but the rest of the stuff is fibrocystic/aging breast stuff.

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  • onceabird
    onceabird Member Posts: 23
    edited November 2020

    After being dx with ADH on the same breast in 2019, I was put on an every-6-months mammo/MRI schedule, mostly because of my age and the extent of the ADH found in the excisional biopsy. This was following my 6 month screening MRI 2 weeks ago, which led to a suspicious finding (BI-RADS 4), which led to an u/s the following day, which was inconclusive, thus leading to an MRI guided biopsy.

    This biopsy was done last week, with the results posted to my health file online last night. I didn't discuss them with the doctor yet, I am just reading the report. I am a worrier so I am trying to get a jump on the possibilities so I don't panic later.

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

    Okay, makes sense. What I said above is probably it. You defintely have “busy” breasts. How old are you? Was the ADH excised

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  • onceabird
    onceabird Member Posts: 23
    edited November 2020

    I am 36. I first had a lump in my breast when I was 28 and it was benign after biopsy, but then a lump in the same area contained ADH. It was excised, yes.

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  • LivinLife
    LivinLife Member Posts: 1,332
    edited November 2020

    Sorry you're going through this again. Glad you found us! Please keep us updated as steps unfold....

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  • peggysmom
    peggysmom Member Posts: 50
    edited December 2020

    To the OP: In the past, intraductal papillomas were all routinely excised. At academic centers in the US, there has been a shift in these recomendations. Because there is such a low upgrade rate to cancer after excision- now, only if the intraductal papilloma is associated with ATYPIA is surgical consultation recommended. Did the pathologist make any comments about recommending excision? (sometimes they do that)

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  • onceabird
    onceabird Member Posts: 23
    edited December 2020

    Hello, and thank you all for your replies.

    My surgeon recommended waiting for 6 months and taking another MRI, in case anyone was wondering. I don't love that option, but it is what the recommendation was.

    Thanks again!

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  • LivinLife
    LivinLife Member Posts: 1,332
    edited December 2020

    Thanks for letting us know! The waiting is hard. If it helps I often found the first few weeks or so is hardest when it's a long time until a "next test" then I move on with life and then I get a little antsy again 3 weeks before the test... Hope it goes something like that for you - means you'd have many weeks of living life as usual in between....

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