Survivor of 20 years with Mammogram callback

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Bluegirl27
Bluegirl27 Member Posts: 44
edited February 2021 in Waiting for Test Results

Well, I am 20 years post DCIS, left breast. I had a 2nd opinion on my pathology from lumpectomy that also picked up LCIS. I had radiation as well. I was 35 when diagnosed and am now 55. I have had normal mammograms all these years up until last week. I received a call back on my 3D mammogram the next day and I was so afraid to call them back, my hands were shaking. The only thing I know is I have to go for more images and an ultrasound, but it's not my left side, this time my right side.


My call back appt is 1/28. I was hoping I could get in this week. I may call and ask them to contact me if they have a cancellation before then. As you.all know, it is true the waiting is the hardest part. I had a mammogram in 12/19 and that was fine. But, I did tell the tech that I can feel a lump on the right side, but I don't always feel it. Plus I have super lumpy breasts and just figured it was probably nothing and knew I'd be having a mammogram in a few months. I have been having back pain on that side but I have a ton of spine issues due to scoliosis surgery in 1978. So maybe there is something there or maybe not, I'll find out soon enough. I wasn't too concerned when my doctors nurse called me at first because it sounded like it was nothing and she only mentioned extra mammogram pictures. But when I called the imaging center she said mammogram and ultra sound which concerned me. They couldn't give me test results and I was heading down to see my sister for the weekend for a much needed break so I didn't call my PCP to ask. But, I just received my mammogram report this morning so I will post at end

In addition, my mom died from breast cancer at 74. But, since my dx was premenopausal and hers was not they didn't necessarily think it could be genetic. But. I have not went through genetic testing although I was going to last year when covid hit.

I have a 16 yr old daughter with Down syndrome who is amazing. But, I am the only parent and it is just me and her at home. I don't have time for anything like surgery, etc nor do I have anyone who could come stay with me if I needed them. So that's what Im going with, trying to stay positive because I have wasted a lot of time in my life worrying about things that never came to be. If nothing else this hiccup is a wake up call about taking care of myself. 2020 and 2021 have been rough..

Here is my report: Can anyone tell me what area of the breast it is in?

MAMMO DI MA SCRN 2D/3D (#16038409, Final, 01/14/2021 3:00pm)

Bilateral Screening Digital Mammogram with CAD with Digital Breast Tomosynthesis (3-D mammography) completed 1/14/2021.

History: 55-year-old female who is referred for screening mammography. She has no breast complaints. She has a family history of breast cancer (mother, postmenopausally). Personal history of left breast (DCIS and LCIS) in 2000 status post lumpectomy and radiation therapy.

Comparison: Mammograms dating back to 7/29/2013.

Views: Bilateral CC and MLO views were obtained. Bilateral CC and MLO Digital Breast Tomosynthesis (3-D Mammography) views were also obtained. Interpretation was assisted with computer-aided detection.

Findings: The breasts are heterogeneously dense, which may obscure small masses. Right breast asymmetry seen only in the craniocaudal projection at middle depth, medially. Left breast post-lumpectomy radiation changes are again seen. Left breast demonstrates no suspicious masses, calcifications, or other abnormalities.

Impression: 1. Right breast asymmetry seen only in the craniocaudal projection at middle depth, medially. Incomplete. Needs additional imaging evaluation and possible ultrasound. 2. No mammographic evidence of malignancy in the left breast. Recommend screening mammography in 12 months. BI-RADS CATEGORY 0 - Need Additional Imaging Evaluation Esther B. Lehmann, M.D. Radiologist Finalized 1/15/2021

Thank you!

Lisa

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Comments

  • moth
    moth Member Posts: 4,800
    edited January 2021

    the birads 0 means they didn't get enough images. They just can't see what they're looking at and that's why they want new images.

    craniocaudal means from head to foot. It's the vertical image they take of the breast, Kind of looks like a profile of the breast, taken from the side, kwim? Medially means towards the midline of your body.

    Good luck with your repeat appt.

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  • Beesie
    Beesie Member Posts: 12,240
    edited January 2021

    Bluegirl, the fact that the asymmetry was only seen on one view is good - it makes it more likely that this is an imaging issue and not actually something in your breast. Not guaranteed, of course, but most call-backs turn out to be nothing serious, and having this seen on one view only increases those odds.

    Good luck, and let us know how it goes.

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  • Bluegirl27
    Bluegirl27 Member Posts: 44
    edited January 2021

    That's good to know that it's most likely nothing bevause it's hard not to be concerned. But, if most people turn out to be normal that's good. It seems like it's better than having a focal symmetry?

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  • Bluegirl27
    Bluegirl27 Member Posts: 44
    edited January 2021

    I just got back from my follow up mammogram for the assymetry. And it didn't show up so they assume it was a summation of tissue. They were getting ready to let me go when I mentioned that I told the mammographer last time that I had felt a lump on my right outer breast within the past few months and also did feel a lump currently in area I felt that the assymetry was originally seen. So she said the radiologist said well that changes everything so we are going to do an ultrasound. The U/S tech did not find anything in the area where the assymetry was originally seen and I told her it may have been just fibrous lumps. She had me turn on my left side a little to look at the area I mentioned I felt something and she did seen a mass. Had radiologist come in and look.and he said it is a little odd, but it's small 11 mm and probably benign. He said you can either do a follow up in 6 months or if you want it would be appropriate to biopsy it as well. I said well I'd rather be proactive and find out now rather wait 6 months and find out its something. I said so you think it's probably benign but at the same time it could be cancer? He said yes. I told him that my DCIS on my other side was never seen on any mammogram but I felt the lump and they were sure that the u/s was just going to find a cyst and drain it, but the u/s found a solid mass and biopsied it and the person said they were sure it wasn't cancer, but it was. Plus my mom died from breast cancer. So they will schedule a biopsy but he said they are really backed up and probably won't be for 2 weeks. I used to go to a breast cancer Center years ago but moved to a different part of the state so this is through Michigan State University Women's Imaging Center and I wonder if it should be fine to have my biopsy done here or go back to a bigger place? I did get pictures of the screen that shows the lump. Thank you!

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  • MinusTwo
    MinusTwo Member Posts: 16,634
    edited January 2021

    Personally I'd go ahead with the biopsy where you are. You can always go to a bigger place for a second opinion if it's inconclusive or if you are not satisfied.

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  • moth
    moth Member Posts: 4,800
    edited January 2021

    Bluegirl, I agree with MinusTwo. I think it's fine to get the biopsy done there and 2 weeks isn't too long to wait. Good for you for being so proactive and making sure they really get a good look! FIngers crossed for you this all turns out to be nothing and will just give you a good baseline moving forward.

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  • Bluegirl27
    Bluegirl27 Member Posts: 44
    edited January 2021

    Thank you this really helps.

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  • Bluegirl27
    Bluegirl27 Member Posts: 44
    edited January 2021

    Thank you so much! This helps me feel better about having the biopsy where I am at. Hopefully, it's nothing, but at the same time I certainly don't feel comfortable waiting 6 months for a recheck.

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  • 2019whatayear
    2019whatayear Member Posts: 767
    edited January 2021

    It sounds like you have a great plan. Hope it turns out to be totally benign!

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  • Bluegirl27
    Bluegirl27 Member Posts: 44
    edited January 2021

    Thank you. I told the radiologist not that I have any desire to say sign me up for a biopsy especially since the biopsy I had that found my DCIS was so painful, but I just can't see waiting. I don't know how many people would choose to wait. There isn't any reason to wait, right? Might be different if I had no previous history or my mom hadn't died from breast cancer or if I were much younger (I'm 55).

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  • Bluegirl27
    Bluegirl27 Member Posts: 44
    edited January 2021

    I got a copy of my report from today and my question is if it is hypoechoic that suggests a solid, right? If so, how could it possibly be a cluster of microcysts?

    MAMMO DI MA UNI DX 2D/3D-RT (#16160224, Final, 01/28/2021 8:15am)

    Digital Diagnostic Right Mammogram with CAD and Limited Right Breast Ultrasound with Digital Breast Tomosynthesis (3-D mammography) completed January 28, 2021.

    History: 55-year-old female with asymmetry in the right breast seen on screening mammography. She returns for further evaluation. She also complained of right breast lumps. She has a remote history of left breast cancer (2000) treated with surgery and radiation. She has a family history of breast cancer (mother at age 72).

    Comparison: January 14, 2021, December 16, 2019, April 30, 2018, March 24, 2017 and November 25, 2015.

    Views: Right mL, right CC spot and right MLO spot views were obtained Right CC spot and MLO spot Digital Breast Tomosynthesis (3-D Mammography) views were also obtained. Limited right breast ultrasound was also performed. Interpretation was assisted with computer-aided detection

    Findings: The breast is heterogeneously dense, which may obscure small masses. The asymmetry seen on screening mammography does not persist on additional projections. There is duct ectasia. No dominant masses or suspicious microcalcifications are seen.

    Ultrasound of the right breast demonstrates no sonographic abnormalities in the area of previously identified asymmetry. At the 9 o'clock position of the right breast there is an oval, hypoechoic 0.9 x 0.4 x 0.3 cm mass that may be a group of microcysts.

    Impression: 1. Mass in the right breast is probably benign and may be microcysts. I discussed management options with the patient on the day of exam including short interval follow-up in six months or ultrasound-guided biopsy. Her preference is for ultrasound guided biopsy which will be scheduled. BI-RADS CATEGORY 3 - Probably Benign


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  • Beesie
    Beesie Member Posts: 12,240
    edited January 2021

    "Clustered microcysts can have fluid–debris levels or thick hypoechoic fluid containing debris within individual microcysts. The latter, a "complicated microcyst," may be difficult to distinguish from a small solid component, and core biopsy or aspiration is reasonable in this setting if there is uncertainty."

    "RESULTS. Of the 79 lesions with acceptable follow-up, all were depicted sonographically, 57 (72%) were seen mammographically, and four (5%) were palpable. Of the 13 lesions biopsied, five (38%) showed apocrine metaplasia; five (38%), fibrocystic changes; two (15%), cysts; and one (8%), a microscopic fibroadenoma and cysts. Of the 66 lesions with 2-year follow-up, 35 (53%) were stable, 15 (23%) had resolved, 12 (18%) decreased, and four (6%) minimally increased at 1 year and were then stable (n = 2) or decreased (n = 2) after 2 subsequent years. Fusion of several small cystic spaces was seen in one (2%) of the lesions followed.

    CONCLUSION. Breast clustered microcysts are relatively common, seen in 5.8% of breast sonograms. In our series of 79 lesions with follow-up, none proved malignant: Follow-up on an annual basis appears reasonable for most such lesions."

    Sonographically Depicted Breast Clustered Microcysts: Is Follow-Up Appropriate? https://www.ajronline.org/doi/full/10.2214/AJR.04.0929


    I am someone who has had breast cancer and I've gladly passed on a biopsy and waited for the 6 month follow-up whenever I've had a BI-RADs3. I think most people don't have biopsies for BI-RADs3, either by choice or because insurance won't pay for it. A BI-RADs3 means the radiologist has assessed a 2% or less chance of cancer; anything greater than 2% and the rating is a BI-RADs4 and a biopsy is recommended. For me, I've simply had enough breast biopsies - 7 of them, and that's not counting numerous fine needle aspirations - so I'm happy to avoid a biopsy if I can. And I trust my radiologist's assessment. I've had enough BI-RADs4s so I am comfortable that when my imaging is given a BI-RADs3, the risk really is very low. Every BI-RADs3 I've had has been stable and eventually resolved on it's own, with no need for a biopsy.

    There is always up to a 2% chance that a BI-RADs3 could be cancer, so of course you have to do what is comfortable for you. Good luck with the biopsy. Hopefully the radiologist has assessed it correctly and it is benign.


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  • Bluegirl27
    Bluegirl27 Member Posts: 44
    edited January 2021

    Thank you for sharing this information as well as your personal experience.

    For me, 20 years ago when I was 34 I felt a lump in my left breast. It didn't show up on mammogram, 9 months later it still didn't show up but it was palpable. The surgeon was sure it was a cyst and sent me for an ultrasound guided aspiration. Only it wasn't a fluid filled cyst it was a solid. So they did a core biopsy right then. They told me they were sure it wasn't cancer. It didn't look like cancer and I was young. It was DCIS, granted Stage 0. I have been going to the Imaging Center for a few years. I used to go to the breast cancer Center where I had my radiation, but I moved for my job. So I just met this radiologist. Not that I necessarily doubt his expertise. I feel comfortable with my decision and the radiologist did as well. I feel positive about the stats in my favor of being benign.



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  • Bluegirl27
    Bluegirl27 Member Posts: 44
    edited January 2021

    My biopsy is scheduled for February 23rd.

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  • Bluegirl27
    Bluegirl27 Member Posts: 44
    edited February 2021

    I had my biopsy today. Luckily, it wasn't painful like the one I had 26 years ago. He did a core biopsy, it's a solid, but I guess there was some fluid too. So, I should have my results tomorrow or Thursday.

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  • LW422
    LW422 Member Posts: 1,312
    edited February 2021

    Good luck, Blue Girl. My thoughts are with you and hoping for a good outcome.

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  • Bluegirl27
    Bluegirl27 Member Posts: 44
    edited February 2021

    Thank you so much!

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  • LivinLife
    LivinLife Member Posts: 1,332
    edited February 2021

    Glad the biopsy itself went well Bluegirl! Hoping this is benign for you (and for your daughter.....)!

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  • Bluegirl27
    Bluegirl27 Member Posts: 44
    edited February 2021

    Thank you!

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  • Bluegirl27
    Bluegirl27 Member Posts: 44
    edited February 2021

    I got my results and it's benign, thank God!!! They said it was PASH (Pseudoangiomatous Stromal Hyperplasia). And I can go back to my yearly mammograms as normal. Thank you everyone who reached out to me. And now that I have been through my first Birads 3 biopsy, if there is a next time I may feel more comfortable waiting.

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  • Beesie
    Beesie Member Posts: 12,240
    edited February 2021

    Great news, congratulations!


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  • Bluegirl27
    Bluegirl27 Member Posts: 44
    edited February 2021

    Thank you!

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  • LW422
    LW422 Member Posts: 1,312
    edited February 2021

    How wonderful for you, BlueGirl!! I'm very happy for you.

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  • LivinLife
    LivinLife Member Posts: 1,332
    edited February 2021

    Soooo happy for you! Thanks for letting us know!

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