Mammogram, biopsy, and mri, still don’t know..

Mandy26 · February 2021

Hello.

I’m so glad I found this place. Ive had no one to talk to about this. I’ve been trying my hardest to do some research myself. Maybe some others here might having something to add. I’m not very good at getting my words I need to say across very fast, so I apologize for the length of this.

I noticed a lump in my right breast last March. I was breastfeeding and assumed it was a clogged milk duct. So I tried for weeks to “get it out”. Then went to the doctor and he scheduled an ultrasound.

At the ultrasound, they found a concerning lump, I did a mammogram right there, and then a needle biopsy same day.

The biopsy came back and all my doctor told me is that it wasn’t cancerous, but there was some fungal in the tissue. But referred me to a surgeon. Surgeon ordered a bilateral mri with contrast.

While waiting for my second mri. I had failed one as I panicked inside it. I noticed a very clear lump in my left breast.

The mri came back and they didn’t even see the original lump in my right breast, and didn’t see anything in my left. But noticed some other lumps in my right breast (“Two linear foci of enhancement” is what the report said).

Surgeon called and just said “it doesn’t look too concerning”. I said how did they not see the lumps. They are as clear as day there, anyone can feel them. He just went, hmm can be dense breast tissue. I do have very dense breast. He ordered a new ultrasound and mammogram.

I was reviewing my image reports tonight and noticed a BI-RADS 4b score on my biopsy/mammogram report, and a BIRADS 0-incomplete on my mri. These reports say a lot of other things that is hard in the head trying to research.

But I’m all worried again tonight because I didn’t realize these BI-RADS scores and I felt I was out of the woods.

I was also on ranitidine during my pregnancy, right before it was recalled

Another thing that concerns me, is getting another mammogram. Especially with dense breast. Should I get another one in less then a year since the first one, when because of my dense breasts, it won’t be very efficient? I’ve just read too much, and had people tell me I shouldn’t get mammograms..... Help?

Thanks for reading. I’m sorry my brain is going a mile a minute

moth · February 2021

it's a very frustrating situation but I think you need to get a firm diagnosis.

I'm a little unclear about the timelines. Was the birads4b the one followed by biopsy which indicated fungal infection? Was that fungal infxn treated?

Are you still breastfeeding? It requires a radiologist familiar with lactating breasts to read imaging of breasts with active milk production. Are you being assessed at a large center? If not, consider sending images for 2nd opinion to a specialty breast clinic.

Mammograms have little risk compared to the risk of missing a cancer diagnosis. Tomosynthesis might also be an option. Repeat ultrasound and repeat MRI might also be required (these have no radiation risk).

I would suggest persisting until the diagnosis is clear and definitive.

Mandy26 · February 2021

Thank you for the reply. I’m honestly confused as well.

I am no longer breastfeeding. I stopped shortly after the the biopsy. The mammogram,ultrasound and biopsy were all done on the same day, back In May 2020. A radiologist reviews them and makes a report and sends it to my doctor, which was my gp at the time.

The biopsy says;

* Benign fibrous breast tissue only (negative for proliferative breast disease in samples).

Then that it was surrounded by fungal, but the radiologist believed it was “contaminants”. The report also noted, (unless there is a cystic structure with a fungus ball which would be very unusual in the breast).

My gp told me it wasn’t cancerous.

But at the end of this report is where it say BI-RADS4b. No one has told me about this BI-RADS score. I just discovered it last night after reading my reports. So that got me worried again. I have access to all my imaging reports. They say a lot of stuff.

They recommended referral to a surgeon for repeat biopsy or imaging. The surgeon ordered an MRI, which I did in Dec, and it didn’t even show the lump. It showed some other things and had BIRAD 0 score. Now he ordered another ultrasound and mammogram. I don’t think they don’t know what is going on.

I don’t know if we have a centre here. I just googled and it seems our cancer centre is just at our hospital. I am going to look into thermography though.

Thank you 🙏

Beesie · February 2021

I'm confused too.

You mentioned the biopsy report and then said "But at the end of this report is where it say BI-RADS4b." BI-RADS ratings are given to mammogram, ultrasound and MRI imaging. BI-RADS ratings are not given to biopsies. So was the BI-RADS 4b on the imaging report or the biopsy pathology report? And if it was on the biopsy report, was it just referring to the imaging that led to the biopsy? A biopsy result generally comes after, and over-rides, a BI-RADS rating.

The fact that the MRI didn't see a mass is good, because it means that the lumps you feel could just be normal breast tissue. Some of us have lumpy bumpy breasts.

You should not be concerned about having another mammogram - whoever is telling you to not have a mammogram is being very short-sighted. As moth said, a mammogram presents very little risk compared to missing a cancer diagnosis. And while mammograms don't always see masses in dense breasts, sometimes masses show up as irregularities in the breast tissue, and then an ultrasound can target more closely on the specific area. For everyone, and especially for those with dense breasts, it's the combination of different screening modalities - mammogram, ultrasound and MRI - that presents the most complete picture of what might be going on.

moth suggested Tomosynthesis, which is a 3D mammogram. This is not the same as thermography. Thermography is not considered reliable for breast cancer screening.

FDA Warns Thermography Should Not Be Used in Place of Mammography to Detect, Diagnose, or Screen for Breast Cancer https://www.fda.gov/medical-devices/safety-communi...

"There is no valid scientific data to demonstrate that thermography devices, when used on their own or with another diagnostic test, are an effective screening tool for any medical condition including the early detection of breast cancer or other diseases and health conditions."

Are you scheduled for the mammogram and ultrasound?

moth · February 2021

the thermography was my mistake! I meant to write *tomosynthesis* and wrote thermography instead! Sorry OP, didn't meant to send you down the wrong path!

Mandy26 · February 2021

The BIRADS 4b score is on the mammogram and biopsy report, but the biopsy report also includes the mammogram and ultrasound. I don’t know anything about any of this. But that would make sense that it is just the score for the mammogram part of the report.

Thank you, that is what the mri said about that lump, but it seems to have picked up some other concerning lumps. I probably should never have looked into those reports.. I thought I was in the clear.

Mammogram, biopsy, and mri, still don’t know..

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FDA Warns Thermography Should Not Be Used in Place of Mammography to Detect, Diagnose, or Screen for Breast Cancer https://www.fda.gov/medical-devices/safety-communi...

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