24F Ultrasound showed BIRADS 4a Very Worried
I have no family history of breast cancer, but I started self checking last year because I did 23andme and it came back that I am super high risk for breast cancer because I have mutations in the FGFR2 and TNCR9 genes. I got them from my dad who doesn’t have a sister.
I never felt anything during my self checks, but now have a lump that I can only feel laying down. My OB/GYN said it was moveable. It didn’t hurt before but it hurts a little bit all the time now after being touched several times.
I had an ultrasound and was shocked that it said it’s 9cm?!?! How can it be moveable if it’s that big? I am 5’5” 107 lbs so you can feel my ribs.
I have a biopsy on Thursday and am so scared. I just got married 3 weeks ago. How worried should I be? I know at my age cancer is very rare, but the size of the mass and the rating of BIRADS 4a is not making me feel good.
IMPRESSION:
Palpable finding 4:00 position right breast measuring 3 cm in long axis. Ultrasound-guided biopsy is recommended.
Incidental note made of 1.1 cm long axis solid nodule in the at the 1:00 position in the right breast. Six-month follow-up ultrasound recommended.
Results of this exam discussed with the patient following completion the study.
BI-RADS Category 4A: Suspicious: Low suspicion for malignancy. Tissue diagnosis is recommended.
Narrative
EXAM: US BREAST LIMITED RT
CLINICAL STATEMENT:
Lump or mass in breast,
COMPARISON: None available.
FINDINGS:
Palpable area right breast. The 4:00 position 5 cm the nipple, there is a 3 x 9 x 2.4 cm dimension solid mass. This is well-circumscribed with long axis paralleling the skin surface. Ultrasound-guided biopsy of the palpable finding is recommended Incidental note is made of a second solid mass at the 1:00 position 3 cm the nipple. This measures 9 mm x 11 mm x 4 mm paralleling the skin surface with low-level internal echoes. This has a probably benign appearance. Six-month follow-up ultrasound for this finding is recommended
Comments
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Hi. I hope all works out well for you. It should but I certainly understand the worry. A 4a birads is a low percentage that your lump is cancer. Let us know how it goes. I hope this helps:
Findings do not definitely look like cancer but could be cancer. The radiologist is concerned enough to recommend a biopsy. The findings in this category can have a wide range of suspicion levels. For this reason, this category is often divided further:
4A: Finding with a low likelihood of being cancer (more than 2% but no more than 10%)
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4A is literally the lowest that the radiologist can assign and still have a biopsy covered by insurance.
For too long, too many doctors poo poo-ed young women with lumps because of how rare breast cancer is in young women. This made no difference for most women, but all the difference in the world for those unlucky young women whose cancer went undetected too long.
Whatever combination of genetics and scanning is making your doctor send this for biopsy, I'm glad that they are taking this seriously even though you are young, and given the 4A rating, it sounds like it's clearly a better safe than sorry situation. Your doctor does not actually think it is cancer, and the biopsy is to rule it out for certain. It literally says benign appearance.
I read that report as saying the finding is 3cm from the nipple, and that its size is well under 1cm (9 mm x 11 mm x 4 mm).
Biopsies are always nerve wracking, but based on everything you've said, it seems like the most likely outcome is that you'll have some good baseline scanning that will come in handy for future screening.
Hang in there!
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Hi, thank you for your reply! The 1cm lump was an incidental benign finding and they aren't going to biopsy it. If you read the top part of the report the lump that they are biopsying is 3cm x 9cm x 2.4cm.
Thank you for your reassurance! I hope it's nothing and as you said due to my age it's most likely to be benign but the size has me concerned.
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Please keep us up to date, and know we're all here for you. Congratulations on your marriage! What a beautiful milestone. Let us know what you find out!
Warmly, The Mods
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Thanks for correcting me and sorry I misread! Hoping for a good outcome for you!
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I agree with the others on BIRADS 4 being low risk for cancer though a necessary minimal rating for biopsy. BIRADS 4 bopsies typically comes back benign in 75-80 % of cases... I hope that's the case for you! They are keeping an eye on other areas which is good too. Obviously if anything changes let someone know soon after. Please let us know how the biopsy goes and once you hear about results..... Ice, ice, ice....
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