Bi Rads 5 and biopsy scheduled tomorrow
I am a 33 year old female . I’ve been spiraling out of control since I got my diagnostic mammogram and ultrasound results in last Thursday. A little background information, I had a cyst in 2021 in my left breast that came back benign and was drained out. January of this year I felt the lump come back in the same breast so I went to my doctor and had an ultrasound which the doctor told me looks like simple cysts and to not worry. Now beginning of this month I started getting some discharge from that nipple and pain and discomfort so I went back and they suggested the diagnostic mammogram. They also did a hormone test and it came back that my prolactin levels are extremely elevated. I am not breast feeding or pregnant so not sure why those would be high. I got my diagnostic mammogram last week and these were the results. I’m just very nervous and I have no family history of breast cancer and am just hoping that it’s something else :( . Anyone have a similar situation and can shed some light ? I can also use some positive words as I get ready for my biopsy tomorrow .
FINDINGS:
BREAST COMPOSITION: The breasts are heterogeneously dense, which may obscure small masses.
No suspicious masses, architectural distortion, or significant calcifications are detected in the right breast. In the left retroareolar and extending medially there is a 6 cm area of branching dilated ducts with extensive suspicious associated calcifications. This corresponds to the region of palpable concern. This is suspicious for carcinoma. There is an additional 5cm area of asymmetry noted in the central upper left breast at the approximate 12:00 position 6 cm from the nipple. However this area appears less apparent on spot compression views. No definitive mass identified on spot compression views.
BREAST ULTRASOUND:
TECHNIQUE: Complete bilateral breast ultrasound, with evaluation of the four quadrants, retroareolar regions and axillae, was performed.
FINDINGS:
Right breast:
1:00 position 2 cm from the nipple measuring 0.2 x 0.2 x 0.2 cm. Cyst.
9:00 position 8 cm from the nipple measuring 0.2 x 0.2 x 0.1 cm. Cyst.
9:00 position 8 cm from the nipple measuring 0.3 x 0.3 x 0.2 cm. Complicated cyst.
12:00 position 3 cm from the nipple measuring 1.2 x 1.00.6 cm. Cyst.
12:00 position 3 cm from the nipple measuring 0.7 x 0.7 x 0.4 cm. Cyst.
2:00 position 9cm from the nipple measuring 0.7 x 0.4 x 0.2 cm. Complicated cyst.
3:00 position 4cm from the nipple measuring 0.6 x 0.6 x 0.2 cm. Complicated cyst.
Extending from the retroareolar posteriorly at the 9 and 10:00 position extensive ductal dilatation is noted with internal echoes and extensive calcifications noted. This is believed to correspond to the branching ducts and calcifications identified mammographically. This corresponds to the region of palpable concern. This is suspicious for carcinoma.
No definitive sonographic correlate to the large area of asymmetry identified in the left breast at the 12:00 position mammographically which may represent asymmetric glandular parenchyma.
IMPRESSION: Extensive at least 6cm area of dilated ducts with extensive abnormal calcifications identified in the left breast which extends to the nipple at the 9 to 10:00 position spacious for carcinoma. This correlates with the region of palpable concern. Stereotactic biopsy is recommended for definitive histologic diagnosis as this modality is best suited to sample the calcifications. A single site biopsy may be performed as this would be representative of the entire area.
The precise location of the stereotactic biopsy should be determined by the radiologist at the time of the procedure.
Asymmetric parenchyma is noted in the central upper left breast mammographically which appear less apparent on spot compression views without definitive sonographic correlate identified. After biopsy results are reviewed MRI of the breast with contrast should be considered to evaluate for full extent of disease and ensure no underlying additional areas of concern.
FOLLOW-UP: Stereotactic biopsy.
Critical results pathway was initiated and the referring physician/physician's office will be notified of the findings and recommendations by the critical results team.
The patient was notified of the findings and recommendations at the time of exam.
ASSESSMENT: BI-RADS Category 5: Highly suggestive of malignancy.