For an Appointment Call: 443-287-2778 Search  We hope you find this information helpful. This is a free service done during volunteer hours. If interested in supporting this service so it can be sustained, consider making a donation at: http://jhweb.dev.jhu.edu/eforms/form/surgery. Select JH Breast Center Education, Outreach and Survivorship Fund under the option: Please designate my gift.

Category:

Breast Imaging

Pages: [ << 1 2, 3, 4, 5, 6, 7 >> ]

Question:  #31 5/24/2009		Q:	hi.. i am 44yrs with a mother history of breast cancer and a father history of cancer pancereas. My breast imaging result was ok except for these two scentences: 1. Sonographic examination shows bilateral fibroadenosis with small cyst at the left breast located at outer periareolar region measuring 3x2mm. 2. Bilateral axilary mildly enlarged lumphnodes(most reactive. I also have adenomyosis and endometriosis asa well as fibroids....I have been bleeding for the past 5 weeks. What is your opinion? Thanks
		A:	this is the deion of benign findings. congrats.
Question:  #32 5/24/2009		Q:	L-thank you so much for your quick response. you ask if i had dense breast. yes, very. i have had dense breast and getting mammos faithfully since the age of 40 as i was on high doses of premarin since the age of 25 after a total hysterectomy. plus i have a very large seroma left in the pocket that was made for the mammo-site cath. i was told a cad mammo can''t see what is under that seroma, and that is where the tumor was!! make sense. that is why the onc wanted a breast mri. hopefully the radilologists will suggest that. the last mammo in oct 08 came back birad 3 with suggestion for breast mri immediately. that is why i had the breast mri a month later nov 08.i have not had any testing in 7 months other than blood work. my ca-27-27 has jumped up 6 points since nov 08 but is in normal range 24. thanks again for all you do.
		A:	a seroma consists of fluid though and xray can see "behind" it. hopefully you will get good news when all the tests are done. L
Question:  #33 5/23/2009		Q:	dx with idc 12/07 stage one,grade 2,pr er pos,her-2 neg.lumpectomy,rads via mammo-site cath 2x day for 5 days.ow on arimidex since 02/08. i had a breast mri in nov 2008. my medical onc ordered a f/u bilat breast mri. ins co refuses to pay-i don''t meet clinical criteria. hence, med onc ordered bilat breast mammogram. scheduled for 06/01/09. do you feel this is all the follow-up i need? i am furious that the ins co says i don''t meet clinical criteria. who are they to decide? thank you
		A:	It actually depends on how dense your breasts are. hopefully you will be getting a digital mammogram which is more accurate than the (old) analog film mammography is. the radiologist would need to be the one making the recommendation then for mri if needed. hopefully your mammo will be easy to read, low density, and not an issue that warrants MRI. L
Question:  #34 5/10/2009		Q:	Family history of breast CA. Went in for my breast MRI...mammo 6 months ago. Reads as follows:In the left breast posteriorly and centrally there is a circumscribed oval reniform mass which is slightly larger than it was on the prior study, still probably intramammary lymph node but the fact that is larger is suffieciently worrisome that 2nd look ultrasound recommended. This measures 3x7mm. Demonstrates benign enhancement. Located 10cmposterior from nipple, at approx 3:00 position. No other abnormality seen. BIRADS 0. Right breast no suspicious findings. Sent for ultrasound which confirmed MRI finding, and now scheduled for biopsy. I''m very alarmed based on family history (mother, aunt breast CA.) Does this seem like a cancer to you, and if not, what could it possibly be? Why would a node be enlarged...I have not been ill recently. Very scared!!
		A:	without the ability to see the films and also see you, its nearly impossible to guess. if they have opted to do biopsy then you will have answers soon. it would be unusual for there to be a cancerous node in that region with nothing showing up in the breast at all as a primary tumor.
Question:  #35 5/10/2009		Q:	I''m 44, after going through a biopsy last year, this year I was called back for an ultrasound for "prominent lymph nodes in the right axillia." In the same view on previous films they definitely did not appear but are definitely there now. Radiologist did u/ and said she thought they were just fatty lymph nodes and sent me on my way. Anything to be concerned about?
		A:	lymph nodes can "light up" for a variety of reasons. most of the time not related to cancer. glad they were thorough in checking them out. sounds like on closer review they were not concerned.
Question:  #36 5/10/2009		Q:	i was diagnosed with DCIS grade 2 in 2001 and underwent 5 weeks of radiation therapy. i have had regular mammograms and sonar scans, and examinations by my very knowledgeable and experienced oncologist. my problem is that after 8 years, i am still experiencing pain in my breast, and this pain is increasing. more recently i am unable to wear underwire bras, and am tender and uncomfortable. is there a more thorough form of breast imaging available. my sister who was 4 years younger than me passed away a year and a half ago with matastatic breast cancer which first manifested when she was 36 (she died at 49, i am now 55).many thanks. sheryl
		A:	request an MRI. its possible this may be some type of lymphedema of the breast or neuralgia that is demonstrating itself late.
Question:  #37 4/25/2009		Q:	Thank you for all your great information. Treated for invasive breast cancer April 2008 in left breast. Lumpectomy followed by brachytherapy. Mammogram in November clear. MRI in February shows in right breast a 1.3 x 1 cm T@ hyperintense cyst withi some peripheral enhancement. A 0.7 x 0.5 cm mass, hyperintense on T2, and demonstrates slow progressive contrast enhancement. A 5 mm mass, hyperintense on T2 and demonstrates medium plateau enhancement. A 4 mm area of non-mass enhancement. Arease "are considered probably benign." I''ll have a follow up MRI in six months. BI-RADS category 3. How much should I worry?
		A:	first, MRI isn't designed for screening... mammography is. based on deion this sounds benign. a mammogram and ultrasound would be helpful to confirm it and have you worrying less.
Question:  #38 4/20/2009		Q:	I have a 1.9cm malignant tumor that showed on my mammo and ultraound. I had an MRI, w/ and w/out contrast and they see a 2.7cm area that is suspicious. Now I have to undergo yet another biopsy this week. They believed I would be having a lumpectomy/radiation from what the 1st pathology reported. They also think that a 2.7 cm mass would have shown on a mammo /ultrasound if it was indeed malignant. I do have cystic breasts, and am afraid that the fatty tissue may have masked the 2.7 cm tumor. Any feedback??? Thanks! Theresa
		A:	MRI are sensitive and can pick up abnormalities without revealing what they are--sensitive but not specific. A biopsy is needed to determine if cysts or a cancer now that there is this finding. It's hard to wait through these extra tests, but more information will be the best thing as you move forward. deb
Question:  #39 4/20/2009		Q:	I had a breast MRI due to my high risk (dense breasts, left breast cancer, triple negative with chemo and radiation in Nov. 2006). The MRI showed an enhanced internal mammary node on the right and recommended ultrasound. My oncologist says it is nothing to lose sleep about but of course I am losing sleep until my ultrasoud. Would it be more worrisome if the node was on the left or does it matter? I feel great - mammogram in Oct. was fine, ultrasound last March was fine - seeing oncologist and surgeon every 6 months for tumor markers and breast exams. How concerning is this finding? Thank you.
		A:	I agree with your doctors, don't lose sleep over it! It could be something or nothing and there is no way to predict based upon the current data. Beating breast cancer also means winning psychologically and not letting every little bump take over your every thought. It's not easy of course, but living in fear isn't really living. Best of luck to you.
Question:  #40 4/11/2009		Q:	Hello Lillie, I am being scheduled to have a PEM biopsy for 4 lesions that all came back with a birads rating 4 after having a PEM mammogram however, nothing showed up on digital mammogram and when an ultrasound was ordered to try to do biopsy that way nothing showed up there either. How can that be? Also, how is the test performed and how long does it take to get results as I have to travel over 3 hours to the facility for the test. Thank you for all your help.
		A:	there is no imaging study that shows 100%, thus the need for this variety of different imaging studies to evaluate you. PEM is like a breast MRI. will take about an hour to do. the doctor has to tell you their specific turn around time for results because that is facility specific.no standard of that.
Question:  #41 3/29/2009		Q:	Hello Again Lillie, Thank you for your answer to my very long question concerning two recent PEM exams. I did have a wire localization for my Aug 08 biopsy and the pathology report said that the three lesions were removed along with the wire and hook. Additionally, an x-ray was done to confirm that the specimen contained all lesions seen on PEM. That said, how could this new PEM just 7 months later have the same lesions?? This is where I am confused, also, in your opinion is the new lesion with a 4.22 lesion-to-background uptake indicative of a malignancy – I have read that the standard threshold for malignancy is greater than 2.5. Thanks again as you are the only person to even listen let alone answer my questions. I cannot express to you how appreciative I am for who you are and what you do!!!
		A:	I'm confused too! either the specimen xray was wrong, or this new PEM is wrong. either they missed the lesions surgically or someone is seeing something else on imaging. consider taking the films (all of them- both PEMS and the wire loc specimens)to another breast imaging radiologist for another reading. LS
Question:  #42 3/29/2009		Q:	Hello Lillie, I am hoping you can help me sort out what is going on. I had a PEM in Aug ’08 recommending surgical biopsy that resulted in a diagnosis of ADH. I just had a follow up PEM 3/09 and am now totally confused (also had digital mammogram 1/09 that came back fine). The radiologist is the same on both reports, they are as follows: 8/08 Findings -Within the left breast there are two subcentimeter foci of moderate to intense FDG uptake identified. One of these is located in the retroareolar region about 3 cm posterior to the nipple and measuring 6.0 mm in size. It shows a lesion-to-background uptake ratio of 3.09 placing it into a suspicious category by PEM criteria. There is a second focus of avid uptake measuring 5 mm in diameter located in the 6 o’clock position of the left breast slightly inferior to the nipple axis, approximately 9 cm posterior to the nipple, with lesion-to-background uptake ratio of 2.80, also placing it into a suspicious category by PEM criteria. In addition to these two nodules, there are some additional smaller punctate foci of FDG uptake located within the lower inner quadrant of the left breast inferomedial to the more posterior nodule. Impression- 5mm focus of avid uptake in the 6 o’clock left breast slightly inferior to nipple axis, 9 cm posterior to the nipple, which is considered suspicious by PEM criteria. Its location correlated approximately with the nodules on mammogram. Would recommend that these mammographic nodules and some surrounding tissue be surgically excised, since their location does seem to correlate fairly closely with this focus of abnormal FDG uptake. 3/09 Findings:Within the left breast, the two subcentimeter foci of FDG uptake seen previously are again demonstrated. That within the retroareolar region approximately 3 cm posterior to the nipple has a relatively stable appearance with approximate measurement of 5x6 mm and lesion-to-background ration of 2.63 as compared to 3.09 previously. The other focus seen previously located approximately 9 cm posterior to the nipple and just inferior to the nipple axis also measures about 5x6 mm with lesion-to-background ratio of 2.85 as compared to 2.8 previously. Faintly seen now within the inferior left breast at about 6 o’clock, also approximately 9 cm posterior to the nipple is a 4x5 mm focus with lesion-to-background of 2.20. This was faintly visible in retrospect on prior scan at which time it had a lesion-to-background ratio of 1.20, thus its uptake now is more intense than before. In addition to the above three lesions that were present previously, there is a new nodule at 6 o’clock left breast centered approximately 2 cm inferior to lesion #2 described above. This new nodule is 7x8 mm in diameter with lesion-to-background uptake of 4.22. Impression – (1) The same two nodules described on the prior scan from 8/08 remain, including the retroareolar nodule and the central left breast nodule located approximately 9 cm posterior to the nipple, both of these are approximately 5x6 mm in size. The lesion-to-background ratios of both nodules remain with the category regarded as suspicious. (2) A third small focus about 4x5 mm in size faintly seen in retrospect on the prior scan but with some interval increase in avidity of uptake with current lesion-to-background ratio of 2.20 as compared to 1.20 previously. (3) A new lesion is seen in the left breast approximately 2 cm inferior to the above described lesion located 9 cm posterior to the nipple. This new lesion is 7x8 mm with rather intense lesion-to-background ration of 4.22. (4) Given the fact that all 4 of the above described subcentimeter nodules fall into a suspicious category based on their lesion-to-background uptake ratio, the possibility of multifocal breast malignancy is not excluded although it is still possible these could be secondary to multiple papillomas. (5) I recommend attempting a second look ultrasound to see if there is a lesion or lesions that would amenable to ultrasound guided core biopsy. If that is not the case, the next option would be pursuing PEM guided biopsy at a facility having that capability. What I don’t understand is what was surgically excised in 8/08 that diagnosed the ADH if the new report still see it? Also, if 2.8 ratio of lesion-to-background uptake is considered suspicious and resulted in ADH, does the new 4.22 ratio of lesion-to-background uptake seem more likely to be a malignancy? And lastly, if 4 lesions are showing with suspicious uptake, how does trying to do an ultrasound guided biopsy of at least one lesion help diagnose what is going on with everything found? Please let me know what you think as I have not been contacted by my doctor yet and do much better when I know all the facts and what they mean. Thank you so much for your time, and expertise, you are such an angle to give so much of yourself to everyone that comes here for your help. I hope you are well and have a great weekend!
		A:	It does sound like the areas intended for surgical removal last year weren't removed. Am not sure what area they did take out! ultrasound is the next step though-- now that PEM tells them exactly were to look they can probably do a core biopsy of several of these areas and see what they are. if any found to be cancer, then anticipate that the others may be as well. Also, inquire if they took any images of the specimen they removed last year before it was sent to pathology. did they do a wire localization procedure to find it before taking you to the operating room too. if you need us you are welcome of course to come to us for these procedures and further help. LS
Question:  #43 3/9/2009		Q:	Hello Lillie, I had my 6 month diagnostic digital mammogram done and was wondering why all of my last reports (I have had a ton of mammograms over the years due to pappilomas etc) state "Patient has extensive nodular breast parenchyma density" and this last report said nothing at all other than everything is stable. Could my breast tissue all of the sudden become normal in appearance (in six months)? Could there be any way that the images were not viewed and reported correctly? I always worry as I have an extensive family history of b/c and I was diagnosed 8/08 with ADH. Thank you and have a great weekend!
		A:	One possiblity is that this is the report from a different radiologist then previous. ds
Question:  #44 3/9/2009		Q:	Hello, i''ve had a surgical biopsy done amost 6 yrs. ago, which thankfully came back neg for bc. My question is, since then my gyn always orders diagnostic mammograms. Last year because i didn''t have Ins. any longer i went ahead and had a regular baseline mammo done through a community mobile unit that was free. I now am experiencing a sensentive painfull spot for a few months. Was that a big mistake? I heard that once you have a biopsy i will always need diagnostic mammograms? is this true?
		A:	Not always true, but it is true that if you are at risk, you should have careful and close follow up.Please do everything you can to maintain vigilance in your breast cancer screening.
Question:  #45 2/28/2009		Q:	Went in to see my Breast Surgeon for results of annual mammo, they advised that the found a small (5mm?) area of density on my left breast that was new. They did US at office but could not see anything except for a new cyst in different part of my breast. Sent for spot compression and another US the next day. The US tech could not find area of concern and clled in the radiologist. He stated that the area could be clearly seen, he also did US but unable to find the area, just the new cyst. Radiologist is advising that I get an MRI now. I was a little stunned and did not ask any questions at the time. I am 50, post menopause, with dense breast, have had 2 biopsys of right breast that were benign, and no family history of BC. With this limited information, can you advise how concerned I should be?
		A:	I wouldn't fret yet. and its not that unusual for ultrasound to not see something there (or for mammo for that matter to not be 100% either.) so makes sense that next step is MRI.
Question:  #46 2/21/2009		Q:	I have a palpable lump that has not presented on digital mammogram, ultrasound, or MRI with contrast. It was described by a surgeon as "not having discrete margins." What is the best course of action regarding this mass, and it is possible for all of the images to miss an early-stage cancerous lesion in dense tissue?
		A:	when something is palpable then it can be biopsied in ultrasound more than 90% of the time. not sure why it isn't showing on any imaging. if you can come our way, do. 443-287-2778
Question:  #47 2/21/2009		Q:	45-year old Asian. Noticed a lump in right breast last Sept and had mammogram and ultrasound done while in China. Mammogram negative, but ultrasound showed a lower echoic solid nodule with irregular margin and a little blood flow signal. The ultrasound report suggested biopsy but general surgeon suggested I wait and do same tests in 6 months. Since I felt the lump growing, had another set of mammogram and ultrasound done in US this past January. Mammogram again negative, but ultrasound said "There is a 1.5 cm hyperdense solid mass with multiple finger-like projections at 10 o''clock corresponding to the clinically palpable lump. This is most worrisome for malignancy. Biopsy under ultrasound guidance is needed" By the time test results came, I had returned to China for work. Because the language was so alarming, I went doctor in China right away and had two additional ultrasounds and MRI done. Regarding the same mass, one report said "an uneven and low echo mass was found in right breast about 10 to 11 o''clock, 25*12mm, picture ratio 2.08, clear boundary, irregular shape, echo decrease on posterior side, calcified spot was detected, blood flow signal was found in the mass and peripherally." The other report said "A low echo lesion was detected on the upper right breast, 29*13mm, irregular shape, unclear boundary, no capsule, uneven ultrasound, blood flow signal can be detected." The MRI report states "a lobular mass was detected in right upper breast, clear boundary, no burr signs, the biggest mass was 16*23mm, low T1w and high T2w, high signal was detected when weighted imaging, ADC:0100145." All the doctors there indicated that this appears malignant, but apparently in China they skip biopsy and go direct to surgery, and they are discussing mastectomy with me. Needless to say, I was very alarmed and flew back to US for vacuum-assisted ultrasound guided biopsy. The final diagnosis for the right breast mass was "consistent with benign fibroadenoma. Multifocal ductal hyperplasia without atypia." QUESTIONS: 1) From everything that I have read about fibroadenomas, they show up on mammograms, are round/oval, clear boundaries, etc. Could a fibroadenoma NOT show up on any mammogram, have "finger-like projections", low echo, and blood flow signal, which are all alarming characteristics? 2) How accurate are vacuum assisted, ultrasound guided core needle biopsy? Should I ask for second opinion on the pathology results? 3) When should fibroadenoma be removed? I have been advised to wait six months and follow-up with another set of mammogram and ultrasound. Within the span of 2 weeks, I have gone from "most worrisome for malignancy" to scheduling for mastectomy to "consistent with benign fibroadenoma" and nothing needs to be done. Should I be rest assured now with the pathology results? Thanks so much!
		A:	My goodness, what an ordeal. The deions on the images do sound like cancer. vascular. irregular edges. worrisome appearance. The biopsies of course sound quite different. several things come to mind.1) did they do some type of quality control to ensure what was intended to be biopsied WAS the correct area? 2) did they place clips where they removed the tissue at time of biopsy? 3) have they re-imaged you since the biopsies? 4) the presence of atypical cells carries a 30% risk that breast cancer is infact there. Don't rush into mastectomy. you were right to delay. address the questions above and also consider having the pathology re-reviewed at anothr center by a breast pathologist. do you want to come our way call 443-287-2778. We are happy to help you. LS
Question:  #48 2/14/2009		Q:	Hi! Ive been waiting 1 month to have biopsy since MRI read bi-rad cat 4 spiculated mass suspicious of cancer. Short story after waiting that long a different radiologist read it and said he thinks its glandular tissue and didnt think I needed biopsy so cancelled biopsy without informing my surgeon who ordered it. Needless to say my md did re-schedule me for biopsy now waiting another 2 weeks. Does/can glandular tissue look spiculated?? have you heard of that before. Plus I have ext family hx of brst ca.
		A:	spiculated is a very specific term and one that carries a worrisome connecting to breast cancer. glandular tissue doesn't look spiculated. sounds like there may have been disagreement about whether it was truly spiculated in its appearance or not. really sorry you are waiting so long for answers. LS
Question:  #49 2/14/2009		Q:	Hi there. I had a mammogram done and got the report back today. My GP is away til Feb. 18th and I would really like to know what it means. I''m worried. Scattered fibrograndular densities noted in both breasts. The inferior aspect of the right breast shows an area of focal asymmetry (not seen on the CC view). No microcalcifications or architectural distortion noted in either breast. The patient is being called back for spot compression views of the right breast with ultrasound of the right breast. INDICATION: Screening LESION: Asymmetry DENSITY: 2 BIRADS: 0 Is this something I need to worry about? Can you please explain? Thank you in advance, I truly appreciate your time. Many thanks.
		A:	it would truly be premature to worry yet. they saw some density. might even be breast tissue compressed on top of itself. so don't panic. it would truly be premature. 80% of the time on re-imaging you they will find that it was nothing of concern. it's good that they are thorough though. LS
Question:  #50 2/9/2009		Q:	I just turned 41, had my first mammogram at 35 and was diagnosed as fibrocystic. Just had digital mammo (my second) and was called back for additonal imaging b/c mammo considered incomplete - no other details given to me. My left breast has always been more lumpy, painful, and I have had pulling sensations and pin prick sensations that I assumed were due to being fibrocystic. No family history, no children. Is a callback with a digital (this would be the second digital at that clinic) something to be more alarmed about? Thanks so much....
		A:	A call aback is not reason for alarm. It could be done for a suspicious finding or for a technical reason or to document a finding looking for future changes. ds
Question:  #51 2/9/2009		Q:	Can you explain what it means when MRI report reads rapid peristent enhancemet and no wash out enhancment?? What do you typically see if it is cancerous?
		A:	In some cases, this enhancement describes possilbe cancer diagnosis. MRI guided needle biopsy may be next step. ds
Question:  #52 2/1/2009		Q:	I have been diagnosed with stage 2b IDC. Over the years the breast surgeon and the radiologist have been claiming my calcifications were "benign" as we have been following them for a few years. It turns out they were not benign at all and were, in fact, a 3 cm tumor and a 1.5 cm tumor. Now the cancer is in one lymph node as well. I can''t help but feel like they misdiagnosed me or at the very least should have biopsied the calcifications a few years ago. I am mad. How do people move on when they feel like they were hurt?
		A:	some don't and pursue things legally. others request that their case be used as a teaching case for the future. and still others will say "I can't do anything about the past. It will just drag me down and take my focus away from moving forward with my treatment." you need to decide which of the three you want to be.
Question:  #53 1/31/2009		Q:	48 yrs old perimenopausal Diagnosed idc Feb4/08. 1.6 cm, Grade 1,Stage 1, snb neg,er/pr pos.,HER2 neg.,Oncotype Score 17,Excisional biopsy Dec18/07,Lumpectomy March14/08 to obtain clear margins, radiation 16 plus 4 boosts finished July/08, on tamoxifen since Aug/08. First mammography after rads ended was done on Jan.15/09. Results: On magnification views faint elongated cluster of pleomorphic calcifications within the upper central portion of the left breast, in the region of the lumpectomy. It is uncertain whether these represent residual or recurring calcifications. These could be further assessed with a stereotactic core biopsy.(This is what the radiologist that did the mammography suggests but my surgeon and her radiologist are suggesting to wait 6 months and repeat mammography. Who''s right ???
		A:	given history of breast cancer, most would steer you toward doing a stereotactic biopsy now.
Question:  #54 1/24/2009		Q:	Due to family history of premenopausal breast and ovarian cancer (sister 28, grandmother 42), I had a screening breast mri (my first)after a mammogram showed probably benign calcifications. I am uninformed BRCA 1/2 (no one else in family has tested yet) MRI results showed: There is a 1 cm irregular mass with an irregular margin in the right breast at 12 oclock anterior depth. This shows heterogeneous enhancement and medium initial rise and delayed washout type vascular enhancement. There is a 1.3 cm irregular mass with an irregular margin in the left breast at 12 oclock middle depth. This shows medium initial rise and delayed persistent type vascular enhancement. There is also a 3 cm segmental area in the left breast at 6 oclock middle depth. This shows heterogeneous enhancement and medium initial rise and delayed persistent type vascular enhancement. There are also scattered subentimeter areas of persistent contrast enhancement seen throughout both breasts which likely represent fibrocystic changes. Area of calcifications from mammogram shows no enhancement. I was referred to a breast specialist/surgeon who told me nothing except that they would do an ultrasound guided biopsy. Ultrasound couldn''t locate anything. Radiologist indicated in report out to me that she thinks I''m fine and not to worry but that I could elect mri biopsy. I''m concerned about the irregular shape of the masses. Does this warrant further testing or is the high rate of mri false positives and the fact it didn''t show up on mammogram or ultrasound enough? Thank you for your response.
		A:	given family history and that the findings have irregular edges, i'd recommend considering that you pursue this now. not later. digital mammography might be helpful too. LS
Question:  #55 1/23/2009		Q:	37 y/o with sig. family hx. Had baseline MRI done 1/13/08 BIRAD category 4. 1cm spiculated abnormality in upper outer quadrant of let breast. Morphology is suspicious of carcinoma. exhibits rapid persisment enhancement with. No washout enhancement. Can you explain that in english please??? Mother just had bil. mastectomy with reconstruction in June 2008. MD plan is mammogram, US and if able to visualize spot do us guided biopsy. If unable to see spot MRI guided biopsy plus MD wants to do open biopsy.
		A:	oh my... based on what you have written as the deion this sounds like a birad 4b. so highly likely this is breast cancer. if you can come to us, do... should be able to be done in mammography as a stereo or core biopsy. your family history ups those odds. might even be time to consider genetic testing for you and mom. call 410-955-7288 and sharon will help you get films read here and onto our biopsy schedule if you wish. hang in.. L
Question:  #56 1/17/2009		Q:	How common is it to get a call back (3-6 months) after your first mammogram? I am 40 and the mammogram showed dense breast tissue.
		A:	about 50% of women will get a call back at the time of their first mammogram. remember they have nothing to compare it to, so am not surprised by this. don't worry... would be premature to do so .LS
Question:  #57 1/17/2009		Q:	I am 42 yrs old no family history of bc, I recently went for my yearly mamogram, and received a letter stating I would need further evaluation. When I called they informed me I needed to speak with my doctors office that they do not give out that information on the phone. After speaking with my doctors office they advised that Advanced Radiology wants to to some spot compressions with US if necessary to take a better look at area in left breast. The nurse at my drs office said that when she hears spot compression it indicates to her that they did not get a good picture and generally nothing more than that. I am very small chested if that makes a difference, however the facility recently switched to digital and advised me that the new technology helps eliminate the need for call backs because of the new computer technology. Does digital reduce the number of call backs? Is it difficult for the radiologist to review last years films vs. this years digital pix? I have been having ri b and back pain on left side since July can pain like that be related to the breast? I''m sure my imagination is working overtime here but my co-worker/friend was just dx with ductal cancer. Stage has not fully been determined yet, however in the three biopsy sites they did all three had cancer cells and lymph nodes under the arm are enlarged and noticeable to the naked eye. She will be seeing surgeon on Tuesday to go over options and form a plan. Thanks for taking the time to calm the nerves and provide strength and support to so many. G
		A:	your brain is no doubt in overdrive... digital is superior to analog film mammography. yes. and you are correct in thinking that due to your previous images not being digital it makes it harder to do a comparison. the first digital you have can result in quite a few call backs because they are seeing more than they saw before. so i'm not surprised you are being requested to return. get the additional spot films that will help them look in more depth at what was probably an area of density that needs further, closer inspection. i would not be assuming that your other aches and pains are in any way related. LS
Question:  #58 1/12/2009		Q:	I had a Breast MRI. Report from Radiologist follows: Impression on report reads: "There is an abnormal enhancing spiculated lesion in the posterior aspect of the right breat. Review of the patient''s mammogram show no suspicious lesion on the mammogram. The patient had slightly concerning calcifications in the left breast and a negative ultrasound left breast. MRI of the left breast is unremarkable. At this point ultrasound of the right breat is strongly recommended to corroborate with the abnormal finding in the posterior aspect of the right breast on today''s MRI scan. Specifically I am concerned about a malignancy in the posterior right breast." On the MRI Breast Quantative Analysis, the Impression reads: "Suspicious appearing tissue washout curve involving the enhancing lesion in the posterior aspect of the right breast. Ultrasound is strongly recommended. Tissue biopsy will probably be necessary. I am scheduled for an Ultrasound and needle biopsy on Thursday - if that is unsuccessful, then will have MRI guided biopsy. How concerned should I be that this is truly a malignancy. Could this be a false positive. I am 53 yr. old. female, no children, do not smoke or drink. Thank you for your response.
		A:	At this point, the finding is stated as suspicious. The deion of a spiculated lesion describes how some cancers look on imaging. A biopsy will give definitive diagnosis. ds
Question:  #59 1/12/2009		Q:	Hi Lillie, Could you tell me how likely it is for a mammogram to miss a palpable mass? I had a digital mammogram last Monday and the radiologist said everything looked stable and that nodes showed up but continued to look the same as in previous films. An ultrasound was also ordered by my doctor and I noted on the paperwork and told the tech about a palpable area but he refused to do the ultrasound. My concern is that I was diagnosed with Atypical Ductal Hyperplasia after a surgical biopsy in Sept. 08 and I have a family history of b/c (mom). Would you feel comfortable with just the mammogram results? Thank you and I wish you a happy healthy New Year.
		A:	A palpable mass needs to be evaluated including a breast exam by doctor, mammogram and ultrasound for imaging to start. ds
Question:  #60 1/11/2009		Q:	I am 40 yrs with no history of cancer and had my 2nd mammogram done. the report says: breast tissue is heterog. dense and along the posterior lateral aspect of the left breast there is oval density with cleft like area of decreased attenuation along anterior border. not seen on prior exam. may be due to positioning. not appreciated on MLO projection. remainder of patterns stable. they are recommending add''l lateral medial spot compression of teh posterior lat. left breast with nodular focus. I did not expect this and am quite shaken by this?? can you please say what this means?
		A:	It sounds like you need additional views to complete the imaging. This density could be due to positioning of breast rather than anything else. Also the density is not seen when the films were taken from side to side, only when take from top. It is not uncommon to have extra films taken to complete the imaging. ds