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, 8 >> ]

Question:  #61 1/12/2009		Q:	I am 37 yr old with grandmother dx OC @ 42 and sister dx BC @ 28. Recently I had a screening mammogram which came back showing a cluster of microcalcifications. Recommendation was follow up in 6 months. Due to family history I was given the option to have a yearly screening breast mri and elected that option. My OBGYN just called with those results showing a 1 cm irregular mass in the right breast indeterminate, a 1.3 cm mass in left breast indeterminate and a 3 cm area also in left breast which looks fibrocystic but also marked indeterminate. The OBGYN has referred me to a breast surgeon. Would ultrasound or biopsy be the next logical step and is the fact that there are multiple masses significant in any way?
		A:	You are right, an ultrasound and biopsy of both sites would be next. You have a significant family history. Has your sister been to genetic counseling? That might also be consideration providing information for you as well. ds
Question:  #62 1/4/2009		Q:	I am 59 and just had my yearly mammogram, findings were BI-RADS category 2-benign, but recommend MRI due to family history, also have scattered fibroglandular densities. Had lumpectomy in 1987-no cancer. Why are they recommending MRI, it cost $3,500.00 and my insurance won''t pay for it, heck they won''t even pay for a screening mammo. Thanks.
		A:	i don't know why given you technically don't qualify to have one based on what you wrote. clearly your insurrance company agrees that there is lack of medical necessity for you to have it done too.
Question:  #63 1/3/2009		Q:	i,m the 1 that askd abt vascularity forgot to ask if papillomas can have this
		A:	usually not.
Question:  #64 1/3/2009		Q:	when a mass shows a focus of vascularity along its dependant border what does that mean/
		A:	that it might have a blood supply increasing the risk of it possibly being malignant.
Question:  #65 1/3/2009		Q:	I had a right breast mastectomy 12-19-07, reduction of left breast to match right, and free flap reconstruction for DCIS stage 0 located through out my ducts. No clear margins after 3 lumpectomies. I was estrogen positive and take Evista. Family history of BC maternal and fraternal as well as fraternal males with prostate cancer. My breast surgeon wants me to have an MRI of my left breast every 6 months my insurance has declined insisting every year is medical standard. How can I get them to change their mind when I appeal their decision?
		A:	actually, the insurance company is correct. no need to do MRI every six months. annually is fine. some do mammogram then 6 months later mri, then 6 months after that mammo.
Question:  #66 1/2/2009		Q:	I had breast cancer 1/08 and went back for mamo and ultrasound 12/08 -they could not get a good image they said and that the area was poorly defined-non palpable and the leison was approx 3 inches- referred to surgical biopsy with wire needle localization- what exactly can the Radiologist see? can the mamo and ultrasound give them a pretty good idea if it is malignant-they referred me to a surgical biopsy- a BIRAD 4/5 on the reading..can they tell from enhanced imaging if this thing is benign or malignant are there markers that lead them to believe this is cancer?
		A:	not being able to see your imaging it is hard to guess here. 80% of the time though mammo and ultrasound will tell them pretty clearly what is going on. a bi-rad of 4/5 is worrisome. a 5 implies they do anticipate it being cancer. i'm befuddled why they aren't doing a core biopsy first in breast imaging though to determine this. if it is close to the chest wall then that may be a reason. but ask.
Question:  #67 1/2/2009		Q:	Age 58. Mother, paternal aunt, maternal aunt all had breast cancer, significant cancer history in family. Benign biopsy 1992. Digital Mamm 12-19-08 Asymmetric nodule right breast seen on cc view. 12-26-08 Spot compression CC MLO ML: breast tissue is mostly fatty with scattered fibroglandular elements. Previously described focal asymmetry medial rt breast is less apparent. US medial aspect right breast and lateral aspect right breast demonstrate no sonographic abnormality. 6 month follow up recommended. I am not comfortable waiting 6 months -- how can we get this biopsied now. What is my next step?
		A:	Take your films to another radiologist who specializes in breast imaging for a second opinion reading of them. if he/she agrees that this looks okay then have faith it does. the key is having a breast imaging radiologist do this review. (someone who just does mammograms...)
Question:  #68 12/19/2008		Q:	I am 54. Had digital mammogram done 10/20. Technician told me not to be surprised if I got called back because the new digital mammogram "read funny". Sure enough a week later I was back for dx mammogram and ultrasound. My original findings were: Scattered fibroglandular density both breasts. No apparent suspicious calcification or adenopathy. Asymmetric density in the medial left breast on the craniocaudal view appears to represent a change from earlier exams. After the dx mammogram the findings were: The asymmetric density seen in the medial left breast on the craniocaudal view on 10/20/08 is not as prominent on the additional images. It is not visualized on the 90 degree lateral view. It is not visualized on some of the rolled views. This may represent superimposed vessels. The asymmetric density identified in the medial aspect of the left breast is smaller on the additional views. Ultrasound findings: There is no evidence of mass or cyst. No sonographic abnormality is noted medial aspect of the left breast. The radiologist spoke to me and explained to me why he kept me for 3 hours (yes 3 hours) taking compression after compression mammograms, to make sure what he was looking at. He told me the more xrays they took, the clearer it became that it was vessels. Told me an MRI might be helpful to get a clearer picture, but if not, get another mammogram in 6 months. When I received a follow-up letter, he gave me BIRADS 0. I thought that after I had the diagnostic and ultrasound, that a number other than 0 would be given. I took all my film to a breast surgeon. She said she had no problem looking at my films, she could see clearly. She said it was nothing but since it''s on some films and not others, I should have MRI. Then in the next breath she tells me MRI have a high percentage of false positives. My insurance will not approve MRI "based on clinical findings". Would like your opinion of the results of the diagnostic mammogram and if you think this is something I should be worrying about. Thank you.
		A:	really hard to comment without seeing the images. so rather than a surgeon looking at them, take them to another breast imaging radiologist for a second opinion reading. if he/she agrees this is just a blood vessel, celebrate and realize that nothing else is needed for 6 months.
Question:  #69 12/14/2008		Q:	I HAD MY YEARLY IMAGING ON DEC 11 AND ON THE 13TH I RECIEVED A LETTER FROM THE IMAGING CENTER WANTING ME TO COME BACK FOR A RIGHT BREAST SPOT VIEW COMPRESSION. DOES THIS MEAN THEY HAVE FOUND SOMETHING? IF SO WHAT COULD IT MEAN?
		A:	it means that they saw something different than before when your last iamging was done. remember though that 80% of the time the findings end up being benign so don't panic. call them and get the additional imaging they recommend. we will hope you fall into the 80%. LS
Question:  #70 12/14/2008		Q:	will titanium clips make it difficult to read mri
		A:	no, it will not interfere with the reading of an MRI. LS
Question:  #71 12/14/2008		Q:	Hi Lillie,first of all thank you so much for your quick response. I was question # 1 on this category and question #3 previously. I would love to got there because the wait is going to drive me crazy for the bx. Unfortunately I am in Phoenix.Do you know of a closer place?
		A:	Gee, i am not familiar with the facilities in your area. call around though. it really isn't acceptable to have to waiting that long. remember i'm just a click away too if you need me further... LS
Question:  #72 12/15/2008		Q:	Hi Lillie,first of all thank you so much for your quick response. I was question # 1 on this category and question #3 previously. I would love to got there because the wait is going to drive me crazy for the bx. Unfortunately I am in Phoenix.Do you know of a closer place?
		A:	Hi cg.gomez75. THis is Ben Park MD PhD answering for Lillie who forwarded me your question. I don't have the previous QandA, but if you need a biopsy close to home, I'd recommend the Arizona Cancer Center in TUscon. Essentially, any NCI designated COmprehensive Cancer Center is always a good place to start. Best, BHP
Question:  #73 12/13/2008		Q:	Hi.After 2 mammos and one US, finaly had an MRI. Results as follows:presence of 2.5cm mass with irregular borders involving lt breast at nine o''clock posiion.this corresponds to the abnormality noted on mammo. Birads 4- suspicious abnormality. Saw breast surgeon who ordered a stereotactic bx. I asked him what the chances of this being malignant, he says he thinks it is CA. I am 33 and very scared. Do u think this is CA and if so, is 2.5cm big for a mass? unfortunately i can''t have a bx until 12/30 and i am so worried since lump was found in September. Thank you in advance, what you do is wonderful !
		A:	irregular borders and a doctor recommending biopsy and saying it probably is cancer is enough to scare you to death... size is larger than desired... stage 2 for its measurement. can you come to us? we could surely do this sooner. 410-955-7288 is sharon's number. she schedules the biopsies. we would want you to fed ex breast imaging studies to us and get a clinical breast exam as well. request that sharon transfer you to sheila for your breast exam consultation. hope that helps. if cancer, this is doable. don't ever doubt that. LS
Question:  #74 12/13/2008		Q:	I am 10 months s/p excisional biopsy for LCIS and core biopsies of multiple benign lesions. Recent MRI:THERE ARE MULTIPLE RAPIDLY-ENHANCING FOCI NODULARITIES WITHIN BOTH BREASTS MEASURING 3-4 MM IN SIZE. WHILE MANY OF THESE WERE PRESENT PREVIOUSLY, THE ENHANCEMENT PATTERN OF MANY OF THESE NOW SUGGEST ENHANCEMENT WITH PLATEAU CHARACTERISTIC AND SOME WHICH MAY HAVE SUBTLE WASHOUT. THIS IS A FAIRLY DIFFUSE PROCESS. A MORE FOCAL 7 MM ENHANCING NODULAR REGION WITH PLATEAU AND WASHOUT IS NOTED IN THE CENTRAL LATERAL LEFT BREAST WITH A MORE FOCAL AREA OF NODULAR ENHANCING REGIONS NOTED IN THE CENTRAL POSTERIOR RIGHT BREAST. REPRESENTATIVE TISSUE SAMPLING OF THESE REGIONS SHOULD BE CONSIDERED WITH MRI GUIDANCE AS THE FOLLOW-UP EVALUATION NOW SUGGESTS PLATEAU KINETICS AND POSSIBLE SUBTLE WASHOUT. AS LONG AS BENIGN RESULTS ARE OBTAINED, THE REMAINDER OF THE ENHANCING NODULARITIES WHICH NOW DEMONSTRATE PLATEAU KINETICS AND POSSIBLE SUBTLE WASHOUT COULD BE FOLLOWED IN SIX MONTHS WITH REPEAT BREAST MRI. F/U digital mammos and U/S showed stability of the previously biopsied lesions. I''m curious, what are criteria for recommending biopsy on MRI?
		A:	if the findings has shown growth since last imaged.
Question:  #75 11/30/2008		Q:	Hi, I had two mammos with the first one reading as follows: breasts mod and inhomogeneously dense.a focal area of increased density within lt breast retroareolar region near the chest appears to represent fibroglandular tissue.on the oblique projection , there is a partially defined 1.3 cm density .double reading by CAD, an area of interest identified, review by Rad suggest a diff area of concern. 2nd mammo with spot compression: with additional views, prev questioned retroareolar density not identified. due to denseness of breast tissue in this area, small masses may be obscured. mammo remains birad 0. My question is,somewhat hard lump still there, I am 33 yrs old,unk history of BC.Does this sound worrisome? thank you so much. Also had US prior to both mammos that didn''t show anything.
		A:	it doesn't sound alarming. worthy of following up with additional imaging though as they will no doubt recommend be done in the coming months.
Question:  #76 11/2/2008		Q:	My mother had a mastectomy in 1996 for DCIS. Node negative, mastectomy, tamoxifen, her2 postive. Saw her breast doctor in March 08 noted a simple cyst by sono in her office. My mom had a sonogram at the radiology for followup 2 weeks ago and radiologist stated no cyst, but very small lymph node noted in axillary tail. My mom is thin, 65 years old. Can normal lymph nodes be seen on sonogram in thin women. Also, is it normal to have lymph nodes present after mastectomy and lymph node dissection. What followup would be recomended and treatment if any.
		A:	not unusual... some nodes can still be found post ax dissection. depends on how aggressive the doctor was in doing the dissection. would be unusual to be aggressive for dcis.
Question:  #77 11/2/2008		Q:	Lillie, Thanks for your response to #6 of this same category. I recently obtained a copy of my MRI report from my dr. The findings are: Right breast: Background enhancement is moderate. Some small lymph nodes are seen within the poterior breast. No dominant mass or tissue distortion is identified. The periareolar region appears unremarkable. Left breast: Background enhancement is quite significant. No dominant mass or tissue distortion is identified. The periareolar region appears unremarkable. Small enhancing lymph nodes are seen within the posterior left breast. Impression: Essentially normal bilateral breast MRI. Is there any reason to be concerned about the significant background enhancement or the small enhancing lymph nodes? What could be the cause of the background enhancement and enhancing lymph nodes? Thanks for your tremendous service you provide.
		A:	this sounds like a good report. lymphnodes can enhance from a recent infection or cold...
Question:  #78 10/31/2008		Q:	Hi, Lille, sorry to be such a nuisance, but I have another question. I had mastectomy, positive nodes, mediastinal nodes. Large tumor removed, mediastinal nodes cleared up, but one axillary node supposedly 1.2. I understand 1 centimeter is a normal node. Question: Ultrasound says 1.2, doctor feels it''s the same by palpation, but CAT scan says it is 2.5. Who is right? Is it now necessary to have a PET scan. Drives me crazy that medicine is so conflicting. THank you again, Lille.
		A:	size of node isn't really significant. simply the knowledge that the node contains cancer beyond simply being micromets is what is important now. a lymph nodes by the way can be the size of a pin head or the size of a quarter and still be a normal benign node. everyone's personal nodes are different, including the number we each have. the node may contain necrotic cells in it now too having had chemo. so showing on a scan doesn't definitively in your case mean it remains full of cancer. pathology would need to answer that by looking at the node under the microscope which of course means surgically removing it.
Question:  #79 10/29/2008		Q:	I am 44 years old and was diagnosed with stage IC invasive ductal carcinoma. I am in a clinical study in which my cancer cells were oncotyped and results showed a low recurrence rate. Because of this the study put me in a group where I had a lumpectomy, followed by radiation therapy and tamoxifen. Due to very very dense breast tissue, I have been following up with breast mris. This last exam showed a BIRADS 4. I''m confused as to what it means by, "Not necessarily breast cancer but reasonable probability of malignancy". Isn''t cancer a malignancy? If it''s not cancer, what else could it be?
		A:	so the report is saying that it warrants biopsy but may not be cancer. might be a benign growth. pursue the biopsy so you have answers that are definitive. LS
Question:  #80 10/11/2008		Q:	Thank you for your response. I do have a couple of more questions: Would the biopsy be done by a surgeon? Why would a lumpectomy not be proticol? How concerned should I be that additional nodules were found in the left breast as well as the lingula? I am trying to become more self educated as to fight for the proper treatment. I appreciate your advice. I know this is simply a recomendation, but it is more than I am getting from the doctor''s offices.
		A:	i'm not able to connect previous questions with new ones... so am not sure which question you were referring to. but let me give you a response that i hope makes sense regarding biopsies. 97% of biopsies can be done by a radiologist in a breast imaging setting. only 3% need to be done surgically. the 3% are those that are calcifications that look suspicious and are close to the chest wall. the definition of lumpectomy is the removal of a known cancer along with a clear margin of tissue around it. if the biopsy showed cancer then lumpectomy would be done.
Question:  #81 10/11/2008		Q:	Hi I had a mastectomy of the right breast,Jan 06 both ductal and lobular carcinoma, T3,L0. I am now 48 chemo inducd menopose on Tam then lately Femara. Dr want mamograms done every year on the Left breast should I ask for MRI or Digital mamorgaphy on account of Lobular carcinoma? Thank you
		A:	don't assume that if you got breast cancer again it would be lobular. that said, the radiologist reading the mammogram is the one to decide if mri is needed. it depends on the density of your breast tissue-- whether your remaining breast is easy or hard to image. LS
Question:  #82 10/11/2008		Q:	I am a 44 year old women with dense brests and a history of calicfications. Due to yet another abnormal mamo and untrasound, I asked for a PET/PEM to be done on my own. The results were as follows: PET readings-A patchy abnormal hypermetabolism 5 x 3/5 x 5.4 cm mass in the upper mid to medial aspect of the right breast suspicious for malignancy.PEM readings stated there were prominent focal areas of increased uptake along the anterior inferior aspect of the mass. There is also a 4 mm nodule in the upper inner quadrant of the left breast whish could be early maliginancy, lastly a 4 mm noncalified nodule in the lingula was found. My doctor has referred me to the Breast CAncer Center for an MRI to be done, which could take up to two weeks to schedule. I also had an Oncologist I have worked with review my files and he suggested going straight to a surgeon as to not waste time. Needless to say I am a bit anxious and not sure exactly what I am facing and what is the best and logical route to take. My doctor would not use the word cancer, yet the oncologist suggested it may be more than a stage two based on size and shape. Any help making this easier to understand would be great.
		A:	PEM is supposed to be a more sophisicated version of an MRI so i don't understand what the value of doing an MRI would be. usually based on these findings and the word "suspicous" and "malignancy" used in describing he findings, a core biopsy is done. this is a large mass so doing a biopsy should be quite easy in ultrasound.
Question:  #83 10/3/2008		Q:	I am a 46 yr old female with very dense breasts. I have inflammation around both nipples and Montgomery Glands based from results of a skin patch biopsy from one breast. My mammogram came back normal. A couple of weeks ago I found lumps in both breats. I had an MRI last week which also came back normal. I''m not for sure that the MRI was done during the optimal time during my monthly cycle. Should I be worried that having the MRI outside the optimal window would exhibit false readings? Any idea what would cause inflammation around the base of the nipple where it meets the areola? Thanks for your site. It provides a great service.
		A:	time for a second opinion at a comprehensive breast center. if you want to come our way call 443-287-2778. MRI during "the wrong time of the month" increases possibility of false positives; not false negatives. LS
Question:  #84 9/29/2008		Q:	I''m going on 2years out for a pT1A pNO pMX which was treated with lumpectomy and radiation. I will be going for my mammogram, MRI (my 2nd following surgery) and breast exam. My family physician wants a chest x-ray to look at the lungs and of course the oncology doctor does what she requests even though she isn''t treating this. It is my understanding that if cancer had spread to the lung it would have to be very sizeable before it showed is this a necessary follow-up test, I have no symptoms of anything going on with my lungs. I''m at the point where having additional radiation is to much of a good thing and not wanting anything that isn''t absolutely necessary. Our my thoughts out of line here? Thank you.
		A:	Our general practice is to not do screening tests unless there is evidence of disease. ds
Question:  #85 9/29/2008		Q:	I am 49 years old. I recently had my annual mammogram and got the following report, Birads 0: Mass or abnormal density: A new density in the left breast on the oblique view superiorly measuring 6 x 7 mm is 6.7 cm from the nipple. It is not definitely seen on the craniocaudal view. Rest of the fibroglandular tissue of both breasts shows no significant change. A new density present in the left breast on the craniocaudal view in the lateral aspect 5.1 cm from the nipple measuring 5 x 4 mm. It is not definitely seen on the oblique view. No spiculated lesions, abnormal calcifications or architectural distortion are seen in either breast. Overall Impression: New density in the left breast on the oblique view and another in the left breast on the craniocaudal view. Recommend coned down compression views and ultrasound of the left breast and 90 degree lateral view. What do these findings mean? I am worried.
		A:	Birads 0 is a good report. It means the radiologist does not have suspicion for a malignancy. The extra views and ultrasound are helpful for further diagnosis of the density. ds
Question:  #86 9/27/2008		Q:	Dear Lilli, I am 48 years old, no fam. hx. of breast cancer, and I take birth control for endometriosis. Over the last 5 years, I had 5 biopsies, all benign. On my last mammo and US (4 months f/u), they found 15 new cysts, 3 of which looked "junky". Radiologist tried to aspirate one of them, but couln''t get in - the cyst moved away constantly. Radioligist said that she still thinks it''s a cyst. She also found one area that she feels is a fibroadenoma, maybe a cyst, maybe fat necrosis. She ordered an MRI to look at all 4 spots. She told me "not to worry, nothing looks suspicious". Due to insurance issues and my cycle, it might be 3 to 4 weeks before MRI can be done. I am upset and don''t know how to stay sane in the meantime. Can I trust the radiologist''s impression that it is nothing to worry about, and can she know just from looking at it? Will the MRI bring the clarity we need? I cannot imagine going through this every time I have a mammo - is there something else I should do? Should I stop birth control? Thanks so much for all your help.
		A:	you can always get a second opinion reading from another radiologist who specializes in breast imaging so you have peace of mind. LS
Question:  #87 9/27/2008		Q:	I had a simple mastectomy of my right breast (negative for malignancy) and mastectomy of my left breast with removal of 10 nodes (positive for stage 0 malignancy, nodes negative) March 2004. I had immediate reconstruction with saline implants. My surgeon said "no more mammograms". My internal medicine doc says "you may need a mammogram". What say you? I have read the literature which mostly says no.
		A:	following bilateral mastectomies with any form of reconstruction the answer is no more mammos are needed. LS
Question:  #88 9/27/2008		Q:	I am 75 years old. I had a lumpectomy in my left breast in 2002 and have had regular tests done once or twice a year to include PET scans, mammos, ultrasound and 1 mri of both breasts. I made an appt to see my oncologist because I thought i felt something in my left breast. I had a mammo, an ultrasound and an mri. I do have dense breasts and only the ultrasound recognized the tumor in 2002 even though I had had regular mammos and could see the outline of the tumor and could feel it also. I was told that the contrast solution lit up when I had the mri in early Sept. and I was scheduled to return in 2 weeks to have an MRI Mammotome Core Biopsy w/gadolinium contrast. This time the contrast solution did not light up and I did not have the biopsy done. I was told to return in 6 months. I had a complete hysterectomy in 1982 and have not had estrogen replacement meds since 2002 when the breast cancer was diagnosed. The doctor who would have done the biopsy said something about hormones at the time of the first mri may have caused the contrast solution to light up. He mentioned adrenalin and/or estrogen. Should I worry about this? He assued me I did not have to worry, but I am worrying anyway. My father had lymphoma, a first cousin had esophogeal cancer, a great-aunt died of breast cancer many years ago. This same great-aunt had 2 club feet and my daughter was born with 2 club feet, which indicates a genetic connection.
		A:	based on hat you described this sounds okay. he is right, hormonal changes does influence the "lighting up" pattern on mri. LS
Question:  #89 9/10/2008		Q:	i had a mammo done on6-19-08 and a sono on the same day the results were normal reflective tissue in axillary tail region on the sono. the mammo states: some focalstromal bending in the axillary tail region but no dicreat reproductable masses probably underlying parenchyma . this is all left breast please help me to understand it a llittle better the doctor only said come every 6 mons. for testing...thanks
		A:	These are normal findings. DS
Question:  #90 9/7/2008		Q:	I was re-called for additional images on my mammography. The first images had shown a small area of concern on the right breast. I had had a previous biopsy on that breast two years ago that was benign and a metal marker was inserted. This new spot is not the metal marker, of course. The ultra-sound showed nothing. I then had a BSGI test, which showed a small amount of radioactive uptake on an area that was not well-cirsumscribed. Now I am scheduled for a biopsy. Is the BSGI result positive for cancer or is the biopsy being called for because the BSGI is inconclusive? Thank you.
		A:	BSGI inconclusive. biopsy is the definitive way to know.