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Diagnostic mammogram's and other breast imaging questions.
|Asked||Publicly Submitted Question|
|3/21/2012||My mom just received the results of her yearly mammagram and she was told a 5mm nodule in the left breast is present! In that major cause for concern?|
|Replied||JHU's Breast Center Reply|
|3/22/2012||Thank you for turning to the Johns Hopkins Breast Center. Congratulations to your mom on having her yearly mammograms, and the mammo did it's job! It identified 'something' that was not there before, (so it's very early detection) and now followup imaging and evaluation needs to be done. The BIRADS score of the mammo will give you more of a sense of amount of concern warranted. I have attached our BIRADS chart from our web site: "When a radiologist interprets a mammogram, he or she assigns a score to it used to communicate with doctors about how concerned he or she is about the findings.|
Did anything look abnormal? How serious is the abnormality that was found? This and other information is efficiently summed up in one number, called the Breast Imaging Reporting and Data System (BI-RADS) score.
BI-RADS scores range from 0 to 6:
0: This score identifies a mammogram study that is still incomplete. The X-ray may have been cloudy, making it difficult to read the images. This can happen, for example, if you moved at the precise moment the picture was taken.
In any case, further information is needed to make a final assessment and assign the true BI-RADS score. If you’ve received a BI-RAD score of 0, you need to make sure that additional imaging is done, such as some extra mammography views or an ultrasound.
1: This score is good news! It means that your mammogram is negative (that is, no evident signs of cancer were found) and that you should continue to have routine screenings.
2: This score also means that your mammogram is normal, with no apparent cancer, but that other findings (such as cysts) are described in the report. You’ll be instructed to continue your routine screening.
3: Now we are entering a gray zone. A BI-RADS score of 3 means that your mammogram is probably normal but that there’s an approximately 2 percent chance of cancer. You’ll be asked to follow-up with a repeat mammogram in six months. And if you have a family or personal history of breast cancer, the radiologist may opt to do more tests now rather than wait.
4: This score means that the findings on your mammogram are suspicious and that there is an approximately 20 percent to 35 percent chance that a breast cancer is present. To make a diagnosis, the doctors will need to perform a biopsy to get a small tissue sample. More than 90 percent of women with a BI-RADS score of 4 can have a core biopsy performed without the need for general anesthesia or an incision in the breast. At our Breast Center, if a biopsy is warranted they are commonly performed the same day the mammogram is read. Nationally, the rate of open excisional biopsies is much higher than necessary. Our rate is very low; more than 90 percent of biopsies done here are core biopsies.
5: This score means that your mammogram results are highly suspicious, with a 95 percent chance of breast cancer. You will need to have a biopsy for diagnosis. Talk to your doctors about what course of action to take.
6: This means that you have already been diagnosed with breast cancer and the pathologist has confirmed the diagnosis.
Hope this helps and best wishes! If we can help, please call Sheila @ 443-287-BRST (2778) for an appointment.
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