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|Breast Abnormalities and Other Symptoms
General questions about breast health and possible symptoms.
|Asked||Publicly Submitted Question|
|6/4/2012||In 09 and 10 mammogram showed heterogeneously dense fibroglandular tiswsue no primary indirect or secondary signs for cancer images are cad reviewed. Conclusion Bilateral BI_RADS 2 Benign finding.|
Jan. 20, 2012 Breast are equal size and contour. Sonographically , the breast have a mild-to moderate fibrocystic pattern. No abnormal shadowing or dominant masses. No ductal abnormalities are encountered.
Conclusion Right BI RADS Category 0 need additional imaging evaluation. No radio graphic or sonographic findings confirming the area of palpable concern. Decisions regarding further evaluation of this area. Suggest MRI as the most sensitive modality to assess the ductal structures. Left BI Rads Category 2--Benign finding.
Had MRI with Contrast Finding were Bilaterally symmetrical, scattered back kground parenchymal density. In the left at 10 o'clock position, 4 cm form the nipple. On the T1 dynamic sequences, the focus enhances brightly but does not show abnormal contrast kinetics. Immediately adjacent in the 10 o'clock position about 6 cm from the nipple is a second area of focal enhancement about a centimeter in long axis. It is best distinguished in the post-processing images. Neither of these shadows appears to be intramural and no abnormal ductal structures are identified in either breast. The two adjacent areas of enhancement in the right breast correspond to her area of palpable concern.
Conclusion 10 oclock position left breast, focal enhancement, most likely a benign process such as a small inflammatory cyst or fibroadenoma. Targeted ultrasound of the specific region is advised. If a focal corresponding suspicious lesion is encountered, it could be biopsied percutaneously. If not the breast could be followed at six month interval BI-RADS 0
In the symptomatic area of the right breast, two adjacent foci of abnormal enhancement. The areas are nonspecific by MR criteria but problematic, since they occur in a area of palpable concern in a patient with nipple discharge, Advise targeted ultrasound with 12 and 17 megahertz transducers. If corresponding findings are identified, the lesions could be biopsied under sonographic guidance. If not the area of palpable concern should be biopsied BI-RADS 4 Suspicious abnormality Biopsy should be considered.
OK Sorry but my question is I don't understand why a doctor can not do a biopsy on this? The radiology report states I need a biopsy and the dr said he cant see it on a ultrasound and he would not do it. Do i have something to be worry about or just blow it off like the dr did?
|Replied||JHU's Breast Center Reply|
|6/4/2012||The accuracy and findings on an ultrasound are directly dependent on the person holding the transducer in their hand. so it is reasonable to go elsewhere to have this re-evaluated in ultrasound by another breast imaging radiologist. Keep in mind that you want an interventional breast imaging radiologist too. not all radiologists who are reading mammograms and doing ultrasound specialize in breast imaging and even fewer of them are skilled to routinely do core biopsies that are ultrasound guided. so consider taking the breast imaging studies perhaps to another breast imaging radiologist at another facility. The key to having it reviewed elsewhere is the question of whether a biopsy is needed.|
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