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Breast Imaging
Diagnostic mammogram's and other breast imaging questions.
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AskedPublicly Submitted Question
2/28/2018I had an my first mammogram last Dec since I turned 40. Result said IMPRESSION: Baseline mammogram Possible focal asymmetries left breast. Needs further evaluation with spot compression left CC, MLO, full true lateral, and if needed targeted left breast sonogram. Any clinically suspicious abnormality must be acted upon independently of mammographic findings. I had an ultrasound last January that said IMPRESSION: Microlobulated solid nodule in the left breast at 2 o'clock position measuring 0.43 x 0.48 x 0.52 cm Ultrasound guided biopsy is recommended The findings were discussed with the patient at the conclusion of the exam. BI-RADS category 4A, low index of suspicion, biopsy is recommended. I had a mammogram the same day which showed IMPRESSION: On the additional images there was a persistent nodule in the left breast corresponding to microlobulated nodule at 2 o'clock position by ultrasound for which ultrasound guided biopsy was recommended Please, see ultrasound report Bi-Rads category 1, negative. There was an addendum. ADDENDUM: Please note of a voice recognition error on the prior BI-RADS which is based on ultrasound finding The corrected BI-RADS is BI-RADS category 4A, low index of suspicion biopsy is recommended. I had the biopsy almost 2 weeks ago. Here is the results: ADDENDUM: Pathology report received. Benign fibrocystic changes with intraductal hyperplasia and columnar cell changes. This is discordant to the sonographic findings. Excision is recommended. In addition, the biopsy clip is separate from the initial suspicious findings seen on mammogram .A seocnd look ultrasound is recommended. Critical results conveyed to doctor. I had postbiopsy mammogram which showed Report: Post sonographically guided vacuum assisted left breast biopsy mammogram. CC and ML projections of the left breast demonstrates biopsy clip separate from the initial nodule seen on mammogram IMPRESSION: 1. Post procedure mammogram for marker placement. 2. Biopsy clip separate from the initial suspicious findings seen on mammogram. A second look ultrasound is recommended. I had the Ultrasound about a week ago and it showed: INDICATION: Follow-up exam, recent left breast ultrasound biopsy, 02/15/2018, with benign findings considered discordant Left-sided whole breast sonography with sagittal and transverse imaging was done. Comparison: 02/15/2018 and 01/09/2018 sonogram and mammogram 2:00, 5 cm FN: A 0.7 x 0.6 x 0.7 cm hypoechoic recently biopsied lesion again identified. What may represent echoes from a biopsy clip are seen nearby. Scanning was done elsewhere reveals no discrete abnormality to correlate with a posteriorly located density seen by mammography. IMPRESSION: Recently biopsied left breast 2:00, 5 cm FN lesion again noted, with a biopsy clip not definitively visualized. Elsewhere no discrete lesions identified to correlate with mammogram findings. Management recommended on clinical basis regarding possible repeat ultrasound guided or perhaps mammography guided percutaneous biopsy, versus follow up diagnostic mammography recommended.

The breast surgeon wants me to do excision even though it is benign. I don't know why. I thought
a second biopsy might do if the first one was Discordant. She also wants me to do the mammogram assisted biopsy for the other lesion. What do you think about my case? I don't know what to do as I'm so confused about the whole thing. I would really appreciate your help.
RepliedJHU's Breast Center Reply
3/1/2018Some surgeons would remove this as a precaution in case the cells decide to turn into breast cancer. Biopsy of the other lesion is the only way to know what it is.

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