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Breast Cancer (Expert Forum)
Trying to understand sisters ultrasound report
Questions posted in the Breast Cancer Forum are answered by medical professionals from The Cleveland Clinic. Topics include Breast Biopsy, Chemotherapy, Hormone Therapy, Lumps, Lumpectomy, Lymph node dissection, Lymphedema, Mammograms, Mastectomy, Radiation Therapy, Reconstruction, Self Breast Exam, and Surgery.
Trying to understand sisters ultrasound report
by justjanny, Sep 06, 2004 12:00AM
50 year old sisters ultrasound report reveals total of 6 solid irregular hypoechoic masses with internal arterial Doppler flow noted on several. Largest mass is 2.7 cm.in maximum dimension. They are irregular bordered with some exhibiting of stellate appearance. In left axilla is enlarged lymph node of 3.5 cm. BI-RADS category 5. Highly sugestive of malignancy. Sister has appointment with surgeon later this week. Recommendation is for biopsy. What should we be prepared for next? Masectomy? Chemo & radiation treatments? What is probable long term outlook?
Doctor's Answer
by CCF-RN,MSN-JS, Sep 07, 2004 12:00AM
Dear justjanny, A category 5 BI-RADS reading is highly suggestive of malignancy, but the tissue evaluation (biopsy) is needed to confirm. If this confirms malignancy - it may be that mastectomy will be recommended if in fact this is multifocal disease. Or possibly there will be a recommendation to shrink the disease with chemotherapy before surgery. In terms of long term outlook there is not enough information at this point to be able to speculate.
Member Comments (2)
by surgeon, Sep 06, 2004 12:00AM
If none of the areas is feelable, the biopsy would likely be "stereotactic biopsy," which means guiding a special needle into the areas using xray or ultrasound as a guide. Another option is a wire-guided biopsy where the radiologist places a wire at the location of one or more of the areas, and the surgeon follows the wire to remove the target tissues. If the areas are in fact feelable, then biopsy can be done without xray guidance. What would happen next would depend on what the biopsies show. It's very unusual to have six cancers in the same breast, so it's possible the findings are in fact benign: ultrasound is not perfectly accurate in diagnosing cancer. If it is cancer, and if there are indeed more than one, then most likely mastectomy would be the treatment. If mastectomy is done, usually radiation is not done. Chemo is done depending on certain characteristics of the cancer, and on the status of the lymph nodes. So for now, it's all up in the air until some form of biopsy is done, and the results are known.
