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BIRADS 1 or BIRADS 3 or maybe 4?
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BIRADS 1 or BIRADS 3 or maybe 4?

Hi,
I am a bit confused over the results of different tests I have had done. Maybe someone here has some experience and can help me understand these results.
My recent mammography from last week showed a non-palpable lesion of 2.3cm x 1.3cm in the upper exterior quarter of the left breast rated as a BIRAD 3. I wasn´t happy waiting for follow-up in six months as I had BIRADS 2 in both breasts a few years ogo, so I requested an ultrasound and my doctor said no, first an MRI and then biopsy. I had the MRI yesterday and the findings are one nodule in the lower exterior quarter of the right breast measuring 11 x 9 x 8 MM. rated BIRADS 1. So which do I have, and how can I rely on the results when they are so difference? Although the MRI and the mammography were done in two different clinics I just realised that the reports were signed by the same doctor.
Thanks in advance for any answers or help
Maire
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587083_tn?1327123862
Hi again,
A fine needle biopsy or other similar biopsies is an out-patient simple procedure done in a Hospital or a Clinic and it takes about an hour or less from start to finish.The Doctor will numb the site and you won't feel pain.Maybe a little uncomfortable but not real pain.Samples of the lump will be extracted and you will feel some pressure in your breast.I had it done 2 years ago and it was very bearable.I had a very small scar that with time it disappeared completely.You might have a bit of bruising the next day and applying an ice pack every so often on your breast, can help a great deal.
I think that the lump seen on your left breast even though the BIRADS score is 3, it might need a biopsy,since it's not very small,( 2.3 cm) but not suspicious either.
On the other hand, the lump seen on the MRI in your right breast(11mm) being a BIRADS category1,it's definitely benign and I don't think that you should be worried about it.Waiting till September is not too long await to have all this explained to you by your Doctor.
Take care and good luck.
                                                                                                                                                                                                                                
                                                                                                                                                                                                                                          
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587083_tn?1327123862
Hi.
A BIRADS score 3 means that the finding is "Probably benign" and a follow up is usually recommended

A BIRADS score 1 certainly means that the lump is definitely benign.

I think that the best thing to do is to talk to your Doctor about your worries and see what he advises you to do.Maybe a biopsy would put your mind at ease if there is any doubt about this lump.
Mammograms,Ultrasound and MRI are very valuable tools to detect abnormalities,but they are not infallible.When one is uncertain about the results,the only sure way to know is to have the lump biopsied.
Please talk to your Doctor about this,I am sure he/she will give you the best advise concerning theses different BIRADS scores and what needs to be done.
Best wishes....
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Avatar_f_tn
Thanks for your speedy reply. I do think this is the best thing to do but my doctor is away until mid September so I will just wait then. I need to clarify why the findings of the MRI and the mammogram are referring to different parts of the breast and if there are 2 abnormalities or just one.
Is a biopsy invasive? How is it carried out, as an out-patient or do you have to stay in hospital. Do you get an anaesthetic? I hope it won´t become an issue for me but on the otherhand it does no harm to be prepared and informed.
It is great to be able to express your concerns on this site. Thanks once again
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962875_tn?1314213636
There are several ways to do a breast biopsy:

A fine-needle aspiration biopsy is done by inserting a thin needle into the suspicious lump and removing cells that are then examined under a microscope. Needle aspiration is sometimes done to distinguish between a solid lump and a fluid-filled lump (cyst). If the lump is a cyst, it will collapse and disappear after the fluid is removed. If there is little or no fluid, the lump probably is not a cyst and another type of biopsy will need to be done.

A core needle biopsy is done by using a large needle fitted with a special cutting tip. As the needle goes through the skin toward the lump (or suspicious area found during a mammogram or breast ultrasound), it collects a core of tissue about the size of a pencil lead.

A stereotactic biopsy is done to evaluate a lump that cannot be felt on breast examination but is seen on mammogram or ultrasound. It is done using a special type of X-ray instrument that can precisely locate the area of the breast from which the biopsy sample is to be taken. A small incision is then made in the skin of the breast and a needle is guided by the instrument to the exact biopsy site to collect a tissue sample. Stereotactic biopsy may not be appropriate for all types of breast lumps.

An open biopsy is done by making an incision in the skin and removing a sample of the suspicious lump, or the entire lump. If the lump contains cancer cells, all or part of the breast can be removed immediately (however, this is not commonly done). If the doctor cannot feel an obvious lump, a needlelike probe can be placed in the suspicious area during a mammogram done just before surgery. The probe then guides the doctor to the correct area for collecting a biopsy sample.

Only the open biopsy is done under anesthesia, and it, too, is normally "same-day" surgery.

Best wishes...
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587083_tn?1327123862
Hi again,
A fine needle biopsy or other similar biopsies is an out-patient simple procedure done in a Hospital or a Clinic and it takes about an hour or less from start to finish.The Doctor will numb the site and you won't feel pain.Maybe a little uncomfortable but not real pain.Samples of the lump will be extracted and you will feel some pressure in your breast.I had it done 2 years ago and it was very bearable.I had a very small scar that with time it disappeared completely.You might have a bit of bruising the next day and applying an ice pack every so often on your breast, can help a great deal.
I think that the lump seen on your left breast even though the BIRADS score is 3, it might need a biopsy,since it's not very small,( 2.3 cm) but not suspicious either.
On the other hand, the lump seen on the MRI in your right breast(11mm) being a BIRADS category1,it's definitely benign and I don't think that you should be worried about it.Waiting till September is not too long await to have all this explained to you by your Doctor.
Take care and good luck.
                                                                                                                                                                                                                                
                                                                                                                                                                                                                                          
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962875_tn?1314213636
Another thought--you might want to check to be sure whether they were supposed to do, and whether they did do,  an MRI on the LEFT breast, to further evaluate the original finding, and if so, what the MRI report had to say about that breast...

Mistakes do happen occasionally. My sister keeps copies of all her images, and when going through them in preparation for her last mammo, was surprised to find several films with another patient's name on them!
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Avatar_f_tn
Thats very interesting about all the different biopsies. I am not sure which one would be suitable for me, the doctor did mention TRU-CUT in his report as an option but that was before the MRI and I have no idea what it is.
By the way, I made a mistake in the first post, both the MRI and the mammogram picked up the abnormalities on the LEFT breast, the MRI said the LOWER exterior quarter Birads 1 and the mammo said UPPER exterior quarter Birads 3, that was the discrepancy.
I was a bit worried while I was having the MRI done that they were only doing the left breast as indicated by the doctor, and I remembered in the old Mammogram the grading was Birads 2 for BOTH breasts. When I looked at the results I was happy to see they had done both. the right breast has not shown any abnormalities in the mammo nor in the MRI.
I hope mistakes don´t happen too often, it does help to be ahead of things and keep checking. Thanks for the info..
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Avatar_f_tn
Hi, thanks for your reply. That was an error where I wrote the right breast, there is nothing abnormal on that side. It is the left side, The MRI showed the 11mm nodule on the ext. lower quarter and the Mammogram showed a 2.3 area in the ext upper quarter - all within days of each examination. I suppose the MRI is the most reliable, (I am hoping!) but will wait for  the doctor to explain about the differences.
If I can survive the MRI then I should be fine with a biopsy.
Maire
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