Biopsy recommended..Category 4 on ultrasound

understanding my ultrasound report....
by clfetsch, Apr 16, 2010 10:21PM
I am 38, had a hysterectomy(bi-lateral oopherectomy) 4 years ago , my grandmother and her sister had breast cancer.  I found 2 lumps about a month ago. I had a screening mammo, a diagnostic mammo and an ultrasound. I got my ultrasound report today and this is what it says:

Findings: The lesion seen on a mammogram is not identified. No solid or cystic lesions are seen.

Impression:

1. The ultrasound examination does not demonstrate any solid or cystic lesions. As the ultrasound does not demonstrate the lesion this is assumed to be solid. Category 4. This would be amendable to stereotactic biopsy.


My diagnostic mammogram reads as follows:

Findings: Vague 1.4 x 1.0 cm nodule in the upper outer quadrant of the left breast. No spiculation or malignant appearing calcification. Recommend breast ultrasound study.

Impression:

1. BI-RADS/Assessment: Category 0, recommend left breast ultrasound study--incomplete, additional imaging required.

What does the ultrasound report mean?? I'm a bit worried here. I am set up to go consult with a surgeon on April 26th.

[japdip]

The Ultrasound report seems to contradict itself in a way .... I would ask for a more specific explanation if you have posted it word for word. It does however say that the area should be biopsied and I would certainly proceed with that recommendation. If you have an appointment with a Surgeon I would take all my films to th appointment for his/her evaluation in regards to the biopsy. There was a "vague" nodule demonstrated on the Mammogram so some further investigation is definitely in order here.    Regards .....

[bluebutterfly2222]

My impression is that the ultrasound report indicates that the lesion seen previously on your mammogram was not identified (seen) on the US.

Since US is very good at detecting and imaging cysts (which are fluid filled),  the conclusion was that the lesion that was able to be seen only on  the mammogrram must be a solid lump, which therefore should be biopsied (through stereotactic biospy) to determine whether it is benign or malignant. It was given a BIRADS Category 4 rating. BIRADS 4 lesions often turn out to be benign. The statement on the mammogram report that there was "no spiculation or malignant-appearing calcification" is a favorable finding.

I hope this will help get you through the wait until your appoiintment with the surgeon, who will be able to explain everything in more detail.

Best wishes...

[clfetsch]

Japdip: What I put is word for word. So I was a bit confused about the whole thing. It is a bit contradicting. That's why I read it a gazillion times to make sense of it, and couldn't.

I guess the only thing to do is to wait and see......again and again LOL. How do I get more specific information about the US? Will the surgeon be able to give me more information on this? Clarify it a bit?

[japdip]

He/She may be able to do that .... be sure you take the actual films (or have them available for him/her to review) and not just the reports. I know what you mean ... I read that several times and am as confused as you. I even wondered if there might have been a typo (on their part) ... these reports are typed from dictation. It just doesn't sound right to me either.
Be sure you stress the point when you see the Surgeon; this is one time I would rely on the Mammogram rather than the US. Please return after your appointment or contact me by private message ... I'm very interested in what the Surgeon sees from the films and the recommendation.   All the best......