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Heterogeneously dense breasts with an 8mm nodule
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Heterogeneously dense breasts with an 8mm nodule

I recently had 2 mammograms and an ultrasound within a weeks time and after the results of the final report the doctor said everything was fine and that they just wanted to do another follow up mammogram/US in 6 months. Nothing was explained to me of what a hypoechoic nodule or complicated cyst is. Was a little concerned due to the rush for additional views etc...
  Here are the results of my 2nd mammogram, it reads Bilateral digital diagnostic mammogram with additional view spot compression.  The tissue of both breast is heterogeneously dense. this may lower the sensitivity of mammography.  patient returned for additional views, asymmetry described on previous mammogram persists, further imaging with US is recommended.No significant masses, calcifications, or other findings are seen in either breast.
US results reads there is a 8mm nodule in the right breast at 12 o'clock posterior depth. This nodule is hypoechoic . color flow imaging demonstrates that there is no vascularity present. There is a 1.2cm cluster of cyst in the left breast at 2 o'clock posterior depth. there are numerous scattered cyst that appear benign. Impression; probably benign -follow up recommended. There is a demonstration of multiple benign appearing cyst The 8mm nodule in the right breast at 12 o'clock posterior depth likely represents a complicated cyst and appears probably benign. a follow up in 6 months is recommended.  The 1.2cm cluster in the left breast at 2 o'clock posterior depth likely represents a complicated cyst and appears probably benign a follow up in 6 months is recommended.  
appreciate any info you can give me.  
thanks~  

  
7 Comments
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587083_tn?1327123862
Hi,
Since the radiologist recommended a follow-up in 6 months,then the BIRADS score assigned on all the tests you had, could be category 3,which means that there are no suspicious lesions, masses, or calcifications to report, but follow-up to confirm that no changes have occurred.A finding placed in this category should have a very high probability of being benign
BIRADS is a quality control system,used by radiologists after interpreting mammograms,ultrasound and MRIs.
This system allows radiologist to categorize the findings by numbers.The scores go from 0 to 5.The higher the number the more suspicious is the abnormality.
The fact that these cysts demonstrates that there is no vascularity present,is a good sign that they are probably benign.Many women with Fibrocystic breasts have simple and complicated cysts.
In the vast majority complicated cysts,( meaning that they contain debris) are not of significance and are rarely found to be malignant.In the cases that it occurs, the cyst walls tend to be thick and irregular, which can be noted on ultrasound, also there tends to be dense tissues surrounding the cysts.The radiologist would have certainly noticed these suspicious characteristics,if they were present.So when an otherwise normal appearing cysts have debris, it's generally not something to get concerned about.
Just keep the recommended follow-up.Also it's a good practice to do your SBE (self breast exam) regularly,one week after the start of you menstrual cycle and if you notice any abnormality,then contact your doctor for evaluation.
Best wishes...
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962875_tn?1314213636
In a nutshell, it says that numerous benign-appearing cysts ( fluid-filled sacks) were seen, as well as  an 8 mm nodule in the right breast that appeared to be a complicated cyst (a type that contains fluid and solid matter), and a 1.2 cm cyst cluster in the left breast which was also thought to be a complicated cyst. Both of these were also considered probably benign,

As indicated above, a simple cyst is a fluid-filled structure and by definition is benign.  If they are large or painful, the fluid can be aspirated with a needle, which quickly provides relief.

A complex cyst is also fluid-filled but has solid structures (walls or septations) within the cyst.   The issue with a complex cyst is whether the solid components are of any concern, although malignancy is quite rare.  
Complex cysts can be more difficult to aspirate, since areas of fluid may be separated into compartments.  If there is concern, a complex cyst can be removed surgically.

In your case,  the only recommendation at this  point was for follow-up in 6 months to check for any changes.

However, if this  greatly concerns you, you could request a consultation with a surgeon to discuss the possibility of  an excision biopsy, just to make certain all the components of your cyst are benign.

Best wishws,
bluebutterfly
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962875_tn?1314213636
Hi again,

Please note: My answer contained an error; zouzi's answer is the correct one!

Two  of the nodules seen on your ultrasound are considered to be complicated cysts, and I discussed instead complex cysts.

Here is a further explanation of the types of breast cysts identified by ultrasound:

Breast cysts are categorized as simple, complicated, or complex. Appropriate categorization is important because the management of each type differs. Simple cysts are defined as anechoic, well-circumscribed, round or ovoid masses with an imperceptible wall and increased through-transmission of sound waves. When all the criteria of simple breast cysts are present, they are considered benign and do not require intervention. Painful cysts can be aspirated for symptom relief.


Complicated cysts contain low-level internal echoes or intracystic debris that may layer and shift with changes in patient position. The homogeneous internal echoes within some complicated cysts may produce an appearance identical to that of a circumscribed solid mass. Complicated cysts do not contain thick walls, thick septa, or other discrete solid-appearing components. The risk of malignancy among complicated breast cysts is less than 2%; these cysts generally can be managed with short-interval follow-up imaging or aspiration. (However, if a complicated cyst is symptomatic, new, or enlarging, needle aspiration is indicated .).

Complex breast cysts (which I discussed in my first reply, but which are NOT relevant to your case!) are defined as cysts with thick walls, thick septa, intracystic masses, or other discrete solid components,
and are associated with a variety of benign, atypical, and malignant pathologic diagnoses. Complex cystic breast masses have a substantial chance of being malignant.

I am sorry for any confusion and concern I may have created with my first response...  :-(

bb
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Avatar_f_tn
Thank you for the quick response. I really appreciate your interpretation of everything it's really helped me to understand more clearly.      
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Avatar_f_tn
Thank you for your response and explanation. This really helped to put my mind at ease and understand the report. It was just a bit scary when you're told you have a nodule that needs a follow up.  And as far as the self breast exam, I never knew it should be done one week after the start of my menstrual cycle. Is this how it should always be done? Thanks so much for the tip.
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587083_tn?1327123862
You welcome sylvain,
Yes,you should perform the examination regularly, a few days after your period has ended when your breasts are less likely to be swollen and tender,also cysts tend to decrease in size.At this time you will be able to detect anything unusual.
I am glad that "bluebutterly2222" and I have helped you put your mind at ease.:)
Please copy and paste the website below that will show you how to do SBE.
All the best!..

http://www.meditherm.com/breast/selfexam.htm
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962875_tn?1314213636
You are very kind to take the time to come back to thank us for our replies.

If you think of it, please let us know how things go with your 6-month followup--we care!

Regards,
bb
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