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Hypoechoic Mass

I just recieved a print out of my mammogram and it says, I have a "slightly irregularly marginated hypoechoic mass" (I don't think the "ly" belongs in irregular...but that's the way it is printed on my imaging report. Also it states, "suspicious for neoplasm' and rates my BI-RADS as catagory IV.

I understand the BI RADS, and located a vague defination for neoplasm, but cannot find any information relative to the hypoechotic mass. DOes anyone know what these mean? I have an appointment to see a surgeon Monday but he generally won't perform one for 2-3 weeks and my report is requesting one ASAP. (my mother and gradnmother died from BC.) Any comments will be helpful as I am sure the next few days will be close to unbearable.
Jean
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Avatar universal
call around and find someone to check you out as soon as possible so you can quit worrying about it.  Good luck!
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Avatar universal
My sonogram states that :
1.distinct hypoechoic masses at 1 & 10 o'clock positions(left) and at retroereolar area & 8 o'clock position(right);measurements range from 4.0mm to 7.00mm. Margins are well defined but could not ascertained whether these are solid or cystic in nature due to lack of distinguishing characteristics.

2.simple cyst at 10'oclock position(right) with diameter of 13.9mm.Walls are distinct with no evident irregularity or solid component.
No features suspicious for malignancy seen.

How's my condition? Is it alarming/big? Do I have to undergo surgery to remove these?
Pls. help...Thanks.

Gracia

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Avatar universal
hi, i'm 22 years old and i've got a lumps on my left breast. My sonogram result was "hypoechoic mass birads 2..at 2 o'clock and 12 o'clock position. The sizes were 1.49 x  1.90cm, i forgot the other one..The dr. said it's a solid mass so more likely it's not a cyst. Dr. prescribed me parlodel. But I still have lots of questions about it. Do i really need to undergo surgery?What if i will not?Will this develop to malignant mass?I'm the first in our family to have breast lumps. Aside from these, it really gets painful especially when my period is coming. Please help!.i'm worried..thanks
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Avatar universal
Hi,
It would be best if you could post your queries as separate posts. It would be easier to respond and also then - each individual case is different.

To lady4law..
A birad4 and suspicion of malignancy / neoplasm and a hypoechoic area would mean that you need a biopsy. Try to schedule an appoitment and if you already have an appointment, try to talk to your surgeon in detail about it. You could then schedule for a biopsy with your interventional radiologist, who would be doing the biopsy most probably.
You belong to the high risk group with a strong family history of breast cancer and so, do explain the urgency you feel about having a confirmed diagnosis to your surgeon. He / she will understand.

To gracia888,
Well the sonogram says no suspicion of malignancy, so you can relax. The thing is there is no confirmed diagnosis available as yet about the lesions seen on the USG.
You need to consult your doctor and discuss this report with him.
I think it would be ebst to either get a biopsy done for a confirmed diagnosis or the other option is to wait for 4-6 months and get a repeat USG or mammogram done to evaluate these lesions.
Do you have a family history of breast cancer? Any other symptoms that might be a cause of alarm?
Any thought about surgery at this stage, would be too premature. But do schedule an appointment so that you can discuss this in detail and clear all your doubts.

To cynthz,
Your description fits that of a fibroadenoma most probably. It undergoes change in size and increases in pain during the menstrual cycle due to the hormonal fluctuations. You need not get a surgery done unless you want to or these are very large, or causing too much pain or pressure symptoms.
Relax and do not worry so much. These are benign lesions, usually managed conservatively in most cases. Just ask your doctor for a cofirmed diagnosis so that you do not have any doubts.

Hope this helps.
Goodluck.
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Avatar universal
I'm just curious is there any difference between lump,cyst,mass/hypoechoic mass, solid homogenous or are they just the same?
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Avatar universal
Hi,

A cyst is a fluid filled sac. On examination would feel like a lump. Can be differentiated on ultrasound.

A solid mass lesion is a solid lesion; again felt like a lump on clinical examiantion. Can be differentiated on ultrasound from a cystic lesion.

A lump is an abnormal thickened structure - mass strycture felt on clinical examination - which could be solid or cystic, benign or malignant.

The normal breast tissue is isoechoic on ultrasound; something with a lesser density would be hypoechoic and something witha higher density would be said to be hyperechoic.

Hope this helps.
Good luck.
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Avatar universal
I have had my first mammogram and it has come back with suspiscous of maligncy.  I have hyperechoic mass and persistant shadowing as well as a cyst.  Can anyone explain this to me.  I went to a surgeon who is sending me back to the radiologist to perform a ultrasound guided biopsy. Help!
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Avatar universal
Hi,

A lesion which is described as hyperechoic means that it bounces back more waves than the surrounding tissue. It is a way to find out tissues which appear different from the surroundings and therefore are probably "suspicious".

The definition of a cyst is defined as before. You can trust your surgeon to give you the best advise and getting a biopsy is the next step for "suspicious lesions".

Let me know if this answered your queries and if you have any more queries. Also tell us what the biopsy report says.

Regards.
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Avatar universal
I have looked at the report again... it says hypoechoic mass and  microcalcifications and persistent shadowing.  What does the persistent shadowing mean?  and are the microcalcifications somethng that I need to be concerned with?  They have scheduled me for a core biopsy ultrasound guided for next week - but, they are not sure if they can get to the cyst with that or they will have to do a stereotactic biopsy next...
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Avatar universal
P.S.  None of these are felt by examination.  They are all located around 1:00
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Avatar universal
Hi,

Shadowing means the usual, its the dark area created where light, and in case of mammograms or ultrasound, the rays cannot enter because of some intervening matter.

I am not sure why your doctor used the term persistent. Perhaps he did multiple exams and noticed the same pattern and wants to convey to his colleagues that he is sure of the findings. There could be other reasons too and only your doctor would be able to tell you what exactly he meant.

Micro calcifications are small collections of calcium and in a concentrated or speculated pattern help detect "suspects".

Its normal procedure in suspected lesions as I told you earlier to have a biopsy after the imaging.

Let us know if there are any more queries.

Regards
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Avatar universal
I had my US guided core biopsy this past Thurs and got the results today.  The path report states Malignancy is not identified.  Final diagnosis:  Extensive schlerosing adenosis with microcalcifications. Focal atypical ductal hyperplasia.  The Radiologist stated it still needed to come out with surgery.  Do I have anything to worry about?

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Avatar universal
Hi,

You can relax about the report coming out to be benign.

Discuss the further plan of management with your breast specialist and let us know what he/she advises.

Keep us posted if you have any doubts and also let us know about how you are doing.

Hope this helps.

Regards.
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Avatar universal
I am meeting with the surgeon next week.  I will keep you posted.  The more I understand about ADH, the more I am confused.  You read one thing and hear another??  DO you have any more info on ADH?
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Avatar universal
Hi,

You could ask specific questions or doubts that you have about Atypical Ductal Hyperplasia.

Atypical Ductal Hyperplasia (ADH) is not cancer. ADH means that the cells lining the milk ducts of the breast are growing abnormally.

Let us know about your queries and post us about what your surgeon tells you.

Regards.
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Avatar universal
I met with a general surgeon and now am meeting with a breast spec. on the 8th.  I spoke with the dr this morning and she already has all my films and went ahead and sheduled surgery for 4/22.  We know it has to come out, it is just a matter of when.  She stated she will have to do a wire localization and then  to the OR to take out the area - into recovery and then home.  So, hopefully not too bad.  Any suggestions on any of this would be great.  Thanks!
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Avatar universal
Hi,

It would be best to discuss the procedure with your surgeon and breast specialist and clear out any doubts that you are having.

You could also post any queries that you have here.

Post us on how you are doing and what your doctor tells you.

Regards.

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Avatar universal
hi
     yesterday i had an ultrasound it says solid hypoechoic nodules measuring half cm, is there a reason to be alarmed ? help
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Avatar universal
Hi,

A hypoechoic lesion is a finding on ultrasound studies that refers to any structure which bounces back sound waves poorly, so that the image generated appears dark on the monitor screen. Structures which have less density, and contain more water, air or fat may appear as hypoechoic.

Well the fact is that a hypoecoic lesion could be either a cyst or a beign tumour or a malignant tumour.

What is your age?

A hypoechoic lesion means that its density is less than the surrounding normal breast tissue which is said to be isoechoic on ultrasound. Further investigations like a biopsy would be required for a confirmed diagnosis.

A biopsy is a very safe procedure and you need to discuss with your doctor whether you need to get one done. You could discuss the procedure with your doctor in detail and clear out any doubts that you are having.

Let us know what the specialist advises and if you have any doubts.

Keep us posted on how you are doing.

Regards.
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Avatar universal
WHAT DOES THIS MEAN SLIGHTLY ROUND LOBULATED HYPOECHOIC MASS WITH CIRCUMSCRIBED MARGIN
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Avatar universal
Hi,
My sonogram said that I have a distinct solid mass at 10 o'clock. Margins are welld defined and echopattern homogenous.  Distinct hypoechoic masses, margins are well defined but it could not be ascertained whether this are solid or cystic in nature due to lack of distinguishing characteristics.  Walls are distinct with no evident irregularity or solid component.
Please help me understand this. thank you
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Avatar universal
I have had a small node for years and now my mammogram shows it has grown and recommended Ultrasound which I just had and now going to the surgeon Monday. The ultrasound says I has a oval hypoechoic structure deep within the chest wall measures up to 1cm.Has an appearance of a benigh lymph node but does not correlate with the position of the mammogram. the mammographic density appears more centrally within the breast tissue. Given the benign features of the ultrasound findings and the enlargement of a density i would recommend mammographically localized biopsy of this density. So, do I have a lump and what is density, is it a mass and should I be worried. I am 56 and was on premarin for 20 years. Am now on Evista. If it is a lump shouldn't I just have it out. Thank you Worried in Michigan
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Avatar universal
My findings for a Left Diagnostic mamogram and left Breast Ultrasound were as follows;  "There is a persisitent small ovoid nodular opacity with only partially circumscribed margins in the middle third of the upper outer left breast, it is not calcified."    Sonogram demonstrates "a small avoid hypoechoic mass.  Ther is a finger-like projection extending from the mass laterally.  There is edge shodowing"  Can anyone explain this to me.  My sister died at 51 with breast cancer.
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Avatar universal
I am a 43 year old mother of three.  Last year I had an ultrasound and later a MRI, that were both BIRADS 4, showing a small nodule at the 1-2 o'clock position.  When the biopsy results came back the pathology read adipose tissue.  I questioned this at the time but my surgeon stated that it was probably a fluid filled cyst that just disappeared.  A follow up MRI on 9/30/08 reads BIRADS 4 stating that the nodule at 1-2 o'clock exhibits more intense contrast enhancement but is similar in size (5mm).  There was a larger nodule at 12 o'clock with considerably more contrast enhancement reaching CAD levels suspicious for malignancy.  I have very small breasts (AA) and the radiologist said that an MRI guided biopsy would not be possible.  I had an ultrasound that did not detect the more suspicious nodule at 12o'clock but did document the nodule at 1-2o'clock.  The next day I went for an ultrasound guided biopsy, but the surgeon stated that she could not find either nodule and a biopsy was not preformed.  I am to follow up in three months with another ultrasound.  I am happy to hear that everything is OK, but I am suspicious that my surgeon simply can't locate the lesion and maybe it is still there.  My breasts are referred to as very, very difficult to read by the radiologists and my surgeon.  I know that Ihave very smalll breasts, they really don't have to tell me at every visit!  How is breast cancer in men detected?  I can't believe that there is no way to get a diagnosis simply because my breast are small.  Am I too concerned about the lack of continuity?  Is it normal to get conflicting results at the same insitution on the same equipment?
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