I am a 46 year old female, no prior history of breast disease in my family. I had an abnormal mammo showing a focal asymmetry density in the left breast and f/u with a spot compression. They wanted me to return in 6mos for a f/u. I got a 2nd opinion from a National Top Doc/Chief of Oncology and Breast disease in Atlanta to review the findings. He could not make a determination from the digital mammo images and suggested a stereotactic biop. We started the biop process and he could see the area in only 2 of 3 images. So instead of going through with the biop, he suggested we look at this from an MRI perspective. Both breast were imaged with contrast (Magnevist) and here are the following findings: the breasts are predominately fatty with scattered fibroglandular tissue demonstrated. Parenchyma appears somewhat more confluent in the lateral aspect of the left breast compared ot the right seen best on the vibe images. In the left breast in the posterior third 1 to 2 o’clock position, there is a 5-mm area of nodular fairly intense enhancement present. This enhances as much as 200% above the baseline and shows question of some minimal washout phenomenon. In the left breast in the junction of anterior and mid third approx. 10 to 11 o’ clock position, there is a focus of slightly ill-defined parenchymal enhancement measuring approx. 7mm in size with progression pattern of enhancement noted. This could correspond to the asymmetric parenchymal density seen on the previous mammographic study. Indeterminate for malignancy in both areas in question. On the right side, there are no suspicious areas of enhancement noted. No pathologic-appearing axillary nodes are noted. No chest wall or abdominal structure abnormalities.
Drs opinion is to do an ultrasound next. What can an ultrasound do that an MRI cannot? I seem to be a difficult case to pinpoint. Is this normal? Thank you in advance. Jana