Aa
Aa
A
A
A
Close
Avatar universal

Stereotactic biop to MRI to Ultrasound

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
    

2 Responses
Sort by: Helpful Oldest Newest
Avatar universal
Thank you for your comments 4/25/08 regarding my concerns.  I have a little more information since I have had an ultrasound that followed the MRI and here are the findings:
     Sonography was performed concentrating on the areas in question on the MR study targeted specifically to the 1 to 2 o'clock position and 10 to 11 o'clock position.  In the 10 to 11 o'clock position, there is no sonographic correlate for the MR abnormality.  In the 1 to 2 o'clock position in the left breast, there is poorly defined hypoechoic but complex appearing area measuring 5mm in diameter.  
Impression:  5mm hypoechoic complex area 1 to 2 o'clock position left breast considered suspicious perhaps accounting for the MR abnormality.  This could be biopsied under sonography.  ACR code 4.

My doctor is now doing a biop of the one considered suspicious on May 27th.  My question is what does this new information say about the abnormality in the 1 to 2 o'clock position and what percent of this type is malignant/benign.  Either way I believe I was lucky to have had the MRI since this was not even identified through Screening mammo.  Your thoughts are welcome.  Thanks and God Bless...
Helpful - 0
Avatar universal
Hi there.

So far, all the tests cannot rule out a malignancy and are all indeterminate.  The proper outlook for any breast lesion or lump is to work it up and consider it as a malignancy until it is proven to be otherwise (through conclusive imaging studies or biopsy).  I also doubt if the ultrasound can give us anything definitive.  It may also turn out to be "indeterminate" just like all the other tests.  If this turns out inconclusive then a biopsy may still be warranted.  I suggest you discuss all options with your doctor and also the possibility of cutting the chase and going directly to biopsy (which also has its pros and cons).  This is just my opinion.  Regards and God bless.
Helpful - 0
Have an Answer?

You are reading content posted in the Breast Cancer Community

Didn't find the answer you were looking for?
Ask a question
Popular Resources
A quick primer on the different ways breast cancer can be treated.
Diet and digestion have more to do with cancer prevention than you may realize
From mammograms to personal hygiene, learn the truth about these deadly breast cancer rumors.
A list of national and international resources and hotlines to help connect you to needed health and medical services.
Herpes sores blister, then burst, scab and heal.
Herpes spreads by oral, vaginal and anal sex.