dilated ducts with no discharge

for almost 2 years I have been having 6 mo. mammos b/c I have "prominent ducts bilatterally" with no discharge. Now I am having an MRI b/c the ultrasound is "showing" something within the ducts. Everything I look up mentions discharge, lumps or masses. What are they looking for, and could this be ectasia with out discharge? My surgeon does not seem concerned at all, but the radiologist gave it a Bi-rad 4. Help!!

tweekerbeeker

[PaulMD]

Hi there.

I understand your concern.  A BIRADS 4 reading means that there is a suspicious new change in the breast and that further work up or a biopsy may be warranted.  However, less than half of patients with BIRADS 4 reading will end up being diagnosed with cancer.  The MRI is the next step in working up this findings however, if it is still equivocal, then a biopsy may be needed.  Possible causes are duct ectasia or non typical hyperplasia.  Not all breast changes or pathologies are accompanied by lumps, discharges or masses and it really possible for some breast problems to by asymptomatic and just show up on the imaging studies.

I hope everything will be fine as statistics tells us that majority of patients with BIRADS 4 reading will end up having a benign condition.

Regards and God bless.

[tweekerbeeker]

thanks for the comment. I just got the results of the MRI but my surgeon will not be back for 2 weeks. What I want to know is what they found. The prior ultrasound showed "a dilated duct w/ increased echogenicity within the lumen".  The mri report says"post contrast imaging demonstrates homgeneous enhancement within the subareolar region pertaining to a dilated duct". Nothing else suspicious.
Impression:reevaluation of the breast with ultrasound with subsequent core biopsy should be considered. Following this procedure, patient can be reevaluated with mri.
Why all the repeat stuff?