hypoechoic focal lesion

[OMS1981]

Hi,

I got a right breast mass associated with the axillary swilling and right arm heaviness. I did 2 ultrasounds

The first one showed well-defined small oval mass measures 13x10 mm seen in the upper quadrant of the right breast at 12 o'clock. The mass shows heterogenous mainly echotexture with no degeneration or calcifications. The mass gives no posterior acaustic shadowing.
- The remaining breast tissue has diffuse dense texture.
- No abnormal calcifications could be seen. No intramammary enlarged lymph glands.
- Normal retromammary layers and normal visualized parts of the pectoralis muscles.
- Normal axillart tao; at both sides with bilateral enlarged lymph nodes with preserved hilum & no pathological change seen. The largest seen at right axilla measure 19x9mm.

The doctor said I got sort of infection and she gave me antibiotic (Cefurxime/Axetil) 500 mg every 12 hours for 7 days.

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After 4 days I had an appointment with surgeon and he asked for second ultrasound. it showed well-defined hypoechoic focal lesion of 16x10 mm in size seen at at 12 o'clock 3 cm from the nipple suggesting fibroadenoma for FNA biobsy.
- Both breasts show highly reflective breast parenchymal echotexture predominantly glandular pattern.
- No dilated ducts.
- Bilateral axillary few lymph nodes the largest is seen in the right axilla measuring 21x7 mm. All are typical in appearance suggesting reactionar lymph nodes.

IMPRESSION:
- Right breast focal lesion suggesting fibroadenoma for biopsy.
- Bilateral Breast fibroadenosis.
- Bilateral axillary reactionary lymph nodes.

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I have a biopsy appointment on August 8.
What do you think of the ultrasounds results?
Is this hypoechoic focal lesion cancerous?. Is it necessary to get it removed?.

Thanks in advance.

[mhv]

Thank you for helping!

[bluebutterfly2222]

Hi,

Here is  some information about phyllodes tumors.

"Phyllodes tumors are rare solid lumps that usually present as a mass found during a woman’s breast self-examination or on a routine physical examination. Smaller masses may be detected mammographically. Phyllodes tumors appear very similar to a benign lump known as a fibroadenoma. These lumps are usually well circumscribed and painless. Imaging evaluation including a mammogram and ultrasound is usually performed and when a solid lump is identified a biopsy is important to obtain tissue for accurate diagnosis. A phyllodes tumor cannot be differentiated from a fibroadenoma by a needle biopsy. This means that your doctor may not be able to accurately tell you whether a solid lump is a benign fibroadenoma or a phyllodes tumor. Risk factors for phyllodes tumor are rapid growth and size greater than 2 cms at the time of the evaluation. In many cases your doctor may recommend complete surgical removal of this mass to ensure that it is not an underlying phyllodes tumor.

Phyllodes tumors are not all cancerous. Many will be classified as benign and not require further evaluation. A skilled pathologist is needed to distinguish a benign phyllodes tumor from one with more aggressive malignant potential. In any event, women who undergo surgery for removal of a phyllodes tumor require close surveillance with followup mammogram and physical examination at regular intervals. Malignant phyllodes tumors are best managed with a wide excision of normal breast tissue around the tumor to obtain clean margins. In most cases, radiation therapy is not required. Very large malignant phyllodes tumors may require complete removal of the breast for management."

You may have already had a follow-up visit with your surgeon by now. If not, when you do see him or her, that will be the best source of information regarding what part of  the above may be  relevant to you, and what additional follow-up or surgical treatment is indicated in your particular case.

Best wishes,
bluebutterfly

[mhv]

I am so sorry, but I honestly don't know.  There are several other people on here that know so much more then me, but unfortunately, they seem to not be active right now.
When is your next appointment?

[OMS1981]

Thanks for your support.

God Bless

[OMS1981]

Thanks for your support.

I had biopsy, it went well, thank God.
Results of the biopsy:

Gross Appearance:
Specimen consists of two cores of grayish white tissue measuring together 1.5x0.1 cm. Submitted in toto (all/1)

Histology:
Breast Glandes surrounded by a fibrous stroma.

Diagnosis:
This picture is consistent with PHYLLODES TUMOUR


What does that mean?

[mhv]

Although I have no answers for you unfortunately, I wanted to lend you support, and tell you I hope you get the best news ever!