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spiculated mass
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spiculated mass

Following mammograms 1 wk apart, I was told a spiculated mass was found at 6 o'clock, left breast.  I'm 79.  Ultrasound followed, and radiologist thinks the mass is a bruise trying to resolve itself, that I should repeat the ultrasound in one month.  There is no external sign of bruising.  I'm inclined to want a breast surgeon in on this, now rather than waiting, and to discuss an excisional biopsy.  Comments, please.        (signed) words
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587083_tn?1327123862
Hi,
Just to clarify a few things about the BI-RADS scores.I've added for you some more info on how radiologists categorize the findings on mammography and ultrasound reports.

BIRADS Classifications:

Category 0,means that your mammogram or ultrasound finding was "Incomplete"
It didn't give the radiologist enough information to make a clear diagnosis.With a score 0, you will probably need to have a follow-up image done.

Here is how the radiologists categorize the findings:

Category 1,There are no suspicious masses or calcifications to report; tissue looks healthy.

Category 2 -- Benign or Negative
Breasts are same size and shape and tissue looks normal. Any cysts, fibroadenomas, or other masses appear benign.

Category 3 -- Probably Benign
There are no suspicious lesions, masses, or calcifications to report, but follow-up to confirm that no cancer exists is recommended. This may be needed if your radiologist does not have your baseline or previous mammogram for comparison.

Category 4 -- Possibly Malignant
There are some suspicious lesions, masses, or calcifications to report; a biopsy is recommended to check the suspicious area.

Category 5 --  Highly suspicious of malignancy
There are masses with an appearance of cancer. A biopsy is recommended to make an accurate diagnosis.
I hope this helps a little understanding the BI-RADS categories.
Sending you my best wishes...
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9 Comments
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25201_tn?1255584436
You certainly have the right to see whomever you wish so make an appointment with a Breast Specialist. There doesn't need to be any external signs of a bruise for the underlying tissues to be bruised. A spiculated mass does seem to raise suspicion, at least in my mind. You might also have your films read by another Radiologist at another institution. It's obvious that you are not comfortable with the wait of only 1 month although that short time shouldn't make any difference in the end result. It may take you that long to secure an appointment with a specialist but there is no reason why you can't go ahead with that and have the re-check in 1 month too.   Regards ....
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Avatar_f_tn
I appreciate your comments.  I've made the appt and happily, will be seen Mar 29.  Opinions from my online research lean heavily toward a malignancy when a 'spiculated' mass is seen, but there are many 'howevers' and 'whereas' comments as well, so I must just hang tight until I see the breast surgeon, who comes highly recommended, and try not to obsess about this.  Right!!!  Kind regards--
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25201_tn?1255584436
That's right .... you know there are always a lot of howevers and whereas' in this business .... unfortunately nothing is exact even though we would like it that way. The waiting and wondering is a bit if a test of our fortifude I suppose. Please let me know after you appointment with the Breast Surgeon.  Take care now .....
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Avatar_f_tn
I just wanted to add a note of encouragement to you, words1952. I'm so glad you were able to get an appointment with a good breast surgeon relatively quickly.I think most of us here try to emphasize that statistically most biopsies end up with benign results. Even with a spiculated mass benign results are always possible. There are women here who've had a BIRADS 5 mammogram and they end up with a benign biopsy.We try to encourage everyone who is going through the various biopsy procedures to remain hopeful. Even the small percentage who end up with breast cancer diagnoses have every reason to be hopeful. Most are caught at an early stage and are highly treatable. The important thing is to be vigilant, get screened and follow through on the recommendations if something unusual is found. It is so much easier to deal with "what is" than to worry about "what ifs" even though the waiting can be very stressful. There are supportive, informative and wonderful women here to help anyone who wants or needs it. I hope you'll decide to let us know what your results are and I wish you all the very best.
Sending you a big hug (       ),
nc
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Avatar_f_tn
A big Thank You for your encouragement, NC.  I'm very relieved to have the appointment, and I'm also very relieved to find my BIRADS are zero!!  The word is new to me and I just skimmed by it on the radiol. report, thinking it was a measure of the amount of radiation used to take the film (which doesn't make sense as I think about it now).  Curses!  Could've saved myself and my kids a lot of aggravation by finding out what BIRADS really meant early on.

You were very kind to post me.  Again, many thanks.
words 1952
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587083_tn?1327123862
Hi,
Just to clarify a few things about the BI-RADS scores.I've added for you some more info on how radiologists categorize the findings on mammography and ultrasound reports.

BIRADS Classifications:

Category 0,means that your mammogram or ultrasound finding was "Incomplete"
It didn't give the radiologist enough information to make a clear diagnosis.With a score 0, you will probably need to have a follow-up image done.

Here is how the radiologists categorize the findings:

Category 1,There are no suspicious masses or calcifications to report; tissue looks healthy.

Category 2 -- Benign or Negative
Breasts are same size and shape and tissue looks normal. Any cysts, fibroadenomas, or other masses appear benign.

Category 3 -- Probably Benign
There are no suspicious lesions, masses, or calcifications to report, but follow-up to confirm that no cancer exists is recommended. This may be needed if your radiologist does not have your baseline or previous mammogram for comparison.

Category 4 -- Possibly Malignant
There are some suspicious lesions, masses, or calcifications to report; a biopsy is recommended to check the suspicious area.

Category 5 --  Highly suspicious of malignancy
There are masses with an appearance of cancer. A biopsy is recommended to make an accurate diagnosis.
I hope this helps a little understanding the BI-RADS categories.
Sending you my best wishes...
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Avatar_f_tn
Many many thanks, Zouzi.  Yours is the most informative look at BI-RADS that I've read.  My skimmed interpretation of zero as being great news isn't worth the paper it's printed on---I found that out yesterday, so I'm doubly grateful for your elaboration. And thanks for your best wishes.  I return them.  

words 1952
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587083_tn?1327123862
You are very welcome words 1952.
There was a time when I didn't even know what BI-RADS meant!. LOL..So no problem here. We all learn as we go along.
I sincerely hope that all will go well for you when you'll meet your Surgeon.
Good luck and God Bless. :)
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Avatar_f_tn
Yeah, BI-RADS was definitely a new one on me.  Again, many thanks.
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