What are BIRADS and other definitions.... HELP!!

[dgruber]

Hi,
First my family history, every female member of my family has had breast cancer, except my sister, who is 4 yrs older than I.(I am 43) My grandFATHER lost a breast to breast cancer, all of these on my mothers side.

I had a lumpectomy done in 98 on the right breast, it was benign.

In June I found a lump in the right breast, went for mammo and ultrasound, mammo picked up that lump, ultrasound picked up a second lump, left breast. Went for a surgical consult, surgeon found a 3rd lump in the right breast, so at that point I had 2 in the right, 1 in the left. All were very, very small. he said due to my family history and the size, to go in at that point would have been like looking for a needle in a haystack and left behind sooo much scar tissue it would have made future mammos harder to read. He wanted to wait a bit for them to grow.

Went in at the end of September for another round of testing, found a 3rd lump in the right breast that the ultrasound girl told me about, so at that point I am looking at 3 in the right, 1 in the left.

Surgeon said that he didn't have the ultrasound report when I was in last week, said they look benign, but we should biopsy to make sure.

I just picked up my ultrasound report for the surgeon to look at on the 15th when I go back to him. He said he wanted it to do the biopsy. It reads:

At 9 oclock in the right breast, 10 cm from the nipple are two hypoechoic cystic areas measuring 4x5x2mm and 2x4x1mm There are multiple tiny hypoechoic lesions in the area of interest between 9 and 11 oclock. None of them dominant. There is a cluster of cysts in the 11 oclock position of the left breast, 7cm from the nipple similar to that noted on the previus study, this measures up to 3mm.

Please, can someone put any of this into laymen's terms for me. To me it sounds like there are more than the 3 in the right and more than 1 in the left that I thought I had.

Can these be cancerous?

Can they turn cancerous if they are not right now? And we wait for them to grow some more?

What are BIRADS? mine are at 3. Exactly what does this mean? Are higher BIRADS good or bad? and just how high does the BIRAD chart go?

Is there a generally accepted time frame that you get the results back from the biopsy?

I've been wandering around, cultivating these lumps since June, I want them out of my body, especially with my family history.

Also, I plan to do genetic testing, although I already know what the results will be, I was told there are drugs that can cut my risk. Is this true and if so, what drugs and how much lower do they cut your risk. I guess realistically, right now, I have a 100% chance of getting breast cancer in my lifetime, if I can cut that ANY, would lighten my mind a great deal.

Sorry this is soooooo long.

Thank You for any and all information available.

dgruber

[dgruber]

Hi,
Thank You all sooo much for the information, it has given me some small comfort to think that they are probably benign.

Also, Thanks soooo much for the info on BIRADS, I undersand them much better now and found a website that has a lot of info on it. I will be reading as much as I can.

And no, my Mother died in March of 2000, she never was tested for the gene, so we have no idea if she had it or not, I would imagine she did though. Her death certificate lists about 10 different types of cancer that killed her, surprisingly enough, breast cancer was not among them.

Thanks again for all the information, although not at ease, my mind is slightly less befuddled by all of this.

[kittyluv1]

Hi!
Obviously your family history is reason for concern, but at this point you are still in the pre-diagnosis phase.  A BIRADS score of 3 means that the areas of suspicion are "probably benign".  The fact that there are numerous areas found on ultrasound sounds as if you are dealing with fibrocystic breasts, which although they may occasionally be uncomfortable, is a benign condition just requiring usual and careful followup with mammograms, repeat ultrasounds if needed and a biopsy should any of these areas change in character between exams.
Having just undergone a wire guided excisional biopsy, my pathology results were available in 3 days and, thankfully, the results were benign.
As far as genetic testing is concerned --- have the other females in your family tested positive for the BRCA gene?  If your mother wasn't BRCA positive, you won't be either.
If you do test positive yourself (given the above), the decisions you make regarding further treatment will require some well thought out discussions with your doctors.  Some women opt to have prophylactic bilateral mastectomies just to get the worry out of their lives, but that is something you need to decide for yourself given your family history and the results of any ultrasounds, biopsies, etc. that you undergo.
Hopefully you are dealing with a benign fibrocystic diagnosis and will just need to maintain your yearly followup exams.
Best wishes and take care -- my thoughts will be with you!  Keep us posted on your progress ---

[japdip]

BIRADS = Breast Imaging Reporting And Data System. This was set up by Radiologists as a reporting system of mammo / ultrasound results. The scores are from 0 to 5; a BIRADS 3 requires a 6 month follow-up. It's just a standardized system that is used by all Radiology Dept.s throughout the country. After reading your report it all sounds like multiple cysts were discovered in both breasts. As far as medication to reduce your risk if you are positive for the breast cancer gene would most likely be Tamoxifen which blocks the production of Estrogen. Many cancers are dependant on Estrogen for growth. Cysts are a benign condition and don't "turn into cancer".    Regards ....

[kateful]

Haven't got any personal experience with breast cancer and hope to be able to still say that after my biopsy next week.  However, hours and hours of research in the last 2 weeks has yielded some information to answer part of your questions.

The higher the BIRAD score, the more likely for malignancy.  HOWEVER, the range for BIRAD 4 is crazy--2%-95% chance of malignancy.  BIRAD 5 is >95%.  Biopsy recommeded for both of these.  BIRAD 3 is considered benign and suggests a 6 mo follow-up mammogram.

I don't know about generally accepted time frame for biopsy results.  That would probably depend on the lab.  I was told that I would get mine in 2-5 days, but usually 2.

I'm sorry I can't answer the drug question, but you are likely to find some answers here.  It appears that Tamoxophen is used for prevention after radiology in many cases.  But there are probably other reasons for that of which I'm not familiar.

Best wishes to you!