Asymmetric breast tissue----possible cause or outcome

[lysgirl]

Dear Surgeon,I'm 42 years old and recently had a yearly mammogram and was called back to have a spot compression ultrasound to my left breast due to a finding of "Deep underlying tissue in the left breast that's different from the right".  My gyn doc told me that there's "asymmetry" in the breasts. She said there was no mass noted, no calcifications just the asymmetry.  I cannot palpate any lumps or masses during my self breast exams.  I am very concerned as my mother died of ovarian cancer and I had an aunt with breast cancer (survivor) and a 1st cousin who died at age 36 of breast cancer.  I did have the BRAC testing a few months back due to my family history and it did come back negative for the mutated gene.  I realize that doesn't mean I can't get breast or ovarian cancer.  The ultrasound is not until next week and in the meantime I am very anxious.  Can you shed any light on what the possibilities are on this.  My gyn doc talked to me briefly and said "Not to worry" but that is easier said than done with my family history.  Your quick response is greatly appreciated.

[CCF-RN,MSN-rf]

Dear lysgirl:  It is very common to have an area of "asymmetry" appear on a mammogram - this is a common description.  In these cases spot compression is recommended to further evaluate the area.  Many times the outcome is that the tissue may have folded over on itself and spot compression will smooth it out, yielding a normal mammogram.  Although you are correct that a negative BRCA does not guarantee freedom from the possibility of breast cancer, it does suggest that heredity may not play a big role in your case.

[barb5971]

A related discussion, worry about tests was started.

[researchb]

A related discussion, An asymmetric area that is problematic was started.

[Montana girl 06]

You can try to post a question by clicking on the blue box at the top of the page that says, "Post a question." Those are the only quesstions answered by the medical professional. Sometimes you need to try different hours of the day because only a limited number of new questions are allowed each day. One thing I would suggest for each of you is to get a copy of the radiology report so you know exactly what's involved.

Wadsy - Have you seen a breast specialist? Usually a doctor has to agree to send a script to the radiology center requesting a proceedure. I had a 3 month follow-up mammogram last year and they didn't tell me it was too soon, but I did have a script from my surgeon.

rhonda - They may be referring to the fact that it is quite common for there to be a callback to check out a suspicious area on a mammo. Most of these turn out benign. After you have the additional tests they will give it a BIRAD rating that tells how suspicious the area is on a scale of 0-5. I think they just wanted you to know that most callbacks turn out fine. However, having been there myself, I know that callbacks produce a lot of anxiety. Hopefully the ultrasound will be able to tell what type of mass they're looking at. If they consider it a benign mass  you'll be off the hook. If they can't determine if it is benign or malignant, they will do a biopsy.

I wish you both the best.

[mscharisma]

I have similar questions re. the impact of stress and the amount of tests or surgery we go through. If you find an answer elsewhere, please share it here. Especially since I read somewhere that more women in the US undergo mastectomies then in Europe, for example, the question comes up if we also have more tests, etc., and if we're actually better off that way in terms of detection, treatment, survival.

From my personal experience (abnormal mammogram the end of June, then waiting from one appointment for this test to the next appointment for that test, and with a biopsy now finally scheduled Sept. 11 - yeap, the first available date), I can tell you at least that much for sure: my blood pressure has never before been as high as it has been in the last few weeks.

[rhonda2122]

Hello, I had my yearly Mammo last friday. I got the dreaded letter advising me to contact my gyno because something had been found. When I called I was told " that a mass was found deep in the upper left quad of my breast next to the rib" now I am waiting for my ultrasound tomorrow... What exactly does all this mean? Everyone at the dr office is like it's "normal" procedure...NO, it's not normal... my last mammo was NORMAL!!! Help

[rhonda2122]

It's me again, rhonda2122... I forgot to add a few things, I am 42 years old. I am hypothyroid, have Hasimotos diseas.......

[Wadsy]

I have had a mammo and a spot compression both showing "a vaguely persistant area of asymmetry" at 11 o clock of the breast" quite dense". I have had an ultrasound that did not show a mass or cyst. The comment from the Radiologist was "If futrther work up is warranted at this time, then MRI of the breast w/ and w/o contrast may be considered. If short interval followup desired, six  month mammographic followup recommended."
Oh Yeah like I want to wait six months, if there is something there, and let it grow? So today at the 3 mth date I went to have a mammo and they were like "its too soon". This made me a little upset. This is my body and life and I want it checked again now. I am 40 years old and I need this for my own peice of mind. They did the mammo, I will have results in a few days.  
I need more input. Does anyone have any?? Should I just get an MRI???? Help

[wildsisters]

I was looking for information on the meaning of asymmetric tissue after getting this result back on a recent mammogram - and came across this site and thread. I've now been for a spot compression (same results...apparently not alarming) and I've been told to report in another month for a breast exam by my doctor (after having one two weeks ago) and to go for yet another mammogram in six months.

Meanwhile...does anyone ever study the impact of the stress these tests and all this eternal waiting has on people? I have a really hard time viewing my body as the organic answer to car parts...broken or working. Because I see history and emotions as part of my physical system, I wonder if the constant suggestion of threat implied by having test after test isn't harmful in and of itself. Of course I want early detection if something is wrong...but I have no symptoms, no lumps, no family history of breast cancer...and I can't help wondering if this much testing is overkill. This is a serious question, if anyone cares to take it on. And are there breast cancers that simply spring (seemingly)from nowhere - without any external indication...and rage out of control in under a year?

These are the kinds of questions I never get to ask a doctor - and which the majority of doctors seem to receive as some kind of insult or challenge. I have a history of trauma associated with hospitals...which is triggered by what is currently going on, and I'd be really grateful if there's someone out there who has considered the emotional impact of the testing process and could answer.

Thank you.

[lysgirl]

Thank you so much for responding to my question as did the surgeon.  I am feeling better about the upcoming ultrasound but still very concerned.  The worst part is this waiting, waiting, waiting.  Maybe someday they can eliminate the need for waiting for test results.  Thank for responding.

[surgeon]

It's rare that one's two breasts are mirror images of each other; so it's quite common that when comparing mammograms of each side, some shadows are seen on one side that don't correspond to those seen on the other. Basically, that's all that assymmetry means. When they've done additional images and have said the tissue in question looks like normal breast tissue, then the cause for worry is pretty much eliminated. I doubt the ultrasound will tell much more than what's already known: you have tissue in an area of one breast that isn't present in that location in the opposite breast, so in looking at the xrays it draws attention. But it looks like normal breast tissue. So there's not much to worry about; the situation is common. The cautious thing is at least to re-xray the area in 3 months or so to be sure there's no change. If the situation is so worrisome to you that it's going to drive you crazy, let your docs know and they can consider doing a biopsy for peace of mind.

[lysgirl]

Thank you so much for your immediate response to my question.  Your answer certainly helps to alleviate some of the stress I am feeling. While I know it is impossible for you to diagnosis something online, it helps greatly to know that you have seen this in the past and typically it represents nothing abnormal.  I realize there is always chance it could be something abnormal, but its comforting to know that theres a good chance its nothing serious.  Thanks again for responding.