Can anyone help me further understand my ultrasound report?

[ddm967]

I received an ultrasound of my left breast last week due to an enhanced nodule seen via MRI, ultrasound was suggested as a followup, it was labeled as a suspected complex cyst.  I had a mammogram earlier this month too and this abnormality was NOT seen on the mammogram.  I picked up the ultrasound notes/report today this is what it states:

The left breast was ultrasounded at 10:00.  There is an area of focal heterogeneity measuring approximately 1.9 x 1.1 x 1.8 cm.  Multiple tiny cysts are present in this region.  There is some mild shadowing present.  No other findings are identified.  

IMPRESSION:  Focus of heterogeneity at 10:00 as described above corresponding with the breast MRI finding.  While this may represent an area of focal fibrocystic change, a malignancy cannot be completely excluded and further evaluation with ultrasound guided breast biopsy is recommended.  The findings were discussed with the patient (they were) and ultrasound guided biopsy was discussed with her at this time.  She has been scheduled for an ultrasound guided breast biopsy at the breast care center.

BIRADS Category 4:  Suspicious Breast Ultrasound

My question is this cyst or multiple of cysts, are they taller than wide or wider than tall???  I am not too good with math so the measurements listed above are a bit confusing for me.  I am just curious to know if it's more horizontal in nature or more vertical. I know one is better news that the other.  I'm scheduled for the biopsy tomorrow.  Anyone else out there experienced this?  IF so, please offer some words of wisdom.  I'm scared to death.  This radiologist talked to me after my ultrasound and said that he thinks it fibrocystic disease but would feel safe doing a tissue sample due to my mother having had breast cancer early at age 38, & I'm 41.  I understand why I need the biopsy, but am worried by the BIRAD 4 rating.  I figure he must have seen something that is making him suspicious, what I don't know.  

Please help if you can shed any light on this ultrasound write up.  I'd really appreciate it.  Thanks

[ddm967]

Thanks!  Sounds good to me then.  I sure do hope you're right and this ordered biopsy is only a precaution due to my family history of breast cancer.  He did say that he thinks it's cystic disease he told me this in the hallway after the ultrasound, but there was an area on ultrasound he couldn't see well enough to say one way or the other and thinks a biopsy of the tissue would be a good idea.  I'm fine with doing it.  I sure do hope all of my worrying and reading info online has been for nothing.  That would be the best news of my life--right up there with other good news I've gotten.  That's all I've been praying for...to hear it's benign.  I guess I've never been thru this before & it's just scary for me since I know my chances are good to get BC due to my mother having it.  I don't want to alarm my mother about this until I get the biopsy results in case it is nothing to be concerned about---she worries tremendously and would feel horrible for me, guilty I suppose.  So I've tried to stay quiet about it, but it's been hard because I'd ideally like her support since she's been there and done that.  I know she doesn't need this stress right now & really--neither do I.  

I hope this biopsy today will help relieve me of my stress and worry.  I truly hope that's all it is and I'll be alright.  Thanks for your comments, I know I've posted alot lately basically asking the same thing--I guess I just want to hear supportive comments from others, that's all.  I do appreciate the input.

[japdip]

You have known by your previous posts that this suspicious area requires a biopsy although the Radiologist thinks it may well be only cysts. A BIRAD 4 rating is simply the rating that requires a biopsy ...... there is noting more meant by it than that. If the rating had been a 3 then no biopsy would have been recommended. The Ultrasound found what the MRI found .... nothing more or less. Regards ....