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Forum Name: Breast Cancer

Question: Abnormal Mammogram results leading to Ultrasound


 aungelm - Fri Jan 23, 2009 6:45 pm

I am very nervous about the results I recieved from my mammogram that warrants further testing. I will include the mammogram results as I read a previous post where they were asked to put them to help you further decide your opinion:

Digital mammography was performed bilaterally using CC and oblique mediolateral projections. The breast are assymetrical and the residual fibroglandular tissue is patchy in a nodular assymetrical pattern with axillary and intramammary lymph nodes bilaterally.

Can you please decifer the results and explain to me what all this means. Should I be concerned? They scheduled me for an ultrasound which I did today at 2:00, and the radiologist took ALOT of pictures. She also told me that she recommends that I see a breast surgeon. She also says she found a fibrocystic cysts amoung the other masses viewed?????? Please let me know what to expect. I would like to thank you in advance for your help!
 John Kenyon, CNA - Sun Mar 08, 2009 10:37 pm

User avatar Hello --

While I don't mean to minimize in any way the concern for potential problems, I have to tell you this is a fairly common scenario. First, the report states the breasts are asymetrical, which is a very common situation -- some would say it is completely normal -- but it has to be mentioned in the report, as does anything which doesn't conform to the standard of absolute normal. As for the "residual fibroglandular tissue" being "patchy in a nodular assymetrical pattern with axillary and intramammary lymph nodes bilaterally," this is merely an observation by the radiologist and is not specific for anything, although it suggests there may be some nodules which are not normal or desireable. These can be fatty, calcification, or, sometimes, tumors (malignant or benign). The next, logical and standard, step is the ultrasound, and many shots are necessary because most breast tissue wont be still the way other body parts tend to be, and there are many angles to cover. I only mention all this because it is so common a followup to mammography, and while it is totally prudent and sensible, in itself it doesn't mean anything except that you didn't get to walk away with a perfectly "clean" mammogram, a very, very common occurence. Fibrocystic cysts are dense breast tissue and fibrocystic breast disease is a common, benign, but often painful problem which can often be corrected by very minor surgery. Since fibrous cysts also sometimes are considered a sign of an increased risk for future breast cancer (even though they themselves are benign), it's often considered worthwhile to remove them if found, mainly to remove the risk factor and to create a "clean" background for future mammogram studies.

The radiologist is following standard (and very sensible) protocol by letting you know about the presence of a fibrous cyst, and the "other masses", a comment which really deserved more explanation, but radiologists are notoriously cryptic, preferring to have a surgeon explain what may or may not be there, especially when the radiologist doesn't actually know. The "other masses" are most likely fatty tissue or calcified lymph nodes, but the fibrous cyst is worth knowing about and may be worth having removed. A breast surgeon, like any other sort of surgeon, is the best consult source because of a surgeon's exquisite knowlege of specialized anatomy (in this case, the female breast). It doesn't necessarily mean the radiologist feels you need to have surgery, but that you should have the pictures evaluated by a breast surgeon, who knows this territory best and can make the best suggestion as to what needs or does not need to be done (if anything).

Your study, so far, is fairly uneventful. This doesn't mean you won't worry, because until you've seen the breast surgeon you won't know exactly what's going on or what may be recommended be done about it (again, if anything). Still, this is a very common scenario, so I hope you won't read too much into it, other than what is fairly certain, which is that there is a fibrous cyst, which could become a problem in the future, although a benign one.

I hope this helps clarify the situation for you. I really wish doctors (especially radiologists) would either take the time to explain more clearly what their reports mean or just refer the patient without all the extra information. It isn't usually helpful to the patient, who usually aren't able to interpret them.

Good luck to you and please do follow up with us here as needed.

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