Understanding a BI-RADS 4 Lesion: Risks & Next Steps

Question
QUESTION:      I was diagnosed with "dilated left retroareolar density.' This was later reported as " tubular retroareolar equal density mass." I can't get a medical appointment for one month and therefore need an explanation of what risks I might face. I'm trying to get a biopsy as soon as possible, to find out for sure. 'Any speculations to offer?

ANSWER: A biopsy is needed to clarify what this is. With a birad 4 there is a clear risk that it is a cancer but it is certainly NOT sure! Beyond that I'm not prepared to do any speculation! It is important to have this done as soon as possible so try to get it sooner if possible. There is actually not much difference in the 2 descriptions.


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QUESTION: I've been frantically trying to get a biopsy and will do so asap. My reason for asking such a specific question is that I was hoping for a specific, informative answer, given that none of the webs or medical dictionaries could provide the required info. And neither did you.

Answer
The reason you can not get more information is that the so called diagnosis you mention really does not contain much information. The first diagnosis translated to everyday English just means "an expanded mass behind the left nipple", the second means "a mass consisting of milk ducts of equal density behind the nipple". That does not tell much! The important thing here is birad 4, which is a scale used to try to evaluate the risk of a lesion being cancerous. As I wrote it means a considerable risk of that but not a certainty. The ONLY way to find out what it really is is by doing a biopsy. Otherwise a biopsy would not be needed! Not being a fortune teller I can unfortunately not tell you more before any biopsy. Nor can anyone else, though I do understand your concern and wish to get more information ASAP! Unfortunately that will only be possible after a biopsy. Maybe more information can also be gained by doing an MRI breast scan. If that can be done faster where you are I do not know though.