QuestionQUESTION: I am 41 years old with 3 young kids. I had a mammogram done last year and all was fine. I had one done now that came back: There are scattered fibroglandular densities. A focal asymmetric density in rt breast. Question compression artifact. No dominant masses, suspicious calcifications, or areas of parenchymal asymmentry or distortion are identified. I am to have a digital mammogram in two wks. I am scared!!!!!! What is the percentage that it may be cancer. (no cancer in family) Please help. Also what does all this mean?
ANSWER: All this means is that you need to undergo a digital mammogram and nothing more. The radiologist can not make any type of assessment based on the current films. It is akin to guessing if it will rain and you can only look through a frosted window, eliminating your ability to see clouds in the sky. The fact that you have had children, and there is no cancer in the family gives you the same lifetime risk of breast cancer of approximately as any other American female, about one in six (seventeen percent). At age forty one. your age specific risk is much less than that.
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QUESTION: I had the digital mammogram done and they still saw the spot, so they did an ultrasound. They told me at the ultrasound there was nothing seen on the ultrasound. I went to a breast cancer hospital to have this done. I now got my results by mail and it says: Sonogram shows no cyst or solid mass. conclusion small focus of asymmmetrically dense tissue on right. Probably fibroglandular. Recommend 6 mth followup. At the bottom it says BIRADS-3 probably benign-follow up 6mths.
I am wondering why it says "probably benign." And what is a
3? Should I be concerned. The breast center and my doctor do not seemed to be concerned. Should I be? Thanks
AnswerBI-RADS refers to the recommendations for mammograms by Breast Imaging Reporting and Data System category. The system is scaled 0 to 6 (seven steps). BI-RADS 3 is "probably a benign finding advising a Short-term follow-up at 6 months, then every 6 to 12 months for 1 to 2 years." The recommendation has a "B" rated strength and is based on consensus guidelines, cohort studies; large case series; validated decision tool; less patient stress; lowered cost of surveillance.
All this means is that your doctor did a less than adequate job of reassuring you about a probably benign finding. That is, the area of concern is most probably not a cancer.
I preface the recommendation with the following statement. There are no one hundred percent accurate tests. To know for certain a biopsy would be required. This is why clinical judgement and communication with a patient to reach consensus on management are the hallmarks of a good clinician. Both sides must participate in the discussion. Unfortunately, not all physicians are well versed in breast disease management.
If you are in doubt, get a second opinion from a breast surgeon.
