Understanding Abnormal Mammogram Results: Focal Opacity & Hypoechoic Lesion
QuestionI made an appointment this morning with a cancer center in my area for a second opinion of my films and reports. Can you explain further what focal irregular 1 cm opacity in central far left posterior with partial dissipation on spot compression means. Wouldn't that spot be the one to follow up on most? Also would you explain what a hypoechoic complex lesion with internal echos within means. thank you
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Followup To
Question -
On 9/14 I had a routine mammo, called back for spot/cone compression views and ultrasound due to heterogeneously dense breasts with benign appearing calcifications and focal nodular opacities in both breasts including a nodular density in central left breast far posteriorly. Cone compression views done on 9/26 with these findings, nodular opacity in interior right breast on right MLO view, nodular density in outer right breast on right cc view and focal opacity in outer left breast on left cc view demonstrate partial dissipation with appearance suggestive of asymmetric breast tissue. No discrete mass noted. Focal irregular 1 cm opacity in central far posterior left preast on left cc ciew also demonstrates partial dissipation. No discrete mass is noted. ultrasound is done same day with these findings, a 0.5cm simple cyst at 12 oclock position right breast. 0.4 cm non-aggressive oval hypoechoic lesion at 2 oclock position right breast. Two hypoechoic lesion at 10 oclock position right breast measuring 0.4 and 0.6cm respectively. Left breast ultrasound demonstrates a hypoechoic complex 0.4cm lesion demonstrating internal echoes within. No other solid or cystic masses in left breast. Impression: ultrasound demonstrates multiple sub-centimeter hypoechoic lesions suggestive of small cysts and complex cysts that are difficult to appreciate on mammogram. Bilateral breast ultrasound follow up in 6 months. Unilateral follow mammogram in 6 months for nodular density in central far posterior left breast. Birad 3 - probably benign.
My Maternal grandmother died of colon cancer, my mother's sister died of lung cancer after a complete radical mastectomy and my mother is still living after a lumpectomy and radiation for breast cancer. Please advise me as to your feelings about these reports. These were all done by my MD at an imaging center that does not specialize in breast. My MD wants to have both tests repeated in three months instead of six. Should I be concerned enough to seek a second opinion or wait and worry for 3 months. Thank you.
Answer -
Your mammograms & ultrasound scans should be complemented with breast MRI scans and all uncertain lesions checked with thin needle aspiration biopsies. If any biopsy result is unclear a surgical biopsy should be done. The results are not alarming, but this procedure should be followed!
AnswerIt means a 1/4 inch lesion located in central far left back area partly disapearing when compressed. What it really is can only be determined by biopsy though more information and hints can be had by breast MRI. Which lesions - maybe all - that are best suited for biopsy should be decided after breast MRI. The hypoechoic (= little ultrasound echo) lesion is probably a fluid filled cyst. The echoes mentioned inside must be checked with biopsy. Thin needle aspiration biopsies - if possible - are the simplest & easiest method available.
