Understanding MRI & Ultrasound Results for Breast Health

Question
Had DCIS in LEFT breast at age 57..treated with lumpectomy and radiation. Have been followed up with MRI, as breasts are VERY dense, even at current age of 65. September MRI found problem in RIGHT breast..following is a summary of report..."small well circumscribed area of moderately intense pathologic enhancement in 9 o'clock position of right breast..area approx 6 mm.  with rapid washout...suggestive of malignancy"" Then I had an U/S. summarizing..." 5mm nonshadowing hyperechoic nodule..9 o'clock (it took them a long time to find it..its almost on the underside)..this nodule demonstrates U/S characteristics indeterminant for malignancy"
I am having a wire localization for excisional biopsy in a few weeks. I wanted an opinion and explanation of some of the terms in both the MRI and U/S reports. Thank you so much for your response.

Answer
Dear Judi,   Based on both of these radiology imaging techniques, you have a suspecious mass in your right breast and it is good that you are having it removed for biopsy....

MRI results are often MORE accurate that ultrasound, but in your case BOTH are revealing an abnormal mass that is consistant with malignancy...

On the MRI the radiologiest noticed a "rapid washout"...  There are 2 phases with a breast MRI...  The "initial phase" the mass will enhance slowly and in the "delayed phase" if the mass continues to enhance slowly, then the mass is considered benign....  In your case, The mass had a RAPID enhancement in the initial phase and a rapid WASHOUT in the delayed phase and this is indicative of malignancy....  Neither the MRI or ultrasound says what the margins of the mass look like....  A benign mass often has well circumscribed margins where as a malignant mass will havespiculated margins....

You "MUST" have the excisional biopsy because based on these facts this could very likely be cancer...  As you know, your chances are better if found and treated early...

Make sure you have researched everything about the type of cancer (if indeed it is cancer when you have the biopsy done) and make WISE decisions about your treatment plan...

thank you,   karen