BI-RADS 3 Question

Posted by katrina123 @katrina123, Oct 11, 2020

A couple of days ago I had a mammogram and an ultrasound. It has been 6 months since my breast radiation. The doctor on the spot said that my images looked normal but then yesterday when I pulled up the details on the internet it said that the images were Birads 3. I was just wondering if is normal to be rated this way after a lumpectomy and radiation. I was so glad that my images looked normal and now I am concerned with the Birads 3 diagnosis.
Thanks
katrina123

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@katrina123
It was told to me by the radiologist that sometimes one gets fat necrosis following breast surgery or radiation. I wound up having a mammogram about 2 months following radiation and then 6 months after that to be sure all was well. However, if you have any concern, I would advise you to speak to either your oncologist or regular doctor and talk with them about doing breast MRI.

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Thank you trixie for your response. Do you happen to know what your birads number was for your mammogram after radiation? I was just curious if it is common for breast cancer patients to have this birads 3 number after radiation and a lumpectomy.
The radiologist has asked that I have an MRI in February and another Mammogram and Ultrasound in April. I have sent my oncologist an e-mail concerning the birads number
Thanks again
katrina123

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@katrina123

Thank you trixie for your response. Do you happen to know what your birads number was for your mammogram after radiation? I was just curious if it is common for breast cancer patients to have this birads 3 number after radiation and a lumpectomy.
The radiologist has asked that I have an MRI in February and another Mammogram and Ultrasound in April. I have sent my oncologist an e-mail concerning the birads number
Thanks again
katrina123

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@katrina123
This was from my report: "BI-RADS 3 – Probably Benign. Recommend follow-up examination in 6 months." Because my second cancer lesion was "neuroendocrine differentiation," they follow up on me more than the usual follow up as it is highly rare beginning in the breast. It sounds like your radiologist is on top of this.

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I'd also like to bring @annac3 and @icya2282 into this discussion.

@katrina123, you might find this explanation about Breast Imaging Reporting and Data System or BI-RADS from the American Cancer Society helpful.
– What is a BI-RADS assessment category? https://www.cancer.org/cancer/breast-cancer/screening-tests-and-early-detection/mammograms/understanding-your-mammogram-report.html

I agree with Trixie that it sounds like your radiologist is on top of things. The BI-RAD categories are used so that everyone is using the same evaluation criteria.

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Hi-
I received this report, which is strange because it doesn’t mention my calcifications.
My radiologist said we can do a follow up u/s in 6 months or a biopsy, but I have implants (cosmetic) so we decided to watch it. Can someone read this and tell me if the results look more reassuringly benign rather than malignant?
***The mammo says indistinct margins but u/s says circumscribed(?). Also- posterior acoustic enhancement?
Any help will be great!

Bilateral breast implants are stable and intact.
There is a 1.4 cm equal density asymmetry with an indistinct margin in the right breast at 11
oclock middle depth. Finding is best noted on tomographic MLO slice 15. Ultrasound
demonstrates a 1.5 cm x 1.1 cm x 0.4 cm oval mass with a circumscribed margin at 11 oclock
middle depth 8 cm from the nipple. This oval mass displays a hyperechoic rim and posterior
acoustic enhancement. This correlates with mammography findings. Color flow imaging
demonstrates that there is no vascularity present.
No other significant masses, calcifications, or other findings are seen in either breast on the
mammogram or bilateral ultrasound.

IMPRESSION: PROBABLY BENIGN
The 1.5 cm x 1.1 cm x 0.4 cm oval mass in the right breast most likely is a fibroadenoma and is
probably benign. A follow-up ultrasound in 6 months is recommended.

REPLY

Hello,
Prior tests do not show this mass (last mammo before this one was 6/2021) – only calcifications which were scattered. I’m guessing they’re gone? Can anyone shed light on these findings- particularly the posterior acoustic enhancement Dr. is doing an u/s in 6 months in lieu of biopsy because I have cosmetic implants and we are avoiding any chance of rupture. Thank you in advance.

TOMOSYNTHESIS: Current study was also evaluated with a Computer Aided Detection (CAD) system.
Tomosynthesis was utilized for interpretation.

ULTRASOUND: Color flow and real-time ultrasound of the right breast 11 oclock, and axilla
regions and color flow and real-time ultrasound of the left axilla were performed. Gray scale
images of the real-time examination were reviewed.

BREAST TISSUE DENSITY: There are scattered areas of fibroglandular density.

FINDINGS: No mammographic correlate for the reported area of pain left axilla. There is no
mass or cyst seen on mammography or sonography. Normal appearing lymph nodes are seen in both
axilla.
Bilateral breast implants are stable and intact.
There is a 1.4 cm equal density asymmetry with an indistinct margin in the right breast at 11
oclock middle depth. Finding is best noted on tomographic MLO slice 15. Ultrasound
demonstrates a 1.5 cm x 1.1 cm x 0.4 cm oval mass with a circumscribed margin at 11 oclock
middle depth 8 cm from the nipple. This oval mass displays a hyperechoic rim and posterior
acoustic enhancement. This correlates with mammography findings. Color flow imaging
demonstrates that there is no vascularity present.
No other significant masses, calcifications, or other findings are seen in either breast on the
mammogram or bilateral ultrasound.

IMPRESSION: PROBABLY BENIGN
The 1.5 cm x 1.1 cm x 0.4 cm oval mass in the right breast most likely is a fibroadenoma and is
probably benign. A follow-up ultrasound in 6 months is recommended.

REPLY
@danielle0313

Hello,
Prior tests do not show this mass (last mammo before this one was 6/2021) – only calcifications which were scattered. I’m guessing they’re gone? Can anyone shed light on these findings- particularly the posterior acoustic enhancement Dr. is doing an u/s in 6 months in lieu of biopsy because I have cosmetic implants and we are avoiding any chance of rupture. Thank you in advance.

TOMOSYNTHESIS: Current study was also evaluated with a Computer Aided Detection (CAD) system.
Tomosynthesis was utilized for interpretation.

ULTRASOUND: Color flow and real-time ultrasound of the right breast 11 oclock, and axilla
regions and color flow and real-time ultrasound of the left axilla were performed. Gray scale
images of the real-time examination were reviewed.

BREAST TISSUE DENSITY: There are scattered areas of fibroglandular density.

FINDINGS: No mammographic correlate for the reported area of pain left axilla. There is no
mass or cyst seen on mammography or sonography. Normal appearing lymph nodes are seen in both
axilla.
Bilateral breast implants are stable and intact.
There is a 1.4 cm equal density asymmetry with an indistinct margin in the right breast at 11
oclock middle depth. Finding is best noted on tomographic MLO slice 15. Ultrasound
demonstrates a 1.5 cm x 1.1 cm x 0.4 cm oval mass with a circumscribed margin at 11 oclock
middle depth 8 cm from the nipple. This oval mass displays a hyperechoic rim and posterior
acoustic enhancement. This correlates with mammography findings. Color flow imaging
demonstrates that there is no vascularity present.
No other significant masses, calcifications, or other findings are seen in either breast on the
mammogram or bilateral ultrasound.

IMPRESSION: PROBABLY BENIGN
The 1.5 cm x 1.1 cm x 0.4 cm oval mass in the right breast most likely is a fibroadenoma and is
probably benign. A follow-up ultrasound in 6 months is recommended.

Jump to this post

Hi @danielle0313, welcome to Mayo Clinic Connect. You'll notice that I moved your 2 messages to this existing discussion about BI-RADS 3.
– BI-RADS 3 Question https://connect.mayoclinic.org/discussion/birads-3-question/

I did this so that you can easily connect with fellow members @katrina123 @trixie1313 @annac3 and @icya2282 who are talking about Breast Imaging Reporting and Data System or BI-RADS assessment categorization. This system sorts mammogram results into categories numbered 0 through 6. With these categories, doctors can describe what they find on a mammogram using the same words and terms. This makes communicating about the test results and following up after the tests easier.

I found this definition of acoustic enhancement
"Acoustic enhancement also called posterior enhancement or enhanced through transmission, refers to the increased echoes deep to structures that transmit sound exceptionally well." Read more https://radiopaedia.org/articles/acoustic-enhancement

Danielle, when is your follow-up appointment to discuss with your doctor?

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@danielle0313
Danielle – I had a Bi-rads 5, ultrasound same day, then biopsy following that which showed malignancy. With your Bi-rads 3, it could be something simple such as a fibroadenoma which could have been caused by inserting implants (it was explained to me that surgery, bumps to area, etc, can cause a fibroadenoma), but please be sure to get follow-up mammograms as having implants can make it difficult to delineate a cancerous area. Hope all goes well for you.

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@colleenyoung

Hi @danielle0313, welcome to Mayo Clinic Connect. You'll notice that I moved your 2 messages to this existing discussion about BI-RADS 3.
– BI-RADS 3 Question https://connect.mayoclinic.org/discussion/birads-3-question/

I did this so that you can easily connect with fellow members @katrina123 @trixie1313 @annac3 and @icya2282 who are talking about Breast Imaging Reporting and Data System or BI-RADS assessment categorization. This system sorts mammogram results into categories numbered 0 through 6. With these categories, doctors can describe what they find on a mammogram using the same words and terms. This makes communicating about the test results and following up after the tests easier.

I found this definition of acoustic enhancement
"Acoustic enhancement also called posterior enhancement or enhanced through transmission, refers to the increased echoes deep to structures that transmit sound exceptionally well." Read more https://radiopaedia.org/articles/acoustic-enhancement

Danielle, when is your follow-up appointment to discuss with your doctor?

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Thanks Colleen! I’m a newbie here learning to navigate.
My primary care ordered the tests so I don’t have a follow up. All I have is my 6 month u/s.

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@trixie1313

@danielle0313
Danielle – I had a Bi-rads 5, ultrasound same day, then biopsy following that which showed malignancy. With your Bi-rads 3, it could be something simple such as a fibroadenoma which could have been caused by inserting implants (it was explained to me that surgery, bumps to area, etc, can cause a fibroadenoma), but please be sure to get follow-up mammograms as having implants can make it difficult to delineate a cancerous area. Hope all goes well for you.

Jump to this post

Hi Trixie – thanks for responding. I hope you are doing alright!
I got implants 17 years ago and I’ve had several mammograms since. All that has ever come up are the calcifications, but I know implants can cause that.

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Hi all!
I hope everyone is doing well.
I had a quick question…. Has anyone ever had persistent night sweats prior to breast cancer diagnosis?
I have had it for some time and all of my bloodwork has come back normal (hormone tests etc).
I know I’ve discussed doing a u/s follow up in 6 months but my primary reason I am concerned is that I grew up on a superfund site (ground contamination with plumes due to the Navy). Think Erin Brockovich but on Long Island NY.
All of my prior mammograms/u/s have come back relatively normal in earlier years, as I’ve noted in earlier posts.
Anyway, just curious! I hate to come off as a hypochondriac😂

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@danielle0313

Hi all!
I hope everyone is doing well.
I had a quick question…. Has anyone ever had persistent night sweats prior to breast cancer diagnosis?
I have had it for some time and all of my bloodwork has come back normal (hormone tests etc).
I know I’ve discussed doing a u/s follow up in 6 months but my primary reason I am concerned is that I grew up on a superfund site (ground contamination with plumes due to the Navy). Think Erin Brockovich but on Long Island NY.
All of my prior mammograms/u/s have come back relatively normal in earlier years, as I’ve noted in earlier posts.
Anyway, just curious! I hate to come off as a hypochondriac😂

Jump to this post

Actually I've lived at 2 other (conceived and born at George Air Force base) superfund sites and worked at another while I was in the Navy (lived at NAB Coronado & worked at NOLF Imperial beach California )… lol

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