Help reading test results

[Skrasevic]

I am a 3 yr survivor of lobular breast cancer in my right breast. I now have a lump in my left. Small and seems to get smaller or bigger depending if i touch it or how i stand when feeling it. I had a mammogram and ultrasound and am now referred to a breast center. Anyone able to help with the results? I did have some cancer cells removed from that breast 5 years ago, so could also be scarring, but i did not feel this until last week.
New hypoechoic area adjacent to scar. May represent scar tissue but neoplasm cant be ruled out. Recommend surgical consult and possible biopsy. Birads 4

Should i worry?  

[Sara_MHModerator]

Hello and welcome to the forum.  We are so glad you are a survivor and are here to support you.  We thank you for your question.  Following up as soon as possible is essential here.  As you know, anything caught early has a better chance at a successful outcome.  Did you have breast cancer cells removed from the left breast or calcification?  The higher the birads number the more suspicious the findings.  But that does not equate to a cancer diagnosis.  A birad of 6 is most likely cancer.  So, please don't worry before you have to. Easier said than done, I know.  It could be scarring or calcifications triggering the birads score.  There is a chance of cancer with a birads of 4, about 20 to 30 percent turn out to cancer.  Focus on how many do not though.  https://www.healthline.com/health/birads-score#takeaway  There area many benign causes of a hypoechoic finding.  

When are you next seeing the breast surgeon?  Are you scheduling a biopsy?  

[Skrasevic]

I had breast cancer cells removed from the left breast in 2015.  This report said no  clusters or calcifications. Hypoehoic area 10 x 8 x 11 with posterior shadowing. No color flow, no enlarged axillary adenopathy. Stable asymmetric nodular tissue.
I have a surgical consultation with a breast sugeon in 2 weeks. They said they can biopsy then too...I guess if he deems it necessary.
Thank you for your responses!!

[Sara_MHModerator]

Thank you for the additional information.  Do you have dense breasts?  My guess is that the biopsy will be done and probably should be especially given your history.  I know you are worried and we're hear to talk about it.  Staying busy is important for distraction at this time.  It's hard to wait for two weeks for this appointment.  Please stay in touch with us and we'll be thinking of you.  

[Skrasevic]

I do have very dense breasts. Thank you for your response and kindness!!

[CHIN_C]

Having dense breasts is more of a qualifier/caveat explaining the limitations of the study. For example, if you had a patient who had an unremarkable screening mammogram (BI-RADS 1 or 2) but heterogeneously or extremely dense breasts, you might consider supplementing subsequent screening mammography with other modalities such as breast ultrasound.

However, in your case, the key takeaway is the BI-RADS 4 category, which translates to "Suspicious Abnormality - Biopsy Should Be Considered." Some radiologists further subdivide this category into:

4A: Low suspicion for malignancy (greater than 2% to less than or equal to 10%)
4B: Moderate suspicion for malignancy (greater than 10% to less than or equal to 50%)
4C: High suspicion for malignancy (greater than 50% to less than 95%)

Since you were only given a score of 4 and not 4A, 4B, or 4C, it is difficult to further narrow down your likelihood of cancer. Regardless, BI-RADS 4 or higher should be biopsied. Given your history of breast cancer and given that this finding is new and adjacent to scar, you should be extra cautious. Just get the biopsy and take things one step at a time. Good luck!