What does this MRI mean?

[TINAontheLake]

I had a mammogram and was told I am high risk with 26% chance of breast cancer and an MRI was ordered with a BI-RADS of 0.  I had the MRI report and got a phone call that "they found what they were looking for which was increased blood flow to a certain area" so I have to have another breast MRI and a core needle biopsy.  

The report has my BI-RADS as now a category 4.

The findings read:

I have fibrocystic changes throughout both breast.  A lymph node is seen in the left auxillary region. Noted to have multiple lymph nodes on prior mammograms which seem stable. Small pleural effusion on the right. Normal lymph nodes seen in both axillary regions on the scout images.
On the high res post-contract images I have multiple lymph noces seen on lateral chest wall. Extensive fibrocystic changes are seen bilaterally.  Small lymph nodes are seen laterally on the right.
On free standing DYNA-CAD work station I have some scattered fibrocystic changes in both breasts. A mild ductal ectasia is present not no abnormal enhancement is identified in the right breast. More ductal ectasia in the subareolar location of the right than the left. There is ONE FOCAL AREA OF PERSISTENT ENHANCEMENT IN THE DEEP SUBAREOLAR LOCATION O FTHE LEFT BREAST ON QUICK CLICK SEGMENTATION. THIS LESION MEASURES 0.9 CM X 0.8 CM.  IT IS LOCATION 7 CM FROM THE NIPPLE AND 3.7 CM FROM CHEST WALL. THE LESIONS MARGINS ARE SOMEWHAT IRREGULAR AS ITS SHAPE. THE LESION IS 82% PERSISTENT AND 18% PLATEAU.  

Can anyone help me interpret what this means?  I have a biopsy scheduled but I've been trying to figure out what all of this means and how likely is it that I have cancer.  I feel like the size is small being less than a cm but the use of the word irregular for shape concerns me.  I wish they had met with me and went over this.  
Any help is appreciated.

[zouzi]

Hi,
First of all,when a BIRAD score 0 is assigned on a report,it means that the test did not give enough information to the Radiologist and more testing is needed.A BIRADS score 4  on the other hand, means that the lesion is suspicious,but not “very” suspicious.In this case a biopsy is always recommended, because this is the only way that will give you a definite diagnosis.
Usually increased vascularity (blood flow) finding increases suspicion, especially if the lesion has irregular borders. A lesion having these characteristics,doesn't necessarily mean that cancer is present,sometimes other benign breast lesions can present this way.including vascularity,but as to what could be causing this "increased vascularity"it is difficult to reassure you completely until a biopsy is performed..
I wish you all the best,and I hope that your pathology report will state "Benign findings”

[japdip]

First the BIRADS score of 0 means that further investigation is necessary to arrive at a diagnosis and this would be the Biopsy that you have scheduled. Evidently there is a lesion that is slightly less than half an inch, which I don't consider particularly small. According to the interpretation of the study this area is suspicious due to it's characteristics ...  blood flow to the area and the irregular shape. These things can be seen in malignant findings. It will take the upcoming biopsy to determine the true nature of this lesion. I appears to me that you are receiving excellent Medical Care in this situation. Any time you feel that you have not received adequate information you need to insist on a detailed discussion with your Dr. I don't know when your biopsy is scheduled but you might still call your Dr.s office and request a face to face meeting about the test results. In these hurried times it is often necessary to "demand" explanations .... sometimes if you don't ask it is assumed that you understand or that you don't need more information.   Best wishes for a good outcome with your biopsy.