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Breast Cancer/Mammo BI-RADS 4B
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Description: No mass palpated by either the patient or doctor; no signs or symptoms. Strong family history. Nulliparous. MAMMO: CC with magnification, MLO with magnfication, and LM view(s) taken of right breast. Breast tissue is dense. There are more than 10 indeterminate, clustered, coarse calcifications lower outer quadrant. MY QUESTION: Isn't it standard practice to then have the patient imaged with either an ultrasound or MRI as well to determine whether there actually is any mass at all, before moving on to a stereotactic biopsy?
ANSWER: Yes both ultrasound & MRI scans should also be done but so SHOULD a stereotactic (or ultrasound or MRI guided) needle biopsy be done too.
These aims are not exclusive.
---------- FOLLOW-UP ----------
QUESTION: Is a mass always seen by mammogram rated BI-RADS 4B(CC, MLO with magnification, and LM views)even if it isn't mentioned in the report? I just can't figure out why the report is recommending that the patient go straight to having a stereotactic biopsy and not recommending something like an ultrasound or MRI first to be sure there is a mass. I just wondered if the radiologist is seeing something that appears like a mass on the mammogram but hasn't put it in the report?
Actually I recommended ultrasound & MRI scans NOT ONLY to find other ways of doing biopsies but ALSO to gain more information of/from the mass.
B RADS 4B means that there is a considerable cancer risk in what the radiologist is seeing, so a biopsy is IMPORTANT and URGENT!
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| Rating(1-10) | Knowledgeability = 10 | Clarity of Response = 10 | Politeness = 10 |
| Comment | Thank you so much, Dr. Nordquist. The patient and I both agree a biopsy is needed and urgent regardless, especially as the mammo was done Nov 12, a month ago. If we could order the U/S ourselves we would, to have the info from it to better chose the type of biopsy, as well as to possibly preserve better info about the particular characteristics of the cancer it might be. We are trying very hard to get an ultrasound ordered. Paying to get it is not an issue. Thank you so very much for your truthful understanding and patience with our questions. | ||
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Answers by Expert:
Claes-Gustaf Nordquist, M.D.
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I`m a doctor of medicine and a specialist in radiation therapy and medical oncology. I have long experience in diagnostics and treatment of breast tumours.
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I'm a Doctor of Medicine and specialist in Medical Oncology and Radiation Therapy educated & trained in Sweden. Now retired. Background in Radiation Therapy, Medical Oncology, Radiation Protection, Nuclear Medicine, Diagnostic Radiology, Gynecological Oncology, Clinical Pathology, Clinical Cytology,Hematology and Internal Medicine. M.D. from the faculty of medicine, Royal Karolinska Institute, Stockholm, Sweden. Have also been an exchange student at the Hebrew University, Hadassah Medical School, Jerusalem Israel. Former medical consultant, Swedish National Board of Radiation Protection. Former Police Surgeon and Medical Examiner, Stockholm Police Department. Former Chief Medical Officer, The Royal Guards, The Royal Horse Guards and the Royal Household Brigade, Royal Swedish Army Medical Corps.You can also reach me on: http://www.lifestylerescue.com/expert/health-fitness-advice/dr-claes-gustaf/128 I have no restrictions on the number of questions there.
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