Expert: Claes-Gustaf Nordquist, M.D. - 5/27/2008

Question
QUESTION: Report from Bilateral ultrasound Finding: In the outer left breast at approx 7 oclock there are scattered small cysts seen. A few of these have have some slight echoes but none of these are at all suspicious. These measure 5-6mm in diameter.

In the right breast in the region of palpable complaint, there is a 7mm simple syst which correlates with the mammo abnormality.

There additional solid lesions seen in the right breast. At 10 o'clock, 3cm from the nipple, there is a 1cm solid mass which has fairly well-circumscribed lobulated borders. This is wider than tall and appears possibly to have collected appearance such as seen with a lymph node. Additional solid mass at 9 o'clock measures 1.5x0.7cm and has lobulated well-circumscribed benign features. These likely represent multiple fibroadenomas.
Impression:
. SIMPLE CYSTS AS WELL AS A FEW SLIGHTLY COMPLEX SMALL CYSTS IN THE OUTER LEFT BREAST IN THE REGION OF THE PALPABLE COMPLAINT.
. 7MM SIMPLE CYST IN THE OUTER RIGHT BREAST IN THE REGION OF PALPABLE COMPLAINT WHICH CORRELATES WITH MAMMO ABNORMALITY.
Impression:
. Several solid lesions are seen in the right breast as. All of these Radiographic features which favor benignity. The multiplicity of lesions also favor benignity.Most likely these represent multiple fibroadenomas. Of course in the setting of solid lesions, Malignancy can never be entirely excluded, I would suggest 6 month follow-up of bilateral breast sonography to confirm stability.

My gyn has referred me to general surgeon for Bi-opsy is this necessary or is he test happy. Would you refer me going by the report findings ive been reading your sight not a lot of 3 go to G/surgeon.

ANSWER: I would probably want to have these impressions confirmed by biopsies. But I would do it with needle biopsies not surgical ones. However I do not know if (ultrasound guided) needle biopsies are available where you are.


---------- FOLLOW-UP ----------

QUESTION: Thank you for your response. Is there still a possibility that this could be something more serious? i did not get the impression on most info that i have read up on that bi-rads 3 do not go for bi-opsy, i am confused by the way things are done in the US as we have only lived here for 18 months i am English and we have a completely different health care system so not sure what type of bi-opsy will be done.

Answer
Well, I'm a Swede living in Sweden so the US health care system is a mystery to me too. However, yes the risk of malignancy is low but based on what information you have given me it can not be excluded. So in order to be safe rather than perhaps sorry I think needle biopsies should be done. But I do not know if such needle biopsies are available where you are or if surgical biopsies will be used. I do not now either if they were available in the part of Britain that you have come from. Good luck!