Expert: Claes-Gustaf Nordquist, M.D. - 5/23/2009

Question
I went for my yearly mammography about 3 weeks ago(I actually missed going last year)....They found an area of asymmetry on the cc view of my right breast, also a 5 mm circumscribed mass versus artifact close to the chest wall..the left breast is unremarkable....recommend additional evaluation with diagnostic right breast mammo to include spot compression and rolled views...also MRI

I went for the 2nd digital mammo of rt breast with spot compression...the previous 5 mm nodular mass , was not present(think it was a skin tag that I have), but the asymmetric density in the outer right still persists....recommended right breast sonogram

On that day it was also recommended that I have an MRI w/wo contrast bilateral .The findings are confusing to me, and I am a bit worried....The right breast which was in question had minimal background level of enhancement, and did not identify the right breast mass.....but did find an area of low-grade enhancement identified in the upper outer quadrant of the Left Breast..which shows indeterminate kinetics on dynamic imaging and pattern of linear/segmental distribution...area measures approx 2-3 cm in greatest dimension....recommending MRI guided vacuum assisted core needle biopsy...I just went yesterday for the ultrasound of the right breast...appointment next week for the Biopsy..    I am confused....WHY DIDN'T THE 2 MAMMOGRAPHYS PICK UP ANYTHING ON THE LEFT BREAST....I AM A BIT NERVOUS..

I HAVE A VERY HIGH RISK FAMILY HISTORY..DAD'S SISTERS(3 OF THEM) HAD BREAST CANCER, MY MOTHER HAD OVARIAN CANCER, MY SISTER TESTED POSITIVE FOR THE BRCA GENETIC TESTING..I TESTED NEGATIVE.....
i AM A BIT NERVOUS...SORRY ABOUT THE LONG POSTING...

Answer
Mammography, MRI scanning & ultrasound scanning are all very different methods of tumor detection from each other, all with their strong points and weak points. It is best when they are used together. So I'm not surprised that things are seen with one method and not with another. Make sure the needle biopsy is done soonest! Important! Good luck!