Expert: Claes-Gustaf Nordquist, M.D. - 9/15/2006

Question
I have been diagnosed with infiltrating mildly differented ductal car., between 3-4 mm  and am scheduled for a mast. on Thursday, 9/21.  My dr. has left a few questions unanswered as to the stage (said they would know after surgery) but would like to understand some things on the reports.

"A spiculated 2.3 x 2.5 x 1.7 cm mass in the 10:00 periareolar with a second spiculated 1.1 x 8.2 x 1.3 cm mass in the right 9:00 retroareolar location.  Both masses demonstrated washout kinetics.  The larger of the 2 has a Angio volume of 1.3 cc and the the samller has an Angio volume of 0.4 cc.  There is a oval 0.6 x 0.3 cm mass with possible nonenhancing septation in the 9:00 position, 1 cm lateral to the plane of the nipple.  Mass does contain foci of washout kinetics.  The PET findings:  a midly hypermetobolic mass in the retroareolar.  An 11 mm hypermetobolic lympp node is seen withn the right axillary region, this is a suspiocious abnormality. What does this all mean?

Thank you.

Mary Wilson

Answer
First of all your lesions are all in the cm. NOT mm. size range (10 times bigger). Had they been in the mm. range no mastectomy had probably been necessary. (1 cm = 1/2.54 inch, 1 mm ten times smaller = 0.1 cm). Interpretation: You have an irregular mass growing out at different points into its surroundings, 2.3x2.5x1.7 cm in size outside the nipple area of your breast at about the 10.00. o'clock position, and another similar mass, 1.1x8.2x1.3 cm mass in the 9.00.o'clock position closer to the nipple. Both masses show cancer compatible signs. There is also an oval mass 0.6x0.3 cm in the 9.00. position also with cancer signs 1 cm. to the side of the nipple outside it. There is also a cancersuspicious lymph node in the right armpit - because it has higher metabolism than normal. So you have some cancer suspicious lesions close to the nipple of your right breast, big enough for mastectomy & suspected cancerinvolved lymph node in your right armpit indicating suspected cancer spread there. Diagnosis confirmation should be possible with thin needle aspiration biopsies.