Oncology (General Cancer)/Abnormal Mammogram


QUESTION: Mammogram reads:  Scattered fibroglandular densities.  Focal architectural distortion within central aspect of right breast.  No suspicious microcalcifications are seen.  Requires additional evaluation.  BI-RADS 0
I have faint scar from surgical biopsy 1991 just above nipple.
I am very worried.

ANSWER: It may be that the focal architechtural distortion was from the biopsy.  I wouldn't worry too much about the fibroglandular densities.  If you were my patient I would want to know why the radiologist was concerned -- sometimes you have a very conscientious radiologist and when you pin him down he isn't very worried.  If he has low suspicion, another mammogram in a couple of months might be all you need.  If his suspicion level is high, then unfortunately another biopsy needs to be done.  I know you are worried, but the best treatment for worry is to find out the answers.  Hope this helps.

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QUESTION: I had a ultrasound which reads:  At the site of an architectural distortion, a spiculated appearing hypoechoic mass with some associated shadowing was noted measuring 1.66 x .078 x 2.27 cm. Due to its indeterminate nature an ultrasound quided mammotome core biopsy of this lesion is recommended.  BI-RADS 4

Every test I have seems to get worse.  Any comments would be helpful.


I think given the ultrasound findings, I would go ahead with a mammatome biopsy.  I appreciate that you are worried and discouraged, but it's better to find out and deal with whatever is there.  Generally spiculation suggests that the process causing it is changing; it doesn't prove cancer, though, which can only be diagnosed by biopsy.  

Oncology (General Cancer)

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Donald Higby, M.D.


I can answer almost all questions related to the treatment and natural course of most kinds of cancer, especially cancers of prostate, colon, lung and breast.


I have been a practicing medical oncologist for 36 years, and have been chief of service at a major medical center for 25 years. I've also done research in cancer treatments.

American Society of Clinical Oncology

New England Journal of Medicine American Journal of Medicine Journal of the American Society of Clinical Oncology Hematology Transfusion Medicine

MD, Stanford University Internal Medicine residency, St. Louis University School of Medicine, St. Louis, MO Medical Oncology Fellowship, Roswell Park Cancer Institute, Buffalo, NY

Awards and Honors
America's Best Physicians, last 14 years

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